Periapikal durumun değerlendirilmesinde gözlemciler arası uyumsuzluğa neden olan vakalar

Year 2006, Volume: 13 Issue: 4, 16 - 21, 29.04.2009

Ayşe Keçeci Bulem Kaya Gül Çelik Ünal Gürhan Taç

Abstract

SüleymanDemirel Üniversitesi
TIP FAKÜLTESİ DERGİSİ: 2006 Aralık; 13(4)



Periapikal durumun değerlendirilmesinde gözlemciler arası

uyumsuzluğa neden olan vakalar


Ayşe Diljin Keçeci, Bulem Üreyen Kaya, Gül Çelik Ünal, Gürhan Taç



Özet


Amaç: Bu çalışmanın amacı, periapikal indeks (PAI) skorlama sistemi kullanılarak periapikal durumun radyografik olarak değerlendirildiği seçilmiş örneklem grubunda, gözlemciler arası uyumun sağlanamadığı ve kararsız kalınan vakaların insidansı ve etiyolojisinin saptanmasıdır. Gereç ve Yöntem: 405 dişe ait 750 kökün değerlendirildiği uzlaşma çalışmasına ait radyografilerde apikal durumun değerlendirilmesinde ortaya çıkan problemler nedeni ile en az bir gözlemcinin farklı skorladığı periapikal radyografiler yeniden değerlendirildi. Gözlemciler arası uyumsuzluğa yol açan nedenler: a) anatomik oluşumlar, b) periodontal ligament boşluğu, c) mineral kaybının görüntülenmesini etkileyen trabeküler yapı ve d) kemik iliği boşlukları olarak sınıflandırılmıştır. Bulgular: Çalışmada, 45 dişe (%9,83) ait 54 kök (%6,89).te gözlemciler arası uyumsuzluk ortaya çıktı. Gözlemciler arası uyumsuzluk sebeplerin dağılımı şu şekildedir: 9 adedi (15,52%) anatomik oluşumlar, 6 adedi (10,34 %) periodontal ligament boşluğu, 33 adedi (56,90%) trabeküler yapı ve 10 adedi (17,24%) kemik iliği boşlukları. Sonuç: Apikal bölgenin farklı morfolojisi ve çevre kemiğin yoğunluğundaki farklılıklar değerlendirmeyi zorlaştırmıştır. Kararsız kalınan zor vakalar, radyografik uzlaşmada belirsizliği göstermektedir. Bu tip vakalarda, ancak etrafındaki komşu yapıların dikkatlice değerlendirilmesinden sonra bir karara varılabilir.


Anahtar kelimeler: gözlemciler arası uyumsuzluk, periapikal, radyograf











Abstract







Disagreement cases caused interobserver variations during evaluation of periapical status







Aim: The aim of this study is to determine the etiology and incidence of the disagreement and borderline cases selected for the radiographic evaluation of periapical status using the periapical index (PAI) scoring system. Material and Method: Borderline cases in the agreement study of evaluation of 405 teeth with 750 roots, which had been given different score at least by one observer were re-evaluated. The reasons of disagreement cases were classified as: a) anatomical landmarks b) periodontal ligament space c) trabecular pattern affecting the view of mineral loss d) bone marrow spaces. Results: Fourty-five disagreement cases (%9,83) with 54 root (%6,89) were observed. The distribution of observer variations according to their reasons were as follows: 9 (15,52%) anatomical landmarks, 6 (10,34 %) periodontal ligament space, 33 (56,90%) trabecular pattern affecting the view of mineral loss, 10 (17,24%) bone marrow spaces. Then, the joint discussion resulted in an agreement for all the cases. Conclusion: The varying morphology of apical areas and varying density of surrounding bone present a number of challenges. Difficult borderline cases illustrate the uncertainty involved in radiographical consensus. In such cases the decision can only be made after careful analysis of surrounding tissues of the apex.







Key words: interobserver variations, periapical, radiograph

Keywords

gözlemciler arasý uyumsuzluk, periapikal, radyograf

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