Department of Conservative Dentistry, Dental School, University Hospital Heidelberg, Heidelberg, Germany.
Institute of Medical Biometry and Informatics, University Heidelberg, Heidelberg, Germany.
J Esthet Restor Dent. 2019 Nov;31(6):572-582. doi: 10.1111/jerd.12522. Epub 2019 Sep 4.
There is a lack of comprehensive indexes, which can measure conditions or changes in dento-facial esthetics before and after treatment. Therefore, the 12-item Dental Esthetic Screening Index (DESI) was developed and validated.
Reliability was tested by five dental professionals, who evaluated 30 standardized patient photographs baseline and after 14 days. Clinical validation was done on 52 patients before and after restorative treatment. For subjective assessment, patients completed a validated questionnaire before and after treatment. Statistical analysis included inter and intrarater reliability, Wilcoxon test and linear regression analysis.
The single item analysis identified two weak extraoral items (κ = 0.15; κ = -0.05), that were removed from the DESI. After this modification, both inter- (κ = 0.83-0.86) and intrarater reliability (ICC = 0.75-0.86) were in excellent to good agreement. In the clinical validation, the DESI was significantly lower after restorative treatment (P < .0001). The patients' perception questionnaires showed significant improvement after restorative therapy (P < .0001). A correlation of the DESI and the results of patients' perception questionnaires could be assumed (P < .0001; R = 0.32).
The DESI was found to be a reliable and valid instrument for the quantitative assessment of dento-facial esthetics. It correlated well with the subjective assessment of the patients.
This comprehensive index would allow for objective quantification of clinical situations, for reliable baseline and outcome assessment in esthetic dentistry. As patients' esthetic feelings and sensations are subjective, this objective index is also proven to be congruent to patients' individual subjective assessment of dento-facial esthetics.
目前缺乏综合指标来衡量治疗前后牙颌面美观状况或变化，因此开发并验证了 12 项牙科美学筛选指数（DESI）。
通过 5 位牙科专业人员对 30 张标准化患者照片进行评估，对可靠性进行了测试，评估时间分别为基线和 14 天后。对 52 例修复治疗前后的患者进行了临床验证。为了进行主观评估，患者在治疗前后完成了一份经过验证的问卷。统计分析包括组内和组间可靠性、Wilcoxon 检验和线性回归分析。
单项分析确定了两个较弱的口腔外项目（κ=0.15；κ=-0.05），并从 DESI 中删除。经过此修改后，组内（κ=0.83-0.86）和组内可靠性（ICC=0.75-0.86）均为极好至良好的一致性。在临床验证中，修复治疗后 DESI 明显降低（P<.0001）。患者感知问卷显示修复治疗后有显著改善（P<.0001）。可以假设 DESI 与患者感知问卷的结果之间存在相关性（P<.0001；R=0.32）。
DESI 被证明是一种可靠有效的定量评估牙颌面美观的工具。它与患者的主观评估高度相关。
该综合指数可以客观量化临床情况，为美学牙科的可靠基线和结果评估提供支持。由于患者的审美感受是主观的，因此该客观指数也被证明与患者对牙颌面美观的个体主观评估一致。
