{"title":"通过目测和探针可见度评估进行牙龈表型分类:与厚度和探针设计的关系","authors":"Burak Fatih Uysal, Timur Köse, Ali Gürkan","doi":"10.1002/JPER.24-0172","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>This study investigated the agreement among dentists in classifying gingival phenotype (GP) through periodontal probe visibility (PPV) assessment with various probe types and the visual method. Additionally, the relationship between GP classifications and gingival thickness (GT) was evaluated.</p><p><strong>Methods: </strong>Photographs were taken with standard periodontal probe (SPP), color-coded periodontal probe (CCPP) tips in white, green, and blue, as well as metal phenotype probe (MPP) tips in gray and black. Evaluators (periodontist, periodontics resident, endodontics resident, dental student) assessed the photographs and classified the GPs. GT was measured by trans gingival probing.</p><p><strong>Results: </strong>Visual method showed poor to fair agreement to classify GP. The lowest agreement regarding PPV was noted with white-tipped CCPP. The highest agreement in singular PPV was observed with CCPP blue (κ = 0.932), followed by CCPP green (κ = 0.791), MPP black (κ = 0.783), SPP (κ = 0.730), and MPP gray (κ = 0.690). Combined PPV data revealed fair to moderate agreement with CCPP and moderate to substantial agreement with MPP in GP classification. The corresponding GT to different GP classifications based on combined PPV were comparable. The agreement between SPP and CCPP in classifying non-thin phenotypes was 89.8%, while the agreement between SPP and MPP was 75.4%. Based on PPV, no significant GT cutoff value was found to distinguish between thin and non-thin phenotypes.</p><p><strong>Conclusion: </strong>Determining a precise GT that guarantees the visibility of a given probe can be difficult when evaluating GP. Regardless of the type of probe, the PPV method has a high potential for misclassifying GP, despite having an acceptable agreement.</p><p><strong>Plain language summary: </strong>Gingival phenotype (GP) is constituted by thickness of the gums and width of keratinized tissue around teeth. Direct visual evaluation or evaluating a periodontal probe's visibility beneath gums are established techniques to classify gingival phenotype. This study investigated how dentists classify GP using visual assessments and different types of periodontal probes, while also exploring the relationship between GP classifications and gingival thickness. Results showed varied agreement among dentists in classifying GP, with lower agreement observed when using certain types of probes, notably the white-tipped phenotype probe. The highest agreement was found with the blue phenotype probe. Data from periodontal probe visibility assessments indicated fair to moderate agreement with certain probes, suggesting some inconsistency in classification methods. Interestingly, GP classification with visual assessments or probes did not correlate with gingival thickness, which may highlight the importance of considering both factors in clinical practice. These findings underline the need for attention when relying solely on visual assessments or specific probe types for accurate GP classification.</p>","PeriodicalId":16716,"journal":{"name":"Journal of periodontology","volume":" ","pages":""},"PeriodicalIF":4.2000,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Gingival phenotype classification by visual and probe visibility assessments: Relationship with thickness and probe design.\",\"authors\":\"Burak Fatih Uysal, Timur Köse, Ali Gürkan\",\"doi\":\"10.1002/JPER.24-0172\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>This study investigated the agreement among dentists in classifying gingival phenotype (GP) through periodontal probe visibility (PPV) assessment with various probe types and the visual method. Additionally, the relationship between GP classifications and gingival thickness (GT) was evaluated.</p><p><strong>Methods: </strong>Photographs were taken with standard periodontal probe (SPP), color-coded periodontal probe (CCPP) tips in white, green, and blue, as well as metal phenotype probe (MPP) tips in gray and black. Evaluators (periodontist, periodontics resident, endodontics resident, dental student) assessed the photographs and classified the GPs. GT was measured by trans gingival probing.</p><p><strong>Results: </strong>Visual method showed poor to fair agreement to classify GP. The lowest agreement regarding PPV was noted with white-tipped CCPP. The highest agreement in singular PPV was observed with CCPP blue (κ = 0.932), followed by CCPP green (κ = 0.791), MPP black (κ = 0.783), SPP (κ = 0.730), and MPP gray (κ = 0.690). Combined PPV data revealed fair to moderate agreement with CCPP and moderate to substantial agreement with MPP in GP classification. The corresponding GT to different GP classifications based on combined PPV were comparable. The agreement between SPP and CCPP in classifying non-thin phenotypes was 89.8%, while the agreement between SPP and MPP was 75.4%. Based on PPV, no significant GT cutoff value was found to distinguish between thin and non-thin phenotypes.</p><p><strong>Conclusion: </strong>Determining a precise GT that guarantees the visibility of a given probe can be difficult when evaluating GP. Regardless of the type of probe, the PPV method has a high potential for misclassifying GP, despite having an acceptable agreement.</p><p><strong>Plain language summary: </strong>Gingival phenotype (GP) is constituted by thickness of the gums and width of keratinized tissue around teeth. Direct visual evaluation or evaluating a periodontal probe's visibility beneath gums are established techniques to classify gingival phenotype. This study investigated how dentists classify GP using visual assessments and different types of periodontal probes, while also exploring the relationship between GP classifications and gingival thickness. Results showed varied agreement among dentists in classifying GP, with lower agreement observed when using certain types of probes, notably the white-tipped phenotype probe. The highest agreement was found with the blue phenotype probe. Data from periodontal probe visibility assessments indicated fair to moderate agreement with certain probes, suggesting some inconsistency in classification methods. Interestingly, GP classification with visual assessments or probes did not correlate with gingival thickness, which may highlight the importance of considering both factors in clinical practice. These findings underline the need for attention when relying solely on visual assessments or specific probe types for accurate GP classification.</p>\",\"PeriodicalId\":16716,\"journal\":{\"name\":\"Journal of periodontology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":4.2000,\"publicationDate\":\"2024-08-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of periodontology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/JPER.24-0172\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"DENTISTRY, ORAL SURGERY & MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of periodontology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/JPER.24-0172","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
引用次数: 0
摘要
背景:本研究调查了牙科医生通过使用不同类型的探针和目测法评估牙周探针可见度(PPV)来划分牙龈表型(GP)的一致性。此外,还评估了 GP 分类与牙龈厚度(GT)之间的关系:使用标准牙周探针(SPP)、白色、绿色和蓝色彩色编码牙周探针(CCPP)以及灰色和黑色金属表型探针(MPP)拍摄照片。评估人员(牙周病学家、牙周病学住院医师、牙髓病学住院医师、牙科学生)对照片进行评估,并对 GP 进行分类。GT通过经牙龈探针测量:结果:目测法对 GP 分类的一致性从较差到一般。白尖 CCPP 的 PPV 一致性最低。单个 PPV 的一致性最高的是蓝色 CCPP(κ = 0.932),其次是绿色 CCPP(κ = 0.791)、黑色 MPP(κ = 0.783)、SPP(κ = 0.730)和灰色 MPP(κ = 0.690)。综合 PPV 数据显示,在 GP 分类中,与 CCPP 的一致程度为一般到中等,与 MPP 的一致程度为中等到较高。基于综合 PPV 的不同 GP 分类的相应 GT 具有可比性。SPP 与 CCPP 在非瘦小表型分类方面的一致性为 89.8%,而 SPP 与 MPP 的一致性为 75.4%。根据PPV,没有发现明显的GT临界值可以区分消瘦和非消瘦表型:结论:在评估 GP 时,确定一个精确的 GT 值以保证特定探针的可见性是很困难的。无论探针的类型如何,PPV 方法尽管具有可接受的一致性,但误判 GP 的可能性很大。白话摘要:牙龈表型(GP)由牙龈的厚度和牙齿周围角化组织的宽度构成。直接目测或评估牙周探针在牙龈下的可见度是划分牙龈表型的成熟技术。本研究调查了牙医如何使用视觉评估和不同类型的牙周探针对 GP 进行分类,同时还探讨了 GP 分类与牙龈厚度之间的关系。结果显示,牙医在对 GP 进行分类时的一致性不尽相同,在使用某些类型的探针(尤其是白尖表型探针)时,一致性较低。蓝色表型探针的一致性最高。牙周探针可见度评估的数据显示,某些探针的一致性一般到中等,这表明分类方法存在一定的不一致性。有趣的是,用目测或探针进行的 GP 分类与牙龈厚度并不相关,这可能突出了在临床实践中考虑这两个因素的重要性。这些发现强调了在仅依赖视觉评估或特定探针类型进行准确的 GP 分类时需要注意的问题。
Gingival phenotype classification by visual and probe visibility assessments: Relationship with thickness and probe design.
Background: This study investigated the agreement among dentists in classifying gingival phenotype (GP) through periodontal probe visibility (PPV) assessment with various probe types and the visual method. Additionally, the relationship between GP classifications and gingival thickness (GT) was evaluated.
Methods: Photographs were taken with standard periodontal probe (SPP), color-coded periodontal probe (CCPP) tips in white, green, and blue, as well as metal phenotype probe (MPP) tips in gray and black. Evaluators (periodontist, periodontics resident, endodontics resident, dental student) assessed the photographs and classified the GPs. GT was measured by trans gingival probing.
Results: Visual method showed poor to fair agreement to classify GP. The lowest agreement regarding PPV was noted with white-tipped CCPP. The highest agreement in singular PPV was observed with CCPP blue (κ = 0.932), followed by CCPP green (κ = 0.791), MPP black (κ = 0.783), SPP (κ = 0.730), and MPP gray (κ = 0.690). Combined PPV data revealed fair to moderate agreement with CCPP and moderate to substantial agreement with MPP in GP classification. The corresponding GT to different GP classifications based on combined PPV were comparable. The agreement between SPP and CCPP in classifying non-thin phenotypes was 89.8%, while the agreement between SPP and MPP was 75.4%. Based on PPV, no significant GT cutoff value was found to distinguish between thin and non-thin phenotypes.
Conclusion: Determining a precise GT that guarantees the visibility of a given probe can be difficult when evaluating GP. Regardless of the type of probe, the PPV method has a high potential for misclassifying GP, despite having an acceptable agreement.
Plain language summary: Gingival phenotype (GP) is constituted by thickness of the gums and width of keratinized tissue around teeth. Direct visual evaluation or evaluating a periodontal probe's visibility beneath gums are established techniques to classify gingival phenotype. This study investigated how dentists classify GP using visual assessments and different types of periodontal probes, while also exploring the relationship between GP classifications and gingival thickness. Results showed varied agreement among dentists in classifying GP, with lower agreement observed when using certain types of probes, notably the white-tipped phenotype probe. The highest agreement was found with the blue phenotype probe. Data from periodontal probe visibility assessments indicated fair to moderate agreement with certain probes, suggesting some inconsistency in classification methods. Interestingly, GP classification with visual assessments or probes did not correlate with gingival thickness, which may highlight the importance of considering both factors in clinical practice. These findings underline the need for attention when relying solely on visual assessments or specific probe types for accurate GP classification.