Bertl Kristina, Ruckenbauer Dorothea, Müller-Kern Michael, Durstberger Gerlinde, Lettner Stefan, Bruckmann Corinna, Ulm Christian
Division of Oral Surgery, Bernhard Gottlieb School of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria.
Department of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden.
Odontology. 2015 Sep;103(3):292-300. doi: 10.1007/s10266-014-0179-9. Epub 2014 Oct 29.
Miller's is the most commonly used classification of gingival tissue recessions, defined as the displacement of the soft tissue margin apical to the cemento-enamel junction. However, data on the reliability of this classification are missing so far, although reliability, which reflects the consistency of repeated measurements, is regarded as a prerequisite for judging the utility of a classification. The aim of the present study was to evaluate inter- and intra-observer agreement on Miller's classification of gingival tissue recessions. Two hundred photographs (50 of each region: maxillary/mandibular anterior/posterior teeth) of gingival tissue recessions were evaluated twice by four observers with different degrees of experience in Miller's classification, gingival phenotype, tooth shape, and identifiability of the cemento-enamel junction. The following inter- and intra-observer agreements were found: Miller's classification, 0.72 and 0.73-0.95; gingival phenotype, 0.29 and 0.45-0.58; tooth shape, 0.39 and 0.44-0.59; and identifiability of the cemento-enamel junction, 0.21 and 0.30-0.59. A higher agreement was detected for anterior teeth. Further, gingival phenotype (thin-high scalloping) significantly correlated with tooth shape (long-narrow) (ρ = 0.662, p < 0.001). Miller's classification of gingival tissue recessions was evaluated by four examiners using 200 clinical photographs and yielded substantial to almost perfect agreement, with higher agreement for anterior teeth. Although limited to photographic assessment, the present study offers the so far missing proof on the sufficient inter- and intra-observer agreement of this classification.
米勒分类法是牙龈组织退缩最常用的分类方法，其定义为软组织边缘向牙骨质-釉质界根尖方向移位。然而，到目前为止，关于该分类法可靠性的数据尚缺，尽管反映重复测量一致性的可靠性被视为判断一种分类法实用性的先决条件。本研究的目的是评估观察者间和观察者内对米勒牙龈组织退缩分类法的一致性。200张牙龈组织退缩的照片（每个区域50张：上颌/下颌前牙/后牙）由四名在米勒分类法、牙龈表型、牙齿形状以及牙骨质-釉质界辨识度方面经验不同的观察者评估两次。发现了以下观察者间和观察者内的一致性：米勒分类法，0.72和0.73 - 0.95；牙龈表型，0.29和0.45 - 0.58；牙齿形状，0.39和0.44 - 0.59；以及牙骨质-釉质界的辨识度，0.21和0.30 - 0.59。在前牙中检测到更高的一致性。此外，牙龈表型（薄高扇贝形）与牙齿形状（长宽形）显著相关（ρ = 0.662，p < 0.001）。四名检查者使用200张临床照片对米勒牙龈组织退缩分类法进行评估，得出了从 substantial 到几乎完美的一致性，在前牙中一致性更高。尽管本研究仅限于照片评估，但它提供了迄今为止该分类法在观察者间和观察者内充分一致性方面所缺失的证据。
