Department of Periodontology, Tufts University School of Dental Medicine, Boston, MA.
Division of Biostatistics and Experimental Design, Tufts University School of Dental Medicine, Boston, MA.
J Periodontol. 2018 Jul;89(7):833-839. doi: 10.1002/JPER.17-0556.
The root coverage esthetic score (RES) was published in 2009 as an esthetic scoring system to measure visible final outcomes of root coverage procedures performed on Miller I and II recession defects. The aim of this study was to evaluate the intra-examiner, intra-group, and inter-examiner reliability of the RES when used among periodontal faculty, post-graduate students in periodontology, and pre-doctoral DMD students when using the RES at Tufts University School of Dental Medicine (TUSDM).
Thirty-three participants (12 second-year DMD students, 11 periodontal residents, and 10 faculty members) were assembled to evaluate 25 baseline and 6-month post-treatment outcomes of mucogingival surgeries using the RES. Each projection was shown for 30 seconds during which the participants were asked to use the RES scoring system to evaluate the surgical outcomes. The results were then recorded on a standardized worksheet grid. To test intra-examiner reliability, seven of the 25 projections were shown twice. Intra-examiner reliability and inter-examiner reliability were assessed using intraclass correlation coefficient using a two-way mixed effect model, and stratified by education level.
Post-graduate (PG) residents had the highest tendency to agree with each other with an interclass correlation (ICC) of 0.53 (95% confidence interval [CI] 0.36 to 0.74). DMD students had an ICC: 0.51 (95% CI: 0.33 to 0.75), and PG faculty members produced an ICC: 0.41 (95% CI: 0.24 to 0.64). There was no statistically significant difference in ICC among the three groups of participants (Kruskal-Wallis test, P = 0.2440). When the data for each RES element were then combined, the mean ICC for the total inter-rater agreement for RES was 0.48 (95% CI: 0.32 to 0.71). This corresponds to an overall moderate agreement among all participants using the RES to evaluate the 25 surgical outcomes. The intra-examiner reliability within each of the three groups was quite high. The highest mean ICC was produced by PG faculty (0.908). The mean ICCs for PG residents was 0.867, and the mean ICC for DMD students was 0.855. The Kruskal-Wallis test (P = 0.46) failed to find any statistical difference in intra-examiner reliability among the three groups of participants.
The RES is a "moderately" reliable scoring system for mucogingival treatments in a dental school setting and can be used even by operators with different levels of periodontal experience. This scoring system can be repeated by the same examiner to obtain reliable results.
根覆盖美学评分（RES）于 2009 年发表，作为一种美学评分系统，用于测量在 Miller I 和 II 型退缩缺损上进行的根覆盖手术的可见最终结果。本研究的目的是评估 RES 在塔夫茨大学牙医学院（TUSDM）的牙周科教员、牙周研究生和预牙科 DMD 学生中使用时的组内、组内和组间可靠性。
召集了 33 名参与者（12 名二年级 DMD 学生、11 名牙周住院医师和 10 名教员），以使用 RES 评估 25 名基线和 6 个月治疗后黏膜-牙龈手术的结果。每个投影显示 30 秒，在此期间，参与者被要求使用 RES 评分系统评估手术结果。然后将结果记录在标准化工作表网格上。为了测试组内可靠性，将 25 个投影中的 7 个显示两次。使用双向混合效应模型，采用组内相关系数评估组内和组间可靠性，并按教育水平分层。
研究生（PG）住院医师之间的一致性最高，组内相关系数（ICC）为 0.53（95%置信区间 [CI]：0.36 至 0.74）。DMD 学生的 ICC 为 0.51（95% CI：0.33 至 0.75），PG 教员的 ICC 为 0.41（95% CI：0.24 至 0.64）。三组参与者的 ICC 无统计学差异（Kruskal-Wallis 检验，P=0.2440）。当将每个 RES 元素的数据合并后，RES 总评分者间一致性的平均 ICC 为 0.48（95% CI：0.32 至 0.71）。这对应于所有参与者使用 RES 评估 25 个手术结果的总体中度一致性。三组内的组内可靠性都相当高。PG 教员的平均 ICC 最高（0.908）。PG 住院医师的平均 ICC 为 0.867，DMD 学生的平均 ICC 为 0.855。Kruskal-Wallis 检验（P=0.46）未能发现三组参与者的组内可靠性存在统计学差异。
RES 是一种在牙科学院环境中用于黏膜-牙龈治疗的“中度”可靠评分系统，甚至可以由具有不同牙周经验的操作人员使用。该评分系统可以由同一检查者重复使用以获得可靠的结果。
