口腔医学本科实习医师牙周探诊检查的准确性及影响因素分析

The accuracy of probing depth measurements of undergraduate students and associated factorsanalysis

目的评估口腔医学本科实习医师牙周邻面探诊的准确性并分析可能的影响因素，以期为牙周临床教学提供参考。方法按照临床带教常规，选取北京大学口腔医学院38名初次进入牙周临床实习的本科生，每名实习医师均使用Williams刻度探针检查并记录1～2例（共58例）慢性牙周炎患者的探诊深度，教师进行重复探诊并加以核对，记录Ramfjord代表牙（41/2＋6/14）邻面探诊深度的复核结果作为本项研究的结果数据。根据实习医师与教师探诊深度的差异，将所有位点分为完全一致位点（实习医师与教师探诊深度相同的位点）、基本一致位点（实习医师与教师探诊深度差异为1mm的位点）和不一致位点（实习医师与教师探诊深度差异≥2mm的位点）。结果随着牙周袋加深，学生的探诊准确性下降。完全一致位点百分比磨牙[58．8％（261／444）]显著低于切牙[73．1％（339／464）]，P〈0．01。实习医师邻面探诊不准确的最主要原因是不能探入龈谷，此项因素占70．7％（87／123）。结论邻面探诊角度的培训应成为牙周临床前期探诊教学的重点，临床实习时教师需重点核查实习医师对深牙周袋和磨牙的邻面探诊。

Objective To investigate the accuracy of probing depth measurements of undergraduate students in department of periodontology and analyze the cause of measurement errors. Methods Thirty-eight dental students from Peking Universty School and Hospital of Stomatology who began their periodontal clinical practice for the first time were recruited. According to principle of clinical teaching, after the students recorded the probing depth of 1-2 periodontitis patients using Williams periodontol probe, an exoerienced teacher checked the probing depth. The measurements of interproximal sites of Ramfjord index（41/6＋6/14）were used as the data of this study. According to the probing depth discrepancies betweenteacher and the students, all the probing sites were divided in three levels： absolutely consistent sites （probing depth measured by teacher and by student was completely consistent）, almost consistent sites（ the depth discrepancy between teacher and student was 1 mm ）, inconsistent sites （ the depth discrepancies between teacher and student≥ 2 mm）. Results The accuracy of probing depth measurements of students decreased with the deepening of probing depth, and the accuracy of probing depth measurements in molar teeth was significantly lower than incisor teeth[58.8% （261/444） vs. 73.1% （339/464）, P 〈 0.01 ]. The main factor associated with the accuracy of probing depth measurements in interproximal sites was the probe＇s inability to get into gingival col, which accounted for 70. 7% （87/123） of the total inconsistent sites. Conclusions The correct angle of insertion of the probe in interproximal sites should be reinforced during the course of pre-clinical education of periodontal probing. More attention should be paid to check the probing depth of deep pockets and molar teeth during the clinical practice of undergraduate students.