Dhanjal K S, Bhardwaj M K, Liversidge H M
Paediatric Dentistry, Dental Institute, Barts and The London School of Medicine and Dentistry, Turner Street, London E1 2AD, United Kingdom.
Forensic Sci Int. 2006 May 15;159 Suppl 1:S74-7. doi: 10.1016/j.forsciint.2006.02.020. Epub 2006 Mar 10.
The aim of this study was to determine intra- and inter-observer variability of the developing third molar from panoramic radiographs. Formation of third molars was assessed according to stages described by modified Demirjian et al.'s methods: Moorrees et al. [C.F.A. Moorrees, E.A. Fanning, E.E. Hunt, Age variation of formation stages for ten permanent teeth, J. Dent. Res. 42 (1963) 1490-1502] and Solari and Abramovitch [A.C. Solari, K. Abramovitch, The accuracy and precision of third molar development as an indicator of chronological age in Hispanics, J. Forensic Sci. 47 (2002) 531-535]; in addition, data were also analysed unmodified, i.e. Haavikko [K. Haavikko, The formation and alveolar and clinical eruption of the permanent teeth, an orthopantomograph study, Proc. Finn. Dent. Soc. 66 (1970) 104-170] and Demirjian et al. [A. Demirjian, H. Goldstein, J.M. Tanner, A new system of dental age assessment, Hum. Biol. 45 (1973) 211-227]. The sample was a random selection of 73 panoramic radiographs from patients aged 8-24 years. After training, the left maxillary and mandibular third molars were scored on two separate occasions without knowledge of previous scores. Cohen's Kappa and percentage agreement were calculated for each method, for maxillary, for mandibular third molars and combined. Percentage agreement for stages was also calculated. Intra-observer agreement was greater for mandibular third molars compared to maxillary third molars, and better for methods with fewer stages. Kappa values indicated good agreement for most methods; the best was Demirjian et al.'s method for mandibular third molar with very good agreement (K = 0.80) for the first author, good agreement for the second author (K = 0.75) and good agreement between observers (K = 0.75). The stages with best agreement were Demirjian's stage E [A. Demirjian, H. Goldstein, J.M. Tanner, A new system of dental age assessment, Hum. Biol. 45 (1973) 211-227] and Moorrees et al.'s stage Cc and R1/4 [C.F.A. Moorrees, E.A. Fanning, E.E. Hunt, Age variation of formation stages for ten permanent teeth, J. Dent. Res. 42 (1963) 1490-1502].
Having clearly defined stages and fewer stages allowed better reproducibility of third molar formation.
本研究的目的是确定全景X线片上正在发育的第三磨牙的观察者内和观察者间的变异性。根据改良的德米尔坚等人的方法（穆里斯等人[C.F.A.穆里斯、E.A.范宁、E.E.亨特，十颗恒牙形成阶段的年龄变化，《牙科研究杂志》42（1963）1490 - 1502]以及索拉里和阿布拉莫维奇[A.C.索拉里、K.阿布拉莫维奇，第三磨牙发育作为西班牙裔人实际年龄指标的准确性和精确性，《法医学杂志》47（2002）531 - 535]）评估第三磨牙的形成；此外，数据也未做修改进行了分析，即哈维科[K.哈维科，恒牙的形成、牙槽及临床萌出，全景X线片研究，《芬兰牙科协会学报》66（1970）104 - 170]和德米尔坚等人[A.德米尔坚、H.戈尔茨坦、J.M.坦纳，一种新的牙龄评估系统，《人类生物学》45（1973）211 - 227]的方法。样本是从8 - 24岁患者中随机选取的73张全景X线片。经过培训后，在不知道先前评分的情况下，对左侧上颌和下颌第三磨牙分两次进行评分。计算了每种方法、上颌、下颌第三磨牙以及综合情况的科恩卡方值和百分比一致性。还计算了各阶段的百分比一致性。与上颌第三磨牙相比，下颌第三磨牙的观察者内一致性更高，且阶段较少的方法一致性更好。卡方值表明大多数方法具有良好的一致性；对于下颌第三磨牙，德米尔坚等人的方法最佳，第一作者的一致性非常好（K = 0.80），第二作者的一致性良好（K = 0.75），观察者之间的一致性也良好（K = 0.75）。一致性最好的阶段是德米尔坚的E阶段[A.德米尔坚、H.戈尔茨坦、J.M.坦纳，一种新的牙龄评估系统，《人类生物学》45（1973）211 - 227]以及穆里斯等人的Cc阶段和R1/4阶段[C.F.A.穆里斯、E.A.范宁、E.E.亨特，十颗恒牙形成阶段的年龄变化，《牙科研究杂志》42（1963）1490 - 1502]。
具有明确界定的阶段且阶段较少可使第三磨牙形成的可重复性更好。
