Safa Alkateb Ahmad, Ozturk Ozener Hafize, Kuru Leyla
Department of Periodontology, Institute of Health Sciences, Marmara University, Istanbul, Turkey.
Department of Periodontology, Faculty of Dentistry, Marmara University, Istanbul, Turkey.
Acta Stomatol Croat. 2023 Jun;57(2):98-112. doi: 10.15644/asc57/2/1.
Numerous indices have been used to grade the severity of gingival overgrowth which led to suspicion regarding the results concerning its prevalence and pathogenicity. The aim of this study was to assess the concordance of three different gingival overgrowth indices, which were used widely in previous studies, and check their reliability and reproducibility.
A total of 30 full-mouth plaster casts and 90 intra-oral photographs collected from 30 patients diagnosed with gingival overgrowth were included in our study. Three trained examiners performed measurements twice on plaster casts using gingival hyperplasia index (A index) and hyperplastic index (B index). Intraoral photographs were assessed also twice using (C index).
Concordance of intra-examiner and inter-examiner reliability of the recorded measurements was carried out for each index using weighted kappa (), with a confidence interval of 95%. The A index revealed intra-examiner total kappa values between 0.724-0.876 for horizontal measurement and 0.512-0.823 for vertical measurement, and inter-examiner total kappa values between 0.255-0.626 horizontally and 0.235-0.279 vertically. The B index presented intra-examiner total kappa values between 0.587-0.868 horizontally and 0.653-0.855 vertically; and inter-examiner total kappa values between 0.393-0.595 and 0.372-0.635 for horizontal and vertical measurements, respectively. The C index achieved the highest intra-examiner concordance with total kappa values between 0.758-0.855 and inter-examiner total kappa values between 0.716-0.804.
The C index evaluated through intraoral photographs is considered the most reliable and applicable method to be utilized. The C index is suggested to be used in large scale populations with its definite detailed criteria.
众多指标已被用于对牙龈过度生长的严重程度进行分级,这引发了对其患病率和致病性相关结果的质疑。本研究的目的是评估先前研究中广泛使用的三种不同牙龈过度生长指标的一致性,并检验其可靠性和可重复性。
本研究纳入了从30例诊断为牙龈过度生长的患者收集的30副全口石膏模型和90张口腔内照片。三名经过培训的检查者使用牙龈增生指数(A指数)和增生指数(B指数)对石膏模型进行了两次测量。口腔内照片也使用(C指数)进行了两次评估。
使用加权kappa()对每个指标记录测量值的检查者内和检查者间可靠性的一致性进行了评估,置信区间为95%。A指数显示,检查者内水平测量的总kappa值在0.724 - 0.876之间,垂直测量的总kappa值在0.512 - 0.823之间;检查者间水平测量的总kappa值在0.255 - 0.626之间,垂直测量的总kappa值在0.235 - 0.279之间。B指数显示,检查者内水平测量的总kappa值在0.587 - 0.868之间,垂直测量的总kappa值在0.653 - 0.855之间;检查者间水平和垂直测量的总kappa值分别在0.393 - 0.595和0.372 - 0.635之间。C指数在检查者内一致性方面表现最佳,总kappa值在0.758 - 0.855之间,检查者间总kappa值在0.716 - 0.804之间。
通过口腔内照片评估的C指数被认为是最可靠且适用的方法。建议使用具有明确详细标准的C指数对大规模人群进行评估。