Partido Brian B, Webb Chadleo A, Carr Michele P
Division of Dental Hygiene, College of Dentistry, The Ohio State University, Columbus, Ohio.
Int J Dent Hyg. 2019 May;17(2):192-198. doi: 10.1111/idh.12388. Epub 2019 Feb 19.
Periodontal therapy disrupts the biofilm harbouring calculus that triggers inflammation. The explorer is primarily used for calculus detection, and the ultrasonic instrument is primarily used for calculus removal. The efficiency in dental hygiene care may improve if the ultrasonic instrument could be used in both calculus detection and removal.
The purpose of this study was to validate the effectiveness of calculus detection between the Thinsert® ultrasonic insert and the 11/12 explorer.
Upon IRB approval, this validation study involved three dental hygiene faculty from the Ohio State University Dental Hygiene Program and 30 patient participants from the Ohio State University community. Using both instruments, calculus was evaluated on Ramfjord index teeth and on four possible surfaces per tooth. Data were analysed to evaluate for interrater reliability, intrarater reliability, sensitivity, and specificity.
For interrater reliability, the average measure of intraclass coefficient (ICC) value was 0.782 with a 95% confidence interval (CI) of 0.749-0.810 (F = 4.852, P < 0.01). For intrarater reliability, mean Kappa averages were in the full agreement range (κ = 0.726, n = 2160, P < 0.01). When using the Thinsert® for calculus detection, the sensitivity was 75%, specificity was 97%, PPV was 81%, and NPV was 94%.
Since calculus evaluation was comparable when using the ODU 11/12 explorer and the Thinsert®, efforts can be focused on developing the tactile sensitivity when using the Thinsert® ultrasonic instrument in the assessment, treatment, and maintenance of periodontal disease and the support of oral health. The efficiency in dental hygiene care may improve by using the Thinsert® ultrasonic instrument in both the detection and removal of calculus.
牙周治疗会破坏含有引发炎症的牙结石的生物膜。探针主要用于牙结石检测，而超声器械主要用于去除牙结石。如果超声器械能够同时用于牙结石检测和去除，那么口腔卫生保健的效率可能会提高。
本研究的目的是验证Thinsert®超声探头与11/12号探针在牙结石检测方面的有效性。
经机构审查委员会批准，本验证性研究纳入了俄亥俄州立大学口腔卫生项目的三名口腔卫生教员以及来自俄亥俄州立大学校区的30名患者参与者。使用这两种器械，对Ramfjord指数牙以及每颗牙的四个可能表面进行牙结石评估。对数据进行分析，以评估评分者间信度、评分者内信度、敏感性和特异性。
对于评分者间信度，组内相关系数（ICC）值的平均测量值为0.782，95%置信区间（CI）为0.749 - 0.810（F = 4.852，P < 0.01）。对于评分者内信度，平均Kappa值处于完全一致范围内（κ = 0.726，n = 2160，P < 0.01）。使用Thinsert®进行牙结石检测时，敏感性为75%，特异性为97%，阳性预测值为81%，阴性预测值为94%。
由于使用ODU 11/12号探针和Thinsert®进行牙结石评估的结果相当，因此在使用Thinsert®超声器械评估、治疗和维护牙周疾病以及支持口腔健康时，可以将重点放在提高触觉敏感性上。通过使用Thinsert®超声器械进行牙结石的检测和去除，口腔卫生保健的效率可能会提高。
