BackgroundTo 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.MethodsThirty‐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.ResultsRD, 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).ConclusionsVariables 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 SummaryAs 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.

中文翻译：

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2018 年牙龈退缩分类的诊断再现性：比较照片诊断和现场诊断


背景为了评估在将面对面的椅旁测量与摄影测量进行比较时如何应用 2018 年牙龈退缩缺陷 (GRD) 分类的诊断再现性。方法由 4 名蒙面操作员对 34 份 GRD 进行拍照和评估。对于每个病例，操作人员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）、牙骨质-牙釉质接合处的可检测性（CEJ）以及牙根台阶的存在（ RSs）、椅子旁和照片上。计算 RD 和 KTW 的组内相关系数 (ICC)，置信区间 (CI) 为 95%； GT、CEJ 和 RS 使用 95% CI 的 Kappa； RT 使用具有 95% CI 的二次加权 Kappa。结果 对于两种临床试验，RD、KTW 和 RT 显示出出色的总体操作者内部一致性 (> 0.93)，以及从良好到优秀的总体操作者间一致性 (> 0.80)和照相测量。 GT、CEJ 和 RS 的协议率较低。每个变量的总体临床和摄影一致性差异均在 0.1 以内，但 RS 的操作者间一致性除外，临床测量为 0.72，摄影测量为 0.45。 CEJ (0.28) 和 RS (0.35) 的临床与摄影测量之间的总体一致性最低。结论 构成 2018 年 GRD 分类的变量在临床和照片上都是可重复的，具有可比的一致性。对于临床和摄影测量，KTW、RD 和 RT 的总体一致性较高，GT、CEJ 和 RS 的总体一致性较低。椅旁评估和摄影评估之间的比较表明，大多数变量的一致性相当好，其中 CEJ 和 RS 显示出相当的一致性。简明语言摘要随着数字诊断的发展以促进临床诊断测量，我们的目的是根据 2018 年 GRD 分类，与传统临床检查相比，评估口内摄影诊断牙龈退缩缺陷 (GRD) 的有效性。34 个 GRD 的标准化照片案件被抓获。四名蒙面操作员在临床环境中两次评估相同的牙龈退缩，两次使用照片评估。针对临床和摄影设置，计算了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。连续测量，例如退缩深度和角化组织宽度，以及邻间附着高度（退缩类型）的评估，显示出极好的一致性无论是临床上还是摄影上。牙龈厚度和牙齿解剖标志的可检测性（例如牙骨质-牙釉质接合处和牙根台阶的存在）的一致性较低。总体而言，椅旁评估和摄影评估之间的一致性总体良好，但在评估牙齿解剖标志时较低。构成 2018 年 GRD 分类的变量在临床和摄影环境中都是可重复的，具有可比的一致性水平。然而，牙龈厚度和评估牙齿解剖标志时的一致性始终较差。