Schropp Lars, Kirkevang Lise-Lotte
Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.
Department of Endodontics, School of Dentistry, University of Oslo, Oslo, Norway.
Eur Endod J. 2020 Jun 11;2(1):1-5. doi: 10.14744/eej.2017.17014. eCollection 2017.
This study aimed to evaluate the accuracy and reliability of periapical radiographs obtained with two different projections in determining the cleanliness of root canals in endodontic retreatment using the sectioned roots as a gold standard.
The amount of residual root-filling material after endodontic retreatment procedures in 42 roots was assessed in radiographs and in microscopic photographs of the sectioned roots by five observers. Furthermore, the cleanliness of 80 roots was assessed based on orthogonal and mesio-angulated radiographs. Four parameters were used for the evaluation of cleanliness. Wilcoxon signed-rank tests and percentage agreement calculations were used for comparisons between the radiographs and the gold-standard observations and between the orthogonal and mesio-angulated radiographs, respectively. Intra- and interobserver reproducibility was tested using Kappa statistics and intra-class correlation tests. The statistically significance level was 0.05.
In general, significantly more residual root-filling material was detected in the photographs of the split roots (gold standard) than in the radiographs. Comparing orthogonal and eccentric projections, only slight differences in cleanliness were found. The intraobserver reproducibility was fair to almost perfect for radiographs and microscopic photographs. For all parameters, the reproducibility was better for the radiographs than for the microscopic photographs. The interobserver variability ranged from fair to almost perfect agreement for the radiographs.
The accuracy of periapical radiographs was poor in determining the cleanliness of root canals after endodontic retreatment, whereas the reliability of the radiographs was fair. A mesio-angulated projection did not contribute essentially to the detection of residual root-filling materials.
本研究旨在以根管切开后的牙根作为金标准，评估两种不同投照方式获取的根尖片在确定根管再治疗中根管清洁度方面的准确性和可靠性。
5名观察者通过根尖片和根管切开后的牙根显微照片评估42颗牙根根管再治疗后的残余根充材料量。此外，基于正交投照和近中角投照的根尖片评估80颗牙根的清洁度。使用4个参数评估清洁度。分别采用Wilcoxon符号秩检验和百分比一致性计算来比较根尖片与金标准观察结果之间以及正交投照和近中角投照根尖片之间的差异。使用Kappa统计量和组内相关检验来测试观察者内和观察者间的可重复性。统计学显著性水平为0.05。
总体而言，在根管切开后的牙根照片（金标准）中检测到的残余根充材料明显多于根尖片。比较正交投照和偏心投照，仅发现清洁度有轻微差异。观察者内对根尖片和显微照片的可重复性从尚可到几乎完美。对于所有参数，根尖片的可重复性优于显微照片。观察者间对根尖片的一致性范围从尚可到几乎完美。
根尖片在确定根管再治疗后根管清洁度方面准确性较差，而根尖片的可靠性尚可。近中角投照对检测残余根充材料没有实质性帮助。
