Yang J W, Jia P Y, Qiu L X, Lu C, Jiang T
Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China.
Fourth Clinical Division, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100025, China.
Zhonghua Kou Qiang Yi Xue Za Zhi. 2021 Apr 9;56(4):324-328. doi: 10.3760/cma.j.cn112144-20200709-00405.
To test the reproducibility of the visual analogue scale (VAS) used in the evaluation of the esthetic effect of anterior dental implants, and to explore the factors that affect the correlation between VAS and pink esthetic score/white esthetic score (PES/WES). From January 2018 to August 2019, a total of 108 doctors and patients were recruited in the Department of Prosthodontics, Implantology and Fourth Clinical Division of Peking University School and Hospital of Stomatology. Among them, there were 35 dental implant specialists who were familiar with PES/WES [implant specialist group, 25 males, 10 females, (37.3±4.5) years old], 34 dentists who were not familiar with PES/WES [dentist group, specialized in Prosthodontics, Periodontology, Orthodontics, and Oral Maxillofacial Surgery, 24 males, 10 females, (36.1±4.2) years old], 39 patients [patient group, 28 males, 11 females, (45.4±8.3) years old]. Twenty oral pictures of patients [12 males, 8 females, (43.7±6.4) years old] treated in the Department of Prosthodontics, Peking University School and Hospital of Stomatology from December 2016 to December 2017 were taken for single implant restoration for esthetic evaluation with VAS. Score 0 for evaluation of not beautiful and score 10 for very beautiful. Re-evaluation of the same 20 pictures with VAS after 1 month, and perform repeatability evaluation of VAS using -square test were conducted. At the same time, 13 implant specialists were randomly selected, to score the same photos with PES/WES. The PES scoring elements were the fullness of the mesial gingival papilla, the fullness of the distal gingival papilla, the curvature of the gingival margin, the protrusion of the root surface, the color and the texture of the soft tissue. The scoring elements of WES were crown shape, crown contour, crown color, surface texture, transparency and individual characteristics in order. Pearson correlation analysis was used to evaluate the correlation between the score of VAS and PES/WES. And the influence of the group on the correlation between PES/WES and VAS was analyzed. The PES score was 7.5±1.8, and the WES score was 7.6±1.9 and the total score was 15.1±3.4. The VAS score of the implant specialist group was 6.8±1.8. The repeatability test of the two VAS results in the patient group was not statistically significant (=0.012, >0.05); the two VAS results of the implant specialist group and the dentist group both had good repeatability (=0.727 and 0.556, <0.01). The VAS score was weakly correlated with the total PES/WES score (=0.27, <0.01). The VAS score was correlated with the score elements in PES/WES (0.01), and the color (=0.20) and shape (=0.22) of the crown were the larger correlation coefficients. The correlation coefficients between the VAS score and the PES/WES scoring system decreased among the implant specialist group (=0.49, moderate correlation), the dentist group (=0.25, weak correlation) and the patient group (=0.12, >0.05). The consistency of VAS and PES/WES is affected by the cognition of the scorer. The combination of the two scoring systems is feasible and necessary for physicians to evaluate the overall esthetic effect of implant restoration.
为检验视觉模拟评分法（VAS）在评估前牙种植美学效果时的可重复性，并探讨影响VAS与粉色美学评分/白色美学评分（PES/WES）之间相关性的因素。2018年1月至2019年8月，北京大学口腔医学院口腔修复科、种植科及第四临床科室共招募了108名医生和患者。其中，有35名熟悉PES/WES的牙种植专科医生[种植专科医生组，男25名，女10名，（37.3±4.5）岁]，34名不熟悉PES/WES的牙医[牙医组，专业为口腔修复学、牙周病学、正畸学和口腔颌面外科，男24名，女10名，（36.1±4.2）岁]，39名患者[患者组，男28名，女11名，（45.4±8.3）岁]。选取2016年12月至2017年12月在北京大学口腔医学院口腔修复科接受治疗的患者的20张口腔照片[男12名，女8名，（43.7±6.4）岁]，用于单颗种植修复的美学评估，采用VAS评分。评估为不美观记0分，非常美观记10分。1个月后对相同的20张照片再次用VAS进行评估，并采用卡方检验对VAS进行重复性评估。同时，随机选取13名种植专科医生，用PES/WES对相同照片进行评分。PES评分要素为近中牙龈乳头饱满度、远中牙龈乳头饱满度、牙龈边缘曲率、牙根表面突出度、软组织颜色和质地。WES评分要素依次为牙冠形状、牙冠轮廓、牙冠颜色、表面质地、透明度和个体特征。采用Pearson相关分析评估VAS评分与PES/WES之间的相关性。并分析分组对PES/WES与VAS之间相关性的影响。PES评分为7.5±1.8，WES评分为7.6±1.9，总分15.1±3.4。种植专科医生组的VAS评分为6.8±1.8。患者组两次VAS结果的重复性检验差异无统计学意义（=0.012，>0.05）；种植专科医生组和牙医组的两次VAS结果均具有良好的重复性（=0.727和0.556，<0.01）。VAS评分与PES/WES总分呈弱相关（=0.27，<0.01）。VAS评分与PES/WES中的评分要素相关（0.01），牙冠颜色（=0.20）和形状（=0.22）的相关系数较大。种植专科医生组（=0.49，中度相关）、牙医组（=0.25，弱相关）和患者组（=0.12，>0.05）中VAS评分与PES/WES评分系统之间的相关系数逐渐降低。VAS与PES/WES的一致性受评分者认知的影响。两种评分系统的结合对医生评估种植修复的整体美学效果是可行且必要的。
