title: Inter-rater agreement in the diagnosis of mucositis and peri-implantitis.
abstract: OBJECTIVE
  The objective was to assess the inter-rater agreement in the diagnosis of mucositis and peri-implantitis.
  
  
  METHODS
  Adult patients with ≥ 1 dental implant were eligible. Three operators examined the patients. One examiner allocated the patients to three groups of nine as follows: nine implants with peri-implantitis, nine implants with mucositis, and 9 implants with healthy mucosa. Each examiner recorded on all 27 patients (one implant per patient) recessions, probing depth, bleeding on probing, suppuration, keratinized tissue depth and bone loss, leading to a final diagnosis of mucositis, peri-implantitis or healthy mucosa. Examiners were independent and blinded to each other.
  
  
  RESULTS
  Fleiss k-statistic with quadratic weight in the diagnosis of peri-implantitis and mucositis was 0.66 [CI95%: 0.45-0.87]. A complete agreement was obtained only in 14 cases (52%). Fleiss k-statistics in bleeding on probing and bone loss were respectively 0.31 [CI95%: 0.20-0.41] and 0.70 [CI95%: 0.45-0.94]. Intra-class correlation coefficients for recession, probing depth and keratinized tissue depth were respectively 0.69 [CI95%: 0.62-0.75], 0.54 [CI95%: 0.44-0.63] and 0.56 [CI95%: 0.27-0.77].
  
  
  CONCLUSIONS
  The inter-rater agreement in the diagnosis of peri-implant disease was qualified as merely good. This could also be due in part to the unclear definition of peri-implantitis and mucositis.
authors.affiliation: Private practice, Rimini, Italy; INDENT, Rimini, Italy; Politecnico delle Marche, Ancona, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Merli
authors.forename: Francesco
authors.initials: F
authors.lastname: Bernardelli
authors.forename: Erica
authors.initials: E
authors.lastname: Giulianelli
authors.forename: Ivano
authors.initials: I
authors.lastname: Toselli
authors.forename: Marco
authors.initials: M
authors.lastname: Moscatelli
authors.forename: Umberto
authors.initials: U
authors.lastname: Pagliaro
authors.forename: Michele
authors.initials: M
authors.lastname: Nieri
mesh_terms: D000328:Adult; D000368:Aged; D016301:Alveolar Bone Loss / Q000175:diagnosis; D032921:Consensus; D015921:Dental Implants; D005260:Female; D005881:Gingiva / Q000473:pathology; D005889:Gingival Recession / Q000175:diagnosis; D006801:Humans; D007633:Keratins; D008297:Male; D008875:Middle Aged; D052016:Mucositis / Q000175:diagnosis*; D015588:Observer Variation; D057873:Peri-Implantitis / Q000175:diagnosis*; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000175:diagnosis; D016037:Single-Blind Method; D013492:Suppuration
chemical_list: D015921:Dental Implants; D007633:Keratins
keywords: dental implant; diagnosis; inter-rater agreement; mucositis; peri-implantitis