牙龈退缩三种分类系统的检查者间和检查者内一致性
Inter- and intra-examiner agreement of three classification systems of gingival recession.
作者信息
Sarlati Fatemeh, Moghaddas Omid, Shabahangfar Reza, Safari Sara, Valaei Naser
机构信息
Department of Periodontics, Dental Branch, Islamic Azad University, Tehran, Iran.
Faculty Member, Thalassemia Research Center, Mazandaran University of Medical sciences, Sari, Iran.
出版信息
J Adv Periodontol Implant Dent. 2019 Aug 31;11(1):1-6. doi: 10.15171/japid.2019.001. eCollection 2019.
BACKGROUND
Several classifications have been proposed for gingival recession defects. Correct diagnosis of the type of gingival recession is necessary for proper treatment planning and assessment of the prognosis. Considering the existing uncertainty regarding the reliability of different classification systems available for gingival recession and their shortcomings, this study sought to assess the reproducibility and reliability of accuracy of three available classifications (Cairo, Mahajan and Miller's classification systems) for gingival recession.
METHODS
This descriptive study was conducted on 32 patients presenting to the Department of Periodontics, who were selected using convenience sampling. The screening process entailed two sessions and those with a minimum of one site of gingival recession disclosing the cementoenamel junction (CEJ) of the tooth with no adjacent tooth loss at the site of recession were enrolled. Each patient was separately evaluated by three calibrated examiners twice with a minimum of one-week interval. Grading of the gingival recession defects was determined using the Cairo, Mahajan and Miller's classification systems for gingival recession. The gradings of each examiner were separately recorded by a blinded examiner. A total of 120 single recession defects were examined and data were analyzed using intra-class correlation coefficient (ICC) and Spearman's test. Level of agreement was evaluated according to Landis and Koch.
RESULTS
The results showed that the reliability of all the three methods was almost perfect (P<0.05), and no significant difference was noted in reliability of the Cairo, Mahajan and Miller's classifications for gingival recession (P=0.7).
CONCLUSION
Based on the results of the study, the highest intra- and inter-observer agreement in the use of the three classifications belonged to the Cairo classification; however, all the three classifications showed high reliability.
背景
针对牙龈退缩缺损已提出了几种分类方法。正确诊断牙龈退缩类型对于合理的治疗计划制定和预后评估至关重要。鉴于现有用于牙龈退缩的不同分类系统的可靠性存在不确定性及其缺点，本研究旨在评估三种现有牙龈退缩分类方法（开罗分类法、马哈拉施特拉分类法和米勒分类系统）的可重复性和准确性可靠性。
方法
本描述性研究对32名到牙周病科就诊的患者进行，采用便利抽样法选取。筛查过程包括两个阶段，纳入至少有一个牙龈退缩部位暴露牙齿牙骨质釉质界（CEJ）且该退缩部位无相邻牙齿缺失的患者。每位患者由三名经过校准的检查者分别评估两次，间隔至少一周。使用开罗分类法、马哈拉施特拉分类法和米勒牙龈退缩分类系统确定牙龈退缩缺损的分级。每位检查者的分级由一名盲法检查者单独记录。共检查了120个单一退缩缺损，并使用组内相关系数（ICC）和斯皮尔曼检验分析数据。根据兰迪斯和科克的标准评估一致性水平。
结果
结果表明，所有三种方法的可靠性几乎完美（P<0.05），开罗分类法、马哈拉施特拉分类法和米勒牙龈退缩分类法在可靠性方面无显著差异（P = 0.7）。
结论
基于该研究结果，在使用这三种分类方法时，观察者内和观察者间一致性最高的是开罗分类法；然而，所有三种分类法均显示出高可靠性。
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