title: Evaluation of a computerized method for denture biofilm quantification: inter-examiner reproducibility.
abstract: OBJECTIVE
  The objective of this work was to evaluate the accuracy and inter-examiner reproducibility of the computerized method Image Tool 2.02 (Windows, version 2.02, University of Texas Health Science Center, San Antonio, TX) in the quantification of complete denture biofilm.
  
  
  METHODS
  Two hundred digital photographs of the internal surface of complete upper dentures with biofilm dyed in 1% neutral red were used. The photographs were burned to a CD and sent to two researchers who received practical training and written instructions on how to use the method; then, in a 20-day period, the stained biofilm on the internal surface was measured, and ten photographs were analyzed daily. Each examiner independently quantified the percentage of stained area on each photograph. The inter-examiner reproducibility (i.e., agreement) was estimated by calculating an intra-class correlation coefficient (ICC) based on an ANOVA mixed model (SPSS software, Chicago, IL).
  
  
  RESULTS
  The ICC showed excellent agreement (ICC = 0.993, p < 0.001). The difference in the percentage of the stained area recorded by the two examiners was < or =1 point for 187 (93.5%) of the 200 photographs.
  
  
  CONCLUSIONS
  The obtained results suggest that the computerized method aided by the Image Tool software (2.0) can be employed to quantify complete denture biofilm, seeing that it demonstrated inter-examiner reproducibility of the results.
authors.affiliation: Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, Sao Paulo, Brazil. chl@forp.usp.br
authors.forename: Cláudia Helena
authors.initials: CH
authors.lastname: Silva-Lovato
authors.forename: Ana Maria Gomes
authors.initials: AM
authors.lastname: Totti
authors.forename: Helena Freitas Oliveira
authors.initials: HF
authors.lastname: Paranhos
authors.forename: Valéria Gomes
authors.initials: VG
authors.lastname: Totti
mesh_terms: D018441:Biofilms / Q000145:classification*; D004396:Coloring Agents; D016250:Compact Disks; D003194:Computer-Assisted Instruction / Q000379:methods*; D003827:Denture, Complete, Upper / Q000382:microbiology*; D006801:Humans; D009499:Neutral Red; D015588:Observer Variation; D010781:Photography / Q000379:methods; D012984:Software; D013499:Surface Properties
chemical_list: D004396:Coloring Agents; D009499:Neutral Red