不同方法对口腔前庭沟深度测量的一致性研究

doi:10.13591/j.cnki.kqyx.2023.06.006

摘要/Abstract

摘要：

目的评价4种口腔前庭沟深度(oral vestibular groove depth,OVGD)测量方法的一致性。方法 3名检查者测量16例受试者16、14、11、46、44、41六个牙位的口腔前庭沟深度,均采用4种测量方法:硅橡胶模型测量(silicone rubber mold measurment,SMM)、藻酸盐模型测量(alginate mold,AMM)、口内直接测量(intra-oral direct measurement,IDM)和口腔扫描测量(oral scan measurements,OSM)。结果 3名检查者间的一致性接近完美(ICC=0.87),4种测量方法间的一致性为一般(ICC=0.49);4种测量方法的结果由大到小依次为IDM>SMM>OSM>AMM;Bland-Altman图显示检查者之间一致性良好,测量方法之间一致性差。结论在4种口腔前庭沟深度测量方法中,检查者对结果几乎没有影响,不同测量方法得到的结果有差异。

关键词: 口腔前庭沟深度, 测量, 一致性

Abstract:

Objective To study the consistencyamong four methods for measuring oral vestibular groove depth (OVGD). Methods Sixteen subjects were selected, and four measuring methods were used:silicone rubber mold measurement(SMM), alginate mold measurement(AMM), intra-oral direct measurement(IDM), and oral scan measurement(OSM). Three examiners(A, B, C)measured the vestibular groove depth of 16, 14, 11, 46, 44, and 41 tooth positions respectively. Results The consistency among the three examiners was nearly perfect(ICC=0.87), and the consistency among the four measuring methods was moderate(ICC=0.49). Results of the four measuring methods were IDM>SMM>OSM>AMM from the largest to the smallest.Bland-Altman plots showed good consistency among examiners and poor consistency among measuring methods. Conclusion Among the four methods of measuring oral vestibular groove depth, examiners have little influence on the results, and the results obtained by different methods are different.

Key words: oral vestibular groove depth, measurement, consistency

中图分类号:

R322.41

邬春兰, 胡玥, 王婷婷, 于德栋, 邓刚, 李超伦. 不同方法对口腔前庭沟深度测量的一致性研究[J]. 口腔医学, 2023, 43(6): 512-517.

WU Chunlan, HU Yue, WANG Tingting, YU Dedong, DENG Gang, LI Chaolun. The consistency studyon different methods of oral vestibular groove depth measurements[J]. Stomatology, 2023, 43(6): 512-517.

图/表 5

表1

表2

图1

图2

表3

参考文献 23

[1]	Fallahi Motlagh M, Sadeghzade F, Abbaszadeh A. Lipswitchvestibuloplasty combined with endosseous implant surgery. One stage versus two stages?[J]. J Oral Maxillofac Surg Med Pathol, 2017, 29(1):33-38. doi: 10.1016/j.ajoms.2016.09.004
[2]	Cillo JE, Finn R. Reconstruction of the shallow vestibule edentulous mandible with simultaneous split thickness skin graft vestibuloplasty and mandibular endosseous implants for implant-supported overdentures[J]. J Oral Maxillofac Surg, 2009, 67(2):381-386. doi: 10.1016/j.joms.2008.06.065
[3]	Lim HC, An SC, Lee DW. A retrospective comparison of three modalities for vestibuloplasty in the posterior mandible:Apically positioned flap only vs. free gingival graft vs. collagen matrix[J]. Clin Oral Invest, 2018, 22(5):2121-2128. doi: 10.1007/s00784-017-2320-y
[4]	Arnoux JP, Papasotiriou A, Weisgold AS. A revised technique for stage-two surgery in the severely resorbed mandible:A technical note[J]. Int J Oral Maxillofac Implants, 1998, 13(4):565-568.
[5]	Melo LGN, Almeida ALPF, Lopes JFS, et al. A modified approach for vestibuloplasty in severely resorbed mandible using an implant-retained postoperative stent:A case report[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontology, 2008, 106(4):e7-e14.
[6]	Bassetti RG, Stähli A, Bassetti MA, et al. Soft tissue augmentation procedures at second-stage surgery:A systematic review[J]. Clin Oral Invest, 2016, 20(7):1369-1387. doi: 10.1007/s00784-016-1815-2 pmid: 27041111
[7]	Wei DH, Di P, Tian JH, et al. Evaluation of intraoral digital impressions for obtaining gingival contour in the esthetic zone:Accuracy outcomes[J]. Clin Oral Invest, 2020, 24(4):1401-1410. doi: 10.1007/s00784-019-03105-6
[8]	Fageeh HN, Meshni AA, Jamal HA, et al. The accuracy and reliability of digital measurements of gingival recession versus conventional methods[J]. BMC Oral Health, 2019, 19(1):154. doi: 10.1186/s12903-019-0851-0 pmid: 31311544
[9]	Landis JR, Koch GG. The measurement of observer agreement for categorical data[J]. Biometrics, 1977, 33(1):159-174. pmid: 843571
[10]	乔舰. 组内相关系数的理论基础及建模应用[J]. 统计与信息论坛, 2016, 31(11):44-48.
[11]	Giavarina D. Understanding bland Altman analysis[J]. Biochem Med (Zagreb), 2015, 25(2):141-151. doi: 10.11613/issn.1846-7482
[12]	Smith MW, Ma J, Stafford RS. Bar charts enhance Bland-Altman plots when value ranges are limited[J]. J Clin Epidemiol, 2010, 63(2):180-184. doi: 10.1016/j.jclinepi.2009.06.001 pmid: 19716265
[13]	Kothiwale S, Ajbani J. Innovative use of increasing the width of attached gingiva using chorion membrane along with platelet rich fibrin membrane[J]. Cell Tissue Bank, 2021, 22(3):389-398. doi: 10.1007/s10561-020-09884-7 pmid: 33231839
[14]	Thoma DS, Buranawat B, Hämmerle CHF, et al. Efficacy of soft tissue augmentation around dental implants and in partially edentulous areas:A systematic review[J]. J Clin Periodontol, 2014, 41(Suppl 15):S77-S91. doi: 10.1111/jcpe.12220
[15]	Blasi G, Monje A, Muñoz-Peñalver J, et al. Influence of vestibular depth on the outcomes of root coverage therapy:A prospective case series study[J]. J Periodontol, 2022, 93(12):1857-1866. doi: 10.1002/jper.v93.12
[16]	Speroni S, Cicciu M, Maridati P, et al. Clinical investigation of mucosal thickness stability after soft tissue grafting around implants:A 3-year retrospective study[J]. Indian J Dent Res, 2010, 21(4):474-479. doi: 10.4103/0970-9290.74208
[17]	Bawankar PV, Kolte AP, Kolte RA. Peri-implant soft tissue stability through vestibular extension procedure:A retrospective study[J]. Quintessence Int, 2022, 53(3):226-235.
[18]	陈卉. Bland-Altman分析在临床测量方法一致性评价中的应用[J]. 中国卫生统计, 2007, 24(3):308-309, 315.
[19]	倪平, 陈卉, 涂娇, 等. 基于Bland-Altman法对定量资料的一致性评价及其SAS宏实现[J]. 中国临床药理学与治疗学, 2014, 19(8):898-903.
[20]	Ferrari Cagidiaco E, Zarone F, Discepoli N, et al. Analysis of the reproducibility of subgingival vertical margins using intraoral optical scanning (IOS):A randomized controlled pilot trial[J]. J Clin Med, 2021, 10(5):941. doi: 10.3390/jcm10050941
[21]	Thoma DS, Lim HC, Paeng KW, et al. Augmentation of keratinized tissue at tooth and implant sites by using autogenous grafts and collagen-based soft-tissue substitutes[J]. J Clin Periodontol, 2020, 47(1):64-71. doi: 10.1111/jcpe.13194 pmid: 31518443
[22]	万蕾蕾, 马静雯, 张纪春, 等. 游离龈移植术后龈瓣收缩效果的临床研究[J]. 现代生物医学进展, 2019, 19(5):876-879, 950.
[23]	Golmayo P, Barallat L, Losada M, et al. Keratinized tissue gain after free gingival graft augmentation procedures around teeth and dental implants:A prospective observational study[J]. J Clin Periodontol, 2021, 48(2):302-314. doi: 10.1111/jcpe.13394 pmid: 33098670

检查者	测量方法	均值	标准差	标准误
A	SMM(n=96)	8.86	2.37	0.24
	AMM(n=96)	8.02	1.90	0.19
	IDM(n=96)	9.11	2.17	0.22
	OSM(n=96)	8.31	2.36	0.24
B	SMM(n=96)	8.81	2.35	0.24
	AMM(n=96)	8.05	1.88	0.19
	IDM(n=96)	9.29	2.25	0.23
	OSM(n=96)	8.30	2.31	0.24
C	SMM(n=96)	8.89	2.34	0.24
	AMM(n=96)	7.99	1.90	0.19
	IDM(n=96)	9.12	1.97	0.20
	OSM(n=96)	8.29	2.36	0.24
A总(n=384)		8.57	2.24	0.11
B总(n=384)		8.36	2.23	0.11
C总(n=384)		8.57	2.19	0.11
SMM总(n=288)		8.85	2.34	0.14
AMM总(n=288)		8.02	1.89	0.11
IDM总(n=288)		9.17	2.12	0.13
OSM总(n=288)		8.30	2.14	0.14

检查者	测量方法	ICC	95%CI	检查者	测量方法	ICC	95%CI
A	SMM(n=96)	0.47	0.36~0.57	SMM	A(n=96)	0.99	0.98~0.99
	AMM(n=96)				B(n=96)
	IDM(n=96)				C(n=96)
	0SM(n=96)			AMM	A(n=96)	0.99	0.99~0.99
B	SMM(n=96)	0.49	0.38~0.60		B(n=96)
	SMM(n=96)				C(n=96)
	AMM(n=96)				C(n=96)
	AMM(n=96)			IDM	A(n=96)	0.80	0.74~0.86
	IDM(n=96)				A(n=96)
	IDM(n=96)				B(n=96)
	OSM(n=96)				B(n=96)
	OSM(n=96)				C(n=96)
C	SMM(n=96)	0.51	0.41~0.61		C(n=96)
	SMM(n=96)			OSM	A(n=96)	0.99	0.99~0.99
	AMM(n=96)				A(n=96)
	AMM(n=96)				B(n=96)
	IDM(n=96)				B(n=96)
	IDM(n=96)				C(n=96)
	OSM(n=96)				C(n=96)
	OSM(n=96)			所有检查者一致性		0.87	0.84~0.89
所有测量方法一致性		0.49	0.43~0.55	所有检查者一致性		0.87	0.84~0.89

项目	95%置信区间下限/mm	95%置信区间上限/mm	偏倚
检查者
B-A	-0.94	0.84	-0.05
C-B	-0.63	0.78	0.07
C-A	-0.78	0.72	0.03
检测方法
AMM-SMM	-5.01	3.32	-0.84
IDM-SMM	-3.28	3.78	0.25
OSM-SMM	-5.38	4.28	-0.55
IDM-AMM	-3.14	5.32	1.09
OSM-AMM	-4.27	4.86	0.29
IDM-OSM	-4.46	6.05	0.80