Evaluating intra-and inter-examiners reproducibility in histometric measurement : the one-wall intrabony periodontal defects in beagle dogs

Abstract

[한글]

[영문]

Background : Accurate and exact measurement is an important factor for a meaningful result for any properly designed study. Reliable and accurate measurements serve as the basis for evaluation in many scientific disciplines. Histometric assessments are used as part of the overall histopathologic evaluation. For periodontal regeneration protocol, the histometric evaluation is used to quantify the amount of regeneration of alveolar bone, cementum, a functionally oriented periodontal ligament, formation of a junctional epithel- ium and the position of any devices and biomaterial implanted in conjunction with the surgical procedure. One of the various measurement methods, histometric measurements are routinely used to evaluate biological events ascertained in histologic sections acquired from animal and human study. But, to get an expected study result, most examiners need to spend innumerable time and effort. Therefore, if all the participating examiners are able to yield a similar result, it will be possible to evaluate the objective results of the study more easily and faster. The purpose of this study was to evaluate the intra and inter examiner reproducibility of histologic and histometric measurements in the intrabony periodontal defect model by the ICC and Overall concordance correlation coefficient (OCCC) as elaborated by Barnhart (Biometics 2002 58, 1020-7), Methods: Twenty young adult (age 18 Month, body weight: 12-15 kg) beagle dogs were used. The mandibular first and third premolar teeth were surgically extracted prior to the experimental surgery in each animal. The experimental surgery included elevation of buccal and lingual mucoperiosteal flaps to surgically create one wall intra bony defects, "box type", critical size, (4×4×4 mm) at the distal aspect of the second and the medial aspect of the fourth mandibular premolars in the right and left jaw

quadrants in each animal. Bilateral intra bony periodontal defects in each jaw quadrant either received: ß-TCP, GDF-0, GDF-100, and Sham-surgery. Histometric analysis using incandescent microscopy, an attached digital camera system, and a PC based image analysis system including a custom program that was performed on the slide of histologic sections acquired from animal study after 8 weeks performed on surgically created intrabony defects. Histometric parameters were recorded and repeated within three months interval by three examiners. Intra and inter examiner reproducibility was assessed using the ICC and the OCCC. results: Most parameters of all the groups showed high intra and inter examiner reproducibility. Parameters including defect height, bone regeneration height, cementum regeneration height, and formation of junctional epithelium yielded inter examiner correlation?0.9. The intra examiner reproducibility showed a high result, over 0.9. conclusions: Histometric evaluation in the one wall intra alveolar periodontal defect model showed high reproducibility not only in single examiner but also among the three examiners.