Department of Endodontology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Dental Medicine, Division of Periodontology, Karolinska Institutet, Huddinge, Sweden.
Acta Odontol Scand. 2021 Oct;79(7):554-561. doi: 10.1080/00016357.2021.1910728. Epub 2021 Jun 2.
To determine whether calibration improves observer reliability when assessing DMFT-score, root-filled teeth and periapical lesions on panoramic radiographs.
A sample of 100 panoramic radiographs was selected from a cohort of myocardial infarction patients ( = 797) and matched controls ( = 796). The following variables were assessed: DMFT-score, remaining teeth, root-filled teeth and periapical lesions. Two specialists, an endodontist and a radiologist, served as reference examiners and undertook two separate assessments. Disagreement cases were jointly assessed and the final results were used as the reference standard. Three observers undertook three separate assessments, the first without prior training, the second after calibration against the reference standard and the third with the sample concealed in the complete material. Statistical analysis was made with Wilcoxon Signed rank test and Sign test. Agreement was calculated as Intraclass Correlation Coefficient (ICC) (95% CI) and Weighted Kappa () (95% CI).
Periapical lesions disclosed high inter-observer variability for the reference examiners and diverged significantly between the observers and the reference standard. For the reference examiners, inter-observer agreement was = 0.53. The observers, in their first assessments had values ranging from 0.22 to 0.60 in relation to the reference standard. Following calibration, the values increased, ranging from 0.59 to 0.80. For the third assessment, the values ranged from 0.54 to 0.75. DMFT-score, remaining teeth and root-filled teeth disclosed high reliability throughout all assessments (ICC = 0.88-0.98 and = 0.98-0.99).
DMFT-score, remaining teeth and root-filled teeth can be reliably assessed on panoramic radiographs. Calibration against a reference standard improves observer reliability in the detection of periapical lesions.
确定在评估全景片上的 DMFT 评分、根管治疗牙和根尖病变时，校准是否能提高观察者的可靠性。
从心肌梗死患者队列（n=797）和匹配对照者队列（n=796）中选择了 100 张全景片样本。评估了以下变量：DMFT 评分、余留牙、根管治疗牙和根尖病变。两位专家，一位牙髓病专家和一位放射科医生，作为参考检查者进行了两次独立的评估。意见不一致的病例进行了联合评估，最终结果作为参考标准。三位观察者进行了三次独立的评估，第一次是在没有事先培训的情况下进行的，第二次是在根据参考标准进行校准后进行的，第三次是在将样本隐藏在完整的材料中的情况下进行的。使用 Wilcoxon 符号秩检验和 Sign 检验进行统计学分析。采用组内相关系数（ICC）（95%CI）和加权 Kappa（）（95%CI）计算一致性。
参考检查者的根尖病变显示出较高的观察者间变异性，并且观察者与参考标准之间存在显著差异。对于参考检查者，观察者间的一致性为 = 0.53。观察者在第一次评估时与参考标准的 值范围为 0.22 至 0.60。经过校准后， 值增加到 0.59 至 0.80。第三次评估时， 值范围为 0.54 至 0.75。DMFT 评分、余留牙和根管治疗牙在所有评估中均显示出较高的可靠性（ICC=0.88-0.98， = 0.98-0.99）。
DMFT 评分、余留牙和根管治疗牙可在全景片上可靠地评估。通过与参考标准进行校准可以提高观察者在检测根尖病变时的可靠性。
