Evaluation of New Cone-beam Computed Tomographic Criteria for Radiographic Healing Evaluation after Apical Surgery: Assessment of Repeatability and Reproducibility.

von Arx, Thomas; Janner, Simone; Hänni, Stefan; Bornstein, Michael (2016). Evaluation of New Cone-beam Computed Tomographic Criteria for Radiographic Healing Evaluation after Apical Surgery: Assessment of Repeatability and Reproducibility. Journal of endodontics, 42(2), pp. 236-242. Elsevier 10.1016/j.joen.2015.11.018

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INTRODUCTION Conventional 2-dimensional radiography uses defined criteria for outcome assessment of apical surgery. However, these radiographic healing criteria are not applicable for 3-dimensional radiography. The present study evaluated the repeatability and reproducibility of new cone-beam computed tomographic (CBCT)-based healing criteria for the judgment of periapical healing 1 year after apical surgery. METHODS CBCT scans taken 1 year after apical surgery (61 roots of 54 teeth in 54 patients, mean age = 54.4 years) were evaluated by 3 blinded and calibrated observers using 4 different indices. Reformatted buccolingual CBCT sections through the longitudinal axis of the treated roots were analyzed. Radiographic healing was assessed at the resection plane (R index), within the apical area (A index), of the cortical plate (C index), and regarding a combined apical-cortical area (B index). All readings were performed twice to calculate the intraobserver agreement (repeatability). Second-time readings were used for analyzing the interobserver agreement (reproducibility). Various statistical tests (Cohen, kappa, Fisher, and Spearman) were performed to measure the intra- and interobserver concurrence, the variability of score ratios, and the correlation of indices. RESULTS For all indices, the rates of identical first- and second-time scores were always higher than 80% (intraobserver Cohen κ values ranging from 0.793 to 0.963). The B index (94.0%) showed the highest intraobserver agreement. Regarding interobserver agreement, the highest rate was found for the B index (72.1%). The Fleiss' κ values for R and B indices exhibited substantial agreement (0.626 and 0.717, respectively), whereas the values for A and C indices showed moderate agreement (0.561 and 0.573, respectively). The Spearman correlation coefficients for R, A, C, and B indices all exhibited a moderate to very strong correlation with the highest correlation found between C and B indices (rs = 0.8069). CONCLUSIONS All indices showed an excellent intraobserver agreement (repeatability). With regard to interobserver agreement (reproducibility), the B index (healing of apical and cortical defects combined) and the R index (healing on the resection plane) showed substantial congruence and thus are to be recommended in future studies when using buccolingual CBCT sections for radiographic outcome assessment of apical surgery.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > School of Dental Medicine > Department of Oral Surgery and Stomatology
04 Faculty of Medicine > School of Dental Medicine > Department of Preventive, Restorative and Pediatric Dentistry

UniBE Contributor:

von Arx, Thomas; Janner, Simone; Hänni, Stefan and Bornstein, Michael

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0099-2399

Publisher:

Elsevier

Language:

English

Submitter:

Eveline Carmen Schuler

Date Deposited:

31 Mar 2016 08:27

Last Modified:

25 Jan 2017 12:15

Publisher DOI:

10.1016/j.joen.2015.11.018

PubMed ID:

26723486

Uncontrolled Keywords:

Apical surgery, cone-beam computed tomography, healing indices, radiographic healing outcome, repeatability, reproducibility

BORIS DOI:

10.7892/boris.76968

URI:

https://boris.unibe.ch/id/eprint/76968

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