Observer Agreement in the Radiographic Evaluation of Technical Quality of Root Canal Treatment and Periapical Status

Yıl 2012, Cilt: 6 Sayı: 2, 1153 - 1159, 01.07.2012

Ülkem Aydın Derya Yıldırım Esin Bozdemir

Öz

The aim of this study was to assess observer agreement in the radiographic evaluation of technical quality of root canal treatment and periapical status. Periapical radiographs of forty-five single-rooted teeth with root canal treatment were evaluated by three observers. The parameters used to assess the technical quality of root canal treatment were, length, density and taper of the root canal filling. The quality of the coronal restoration and the periapical status of the endodontically treated teeth were also evaluated. An interrater reliability analysis using the Kappa statistic was done to determine consistency among raters. The mean observer agreement for the three raters was found to be Kappa=0.5 for the quality of the coronal restoration; Kappa=0.6 for the length, Kappa 0.6 for the density, Kappa=0.4 for the taper of the root canal filling and Kappa=0.3 for the periapical index. The results indicate that improvement in the evaluation of the taper of root canal filling and periapical status is necessary whereas results for length and density of root canal filling were reliable

Anahtar Kelimeler

Interobserver variation, Root canal therapy, Periapical diseases, Radiography

Kanal Tedavisinin Teknik Kalitesinin ve Periapikal Durumun Radyografik Değerlendirmesinde Gözlemci Uyumu

Öz

Bu çalışmanın amacı kök kanal tedavisinin teknik kalitesinin ve periapikal durumun radyografik olarak değerlendirilmesinde gözlemci uyumunun belirlenmesidir. Kök kanal tedavisi yapılmış 45 adet tek köklü dişin periapikal radyografı üç gözlemci tarafından incelendi. Kök kanal tedavisinin teknik kalitesi, uzunluk, densite ve taper parametreleri ile değerlendirildi. Ayrıca, endodontik tedavili dişlerde koronal restorasyonun kalitesi ve periapikal durum değerlendirildi. Gözlemciler arası uyum Kappa istatistiği ile analiz edildi. Üç gözlemci için ortalama gözlemci uyumu; koronal restorasyonun yeterliliği için Kappa=0,5 olarak, kanal tedavisinin kalitesinin değerlendirilmesinde ise uzunluk için Kappa=0,6 olarak, densite için Kappa=0,6 olarak, taper için Kappa=0,4 ve periapikal indeks için Kappa=0,3 olarak hesaplandı. Elde edilen bulgulara göre, özellikle kök kanal dolgusunun taperi ve periapikal durumun değerlendirilmesinde gözlemciler arasındaki farklar önemlidir. Buna karşın, kök kanal dolgusunun uzunluğunun ve densitesinin değerlendirilmesinde daha güvenilir sonuçlar elde edilmektedir

Anahtar Kelimeler

Gözlemciler arası değişkenlik, Kök kanal tedavisi, Periapikal hastalıklar, Radyografi

Kaynakça

• San Martin DC. Guide to Clinical Endodontics. American Association of Endodontists. 5th Edition, 2013.
• Er O., Sagsen B., Maden M., Cinar S., Kahraman Y. Radiographic technical quality of root fillings performed by dental students in Turkey. Int. Endod. J. 39: 867–872, 2006.
• Ilgüy D., Ilgüy M., Fisekçioglu E., Ersan N., Tanalp J., Dölekoglu S. Assessment of root canal treatment outcomes performed by Turkish dental students: Results after two years. J. Dent. Educ. 77: 502–509, 2013.
• Gündüz K., Avsever H., Orhan K., Demirkaya K. Cross-sectional evaluation of the periapical status as related to quality of root canal fillings and coronal restorations in a rural adult male population of Turkey. BMC Oral Health 11: 20, 2011.
• Gumru B., Tarcin B., Pekiner FN., Ozbayrak S. Retrospective radiological assessment of root canal treatment in young permanent dentition in a Turkish subpopulation. Int. Endod. J. 44: 850– 856, 2011.
• Kayahan MB., Malkondu O., Canpolat C., Kaptan F., Bayirli G., Kazazoglu E. Periapical health related to the type of coronal restorations and quality of root canal fillings in a Turkish subpopulation. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. 105: e58–e62, 2008.
• Adebayo ET., Ahaji LE., Nnachetta RN., Nwankwo O., Akabogu-Okpeseyi N., Yaya MO., Hussain NA. Technical quality of root canal fillings done in a Nigerian general dental clinic. BMC Oral Health. 15: 42, 2012.
• Estrela C., Leles CR., Hollanda ACB., Moura MS., Pécora JD. Prevalence and risk factors of apical periodontitis in endodontically treated teeth in a selected population of Brazilian adults. Braz. Dent. J. 19: 34–39, 2008.
• Bierenkrant DE., Parashos P., Messer HH. The technical quality of nonsurgical root canal treatment performed by a selected cohort of Australian endodontists. Int. Endod. J. 41: 561– 570, 2008.
• Balto H., Al Khalifah SH., Al Mugairin S., Al Deeb M., Al-Madi E. Technical quality of root fillings performed by undergraduate students in Saudi Arabia. Int. Endod. J. 43: 292–300, 2010.
• Nicopoulou-Karayianni K., Bragger U., Patrikiou A., Stassinakis A., Lang NP. Image processing for enhanced observer agreement in the evaluation of periapical bone changes. Int. Endod. J. 35: 615–622, 2002.
• Saunders MB., Gulabivala K., Holt R., Kahan RS. Reliability of radiographic observations recorded on a proforma measured using inter- and intraobserver variation: A preliminary study. Int. Endod. J. 33: 272–278, 2000.
• Eckerbom M., Andersson JE., Magnusson T. Interobserver variation in radiographic evaluation of endodontic variables. Endod. Dent. Traumatol. 2: 243–246, 1986.
• Keçeci AD., Kaya BÜ., Ünal GÇ., Taç G. Periapikal durumun değerlendirilmesinde gözlemciler arası uyumsuzluğa neden olan vakalar. S.D.Ü. Tıp Fak. Derg. 13: 16–21, 2006.
• Ørstavik D., Kerekes K., Eriksen HM. The periapical index: A scoring system for radiographic assessment of apical periodontitis. Endod. Dent. Traumatol. 2: 20–34, 1986.
• Landis JR., Koch GG. The measurement of observer agreement for categorical data. Biometrics 33: 159–174, 1977.
• Al-Omari MA., Hazaa A., Haddad F. Frequency and distribution of root filled teeth and apical periodontitis in a Jordanian subpopulation. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. 111: e59-65, 2011.
• De Moor RJ., Hommez GM., De Boever JG., Delmé KI., Martens GE. Periapical health related to the quality of root canal treatment in a Belgian population. Int. Endod. J. 33: 113–120, 2000.
• Helminen SE., Vehkalahti M., Kerosuo E., Murtomaa H. Quality evaluation of process of root canal treatments performed on young adults in Finnish public oral health service. J. Dent. 28: 227–232, 2000.
• Kirkevang LL., Hörsted-Bindslev P., Orstavik D., Wenzel A. A comparison of the quality of root canal treatment in two Danish subpopulations examined 1974-75 and 1997-98. Int. Endod. J. 34: 607–612, 2001.
• Lupi-Pegurier L., Bertrand MF., Muller-Bolla M., Rocca JP., Bolla M. Periapical status, prevalence and quality of endodontic treatment in an adult French population. Int. Endod. J. 35: 690–697, 2002.
• Yılmaz Z., Görduysus MÖ. Endodontik tedavilerin kalitesi ile periapikal durum arasındaki ilişkinin periapikal indeks skorlama (PAI) yöntemi ile değerlendirilmesi. Hacettepe Dişhekimliği Fakültesi Dergisi. 1: 96–104, 2007.
• Quality guidelines for endodontic treatment: consensus report of the European Society of Endodontology. Int. Endod. J. 39: 921–930, 2006.
• Barrieshi-Nusair KM., Al-Omari MA., Al-Hiyasat AS. Radiographic technical quality of root canal treatment performed by dental students at the Dental Teaching Center in Jordan. J. Dent. 32: 301–307, 2004.
• Santos SM., Soares JA., César CA., Brito-Jşnior M., Moreira AN., Magalhães CS. Radiographic quality of root canal fillings performed in a postgraduate program in endodontics. Braz. Dent. J. 21: 315–21, 2010.
• Santos SM., Soares JA., Costa GM., Brito- Jşnior M., Moreira AN., de Magalhães CS. Radiographic parameters of quality of root canal fillings and periapical status: A retrospective cohort study. J. Endod. 36: 1932-1937, 2010.
• Rafeek RN., Smith WA., Mankee MS., Coldero L.G. Radiographic evaluation of the technical quality of root canal fillings performed by dental students. Aust. Endod. J. 38: 64–69, 2012.
• Eriksen HM., Bjertness E. Prevalence of apical periodontitis and results of endodontic treatment in middle-aged adults in Norway. Endod. Dent. Traumatol. 7: 1–4, 1991.
• Ng YL., Mann V., Rahbaran S., Lewsey J., Gulabivala K. Outcome of primary root canal treatment: Systematic review of the literature - part 1. Effects of study characteristics on probability of success. Int. Endod. J. 40: 921–39, 2007.
• Da Silva K., Lam JM., Wu N., Duckmanton P. Cross-sectional study of endodontic treatment in an Australian population. Aust. Endod. J. 35: 140–146, 2009.