Diagnostic reproducibility of the 2018 Classification of Gingival Recessions: Comparing photographic and in-person diagnoses.

IF 4.2 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE
Riccardo Di Gianfilippo, GiovanPaolo Pini Prato, Debora Franceschi, Walter Castelluzzo, Luigi Barbato, Alessandra Bandel, Maria Di Martino, Claudio M Pannuti, Leandro Chambrone, Francesco Cairo
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引用次数: 0

Abstract

Background: To assess how the diagnostic reproducibility of the 2018 Classification of Gingival Recession Defects (GRD) could be applied when comparing in-person chairside measurements with photographic measurements.

Methods: Thirty-four GRD were photographed and evaluated by 4 masked operators. For each case, the operators measured twice recession type (RT), recession depth (RD), keratinized tissue width (KTW), gingival thickness (GT), detectability of the cemento-enamel junction (CEJ), and presence of root steps (RSs), chairside, and on photographs. Intraclass correlation coefficient (ICC) with 95% confidence intervals (CI) was calculated for RD and KTW; Kappa with 95% CI was used for GT, CEJ, and RS; quadratic weighted Kappa with 95% CI was used for RT.

Results: RD, KTW, and RT showed excellent overall intra-operator agreement (> 0.93), and from good to excellent overall inter-operator agreement (> 0.80), for both clinical and photographic measurements. Agreements were lower for GT, CEJ, and RS. Overall clinical and photographic agreements were within 0.1 difference for every variable, except for inter-operator agreement for RS which was 0.72 for clinical measurements and 0.45 for photographic measurements. The lowest overall agreement between clinical versus photographic measurements existed for CEJ (0.28) and RS (0.35).

Conclusions: Variables composing the 2018 Classification of GRD are reproducible, both clinically and on photographs, with comparable agreements. The overall agreement was higher for KTW, RD, and RT, and lower for GT, CEJ, and RS, for both clinical and photographic measurements. The comparison between chairside and photographic evaluations indicated fair to excellent agreement for most variables, with CEJ and RS showing fair agreement.

Plain language summary: As digital diagnostics evolve to facilitate clinical diagnostic measurement, we aimed to assess the effectiveness of intraoral photography for diagnosing gingival recession defects (GRD) according to the 2018 Classification of GRD, compared to traditional clinical examination. Standardized photographs of thirty-four GRD cases were captured. Four masked operators evaluated the same gingival recessions twice in a clinical setting and twice using photographs. Measurement repeatability within and between operators was calculated for both clinical and photographic settings, and the two settings were compared. Continuous measurements such as recession depth and keratinized tissue width, as well as the evaluation of interproximal attachment height (recession type), showed excellent agreement both clinically and photographically. Agreement was lower for gingival thickness and the detectability of tooth anatomical landmarks, such as the cemento-enamel junction and the presence of root steps. Overall, the agreement between chairside and photographic evaluations was generally good, but lower when evaluating tooth anatomical landmarks. The variables composing the 2018 Classification of GRD are reproducible in both clinical and photographic settings, with comparable levels of agreement. However, there was consistently worse agreement for gingival thickness and when evaluating tooth anatomical landmarks.

2018 年牙龈凹陷分类的诊断重现性:比较照相诊断和当面诊断。
背景:目的:评估在比较亲自椅旁测量和照片测量时,如何应用2018年牙龈退缩缺陷(GRD)分类的诊断重现性:由 4 名蒙面操作员对 34 个 GRD 进行拍照和评估。对于每个病例,操作员都在椅旁和照片上测量了两次退缩类型(RT)、退缩深度(RD)、角化组织宽度(KTW)、牙龈厚度(GT)、牙龈-釉质交界处(CEJ)的可探测性以及根台阶(RS)的存在。对 RD 和 KTW 计算了带 95% 置信区间 (CI) 的类内相关系数 (ICC);对 GT、CEJ 和 RS 使用了带 95% CI 的 Kappa;对 RT 使用了带 95% CI 的二次加权 Kappa:RD、KTW 和 RT 的临床和摄影测量结果显示出极佳的整体操作者内一致性(> 0.93),以及良好到极佳的整体操作者间一致性(> 0.80)。GT、CEJ 和 RS 的一致性较低。除 RS 的操作者间一致性(临床测量为 0.72,摄影测量为 0.45)外,每个变量的临床测量和摄影测量的总体一致性均在 0.1 的差值范围内。CEJ(0.28)和RS(0.35)的临床测量与摄影测量的总体一致性最低:构成 2018 年 GRD 分类的变量在临床和照片上都具有可重复性,且一致性相当。在临床和照片测量中,KTW、RD和RT的总体一致性较高,而GT、CEJ和RS的一致性较低。椅旁评估和照片评估之间的比较表明,大多数变量的一致性为一般到优秀,CEJ和RS的一致性为一般。原文摘要:随着数字诊断技术的发展,促进了临床诊断测量,我们的目的是根据2018年牙龈退缩缺损分类,评估口内摄影与传统临床检查相比诊断牙龈退缩缺损(GRD)的有效性。我们拍摄了 34 例 GRD 的标准化照片。四名蒙面操作员对相同的牙龈退缩进行了两次临床评估和两次照片评估。计算了临床和照片两种设置下操作员内部和操作员之间的测量重复性,并对两种设置进行了比较。退缩深度和角化组织宽度等连续测量值以及近端间附着高度(退缩类型)的评估在临床和照片上都显示出极好的一致性。在牙龈厚度和牙齿解剖标志(如牙本质-釉质交界处和牙根台阶的存在)的可探测性方面,两者的一致性较低。总体而言,椅旁评价和照片评价之间的一致性普遍较好,但在评价牙齿解剖标志时一致性较低。构成 2018 年 GRD 分类的变量在临床和照相环境中都具有可重复性,一致性水平相当。然而,牙龈厚度和评估牙齿解剖标志时的一致性一直较差。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of periodontology
Journal of periodontology 医学-牙科与口腔外科
CiteScore
9.10
自引率
7.00%
发文量
290
审稿时长
3-8 weeks
期刊介绍: The Journal of Periodontology publishes articles relevant to the science and practice of periodontics and related areas.
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