Department of Orthodontics, School of Dentistry, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen Str. 50, Witten, 58448, Germany.
Private Practice, Kleve, Germany.
BMC Oral Health. 2024 Mar 22;24(1):373. doi: 10.1186/s12903-024-04163-3.
Assessment of midpalatal suture maturation on cone-beam computed tomography (CBCT) scans is performed by visual inspection and is therefore subjective. The extent to which the assessment of midpalatal suture maturation is affected by rater experience has not been adequately explored in the existing literature, thus limiting the availability of evidence-based findings. This study compared the outcomes of classification by dental students, orthodontic residents, and orthodontists.
Three different groups of students, orthodontic residents, and orthodontists evaluated 10 randomly chosen CBCT scans regarding midpalatal suture maturation from a pool of 179 patients (98 female and 81 male patients) aged 8 - 40 years which were previously classified by evaluating CBCT scans. The pool was set as benchmark utilizing midpalatal suture maturation classification by one examiner (OsiriX Lite version 11.0; Pixmeo SARL, Bernex, Switzerland). For assessment of intra-rater reliability of the examiners of each group the randomly chosen subjects were reclassified for midpalatal suture maturation after a wash-out period of two weeks by using the same software. Statistical analysis was performed to evaluate intra- and interrater reliability of the three groups with differing experience level.
Groupwise intra-rater reliability assessment between the classification and reclassification was weak for examiners with a low level of experience (k = 0.59). Orthodontists had highest degree of agreement with regard to benchmark classification with an inter-rater reliability to be considered as moderate (k = 0.68).
Assessment of midpalatal suture maturation on CBCT scans appears to be a subjective process and is considerably related to the experience level of the examiner. A high level of clinical experience seems to be favorable but does not necessarily ensure accurate results.
在锥形束计算机断层扫描（CBCT）扫描上评估正中骀缝成熟度是通过肉眼观察进行的，因此具有主观性。在现有文献中，尚未充分探讨评估正中骀缝成熟度受评估者经验影响的程度，这限制了基于证据的发现的可用性。本研究比较了牙科学学生、正畸住院医师和正畸医生的分类结果。
从 179 名 8 至 40 岁的患者（98 名女性和 81 名男性）的 CBCT 扫描中，随机选择了 10 个 CBCT 扫描，分为三个不同组的学生、正畸住院医师和正畸医生，评估正中骀缝成熟度。评估者将 179 名患者的正中骀缝成熟度进行分类，以此作为评估基准。为评估每个组评估者的内部可靠性，在两周的洗脱期后，使用相同的软件重新对随机选择的患者进行正中骀缝成熟度分类。使用统计学方法评估具有不同经验水平的三组评估者的内部和组间可靠性。
经验水平较低的评估者（k=0.59），分类和再分类的组内可靠性评估为弱。正畸医生在基准分类方面具有最高的一致性，被认为具有中度的组间可靠性（k=0.68）。
在 CBCT 扫描上评估正中骀缝成熟度似乎是一个主观的过程，并且与评估者的经验水平密切相关。高水平的临床经验似乎是有利的，但不一定能确保准确的结果。
