School of Health and Life Sciences, Post-Graduate Program in Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.
Department of Conservative Dentistry, School of Dentistry, Rio Grande do Sul Federal University, Porto Alegre, Brazil.
Int Endod J. 2024 Dec;57(12):1848-1857. doi: 10.1111/iej.14142. Epub 2024 Sep 10.
To evaluate the agreement between six currently available periapical radiography-based methods for measuring the root canal curvatures in mesial roots of mandibular first molars, assessed by two examiners with different proficiency levels.
Non-endodontically treated mesial roots of 41 human mandibular first molars were radiographed using the parallelling technique. Two independent observers (a specialist in endodontics and radiology and a final-year dental student) assessed their root canal curvature using the methodologies described by Schneider (1971, Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 32, 271), Weine (1982, Endodontic therapy), Berbert and Nishiyama (1994, Revista Gaúcha de Odontología, 356), Luiten et al. (1995, Journal of Endodontics, 21, 26), Hankins and ElDeeb (1996, Journal of Endodontics, 22, 123) and Pettiette et al. (1999, Journal of Endodontics, 25, 230). Intra- and inter-examiner reliability was assessed using the intraclass correlation coefficient. The differences in curvature angle measured by the different methods were compared using the one-way anova for repeated measures test, followed by Tukey's post hoc analysis. The effect was calculated using the Cohen's d method. To determine the agreement between methods, the Bland-Altman analysis was used. The significance level was set at 5%.
Agreement for the observers was excellent (>0.81) for the six methods considered. For the angle comparisons between methods, the maximum differences were for Schneider versus Weine (35.77°) and Luiten versus Hankins (35.14°), whilst the highest percentage of angles with a difference >10° were Weine versus Luiten and Berbert versus Pettiette (90%) and the comparison Weine versus Hankins presented with the lowest frequency (15%). Excellent agreement was found for five comparisons: Weine versus Luiten (0.940), Berbert versus Pettiette (0.917), Weine versus Pettiette (0.907), Luiten versus Pettiette (0.904) and Berbert versus Luiten (0.812). Compared to Schneider's method, the other methods showed a tendency of increasing difference as the angles became more acute. The other methods exhibited linear differences, remaining constant for smaller and larger angles.
Reliability was excellent for all methods assessed separately. Maximum differences in curvature angles were found when comparing Schneider versus Weine and Luiten versus Hankins. Excellent agreement was found for Weine versus Luiten, Berbert versus Pettiette, Weine versus Pettiette, Luiten versus Pettiette and Berbert versus Luiten. In the presence of dilacerations, the method by Schneider was less sensitive.
评估六位当前可用的基于根尖射线照相术的方法在评估两名不同熟练程度的检查者测量下颌第一磨牙近中根根管曲率的一致性。
使用平行技术对 41 个人类下颌第一磨牙的非牙髓治疗近中根进行射线照相。两名独立的观察者（牙髓病学和放射学专家和牙科学最后一年的学生）使用 Schneider（1971，口腔外科学，口腔医学，口腔病理学和口腔放射学，32，271）、Weine（1982，牙髓治疗）、Berbert 和 Nishiyama（1994，Revista Gaúcha de Odontologia，356）、Luiten 等人描述的方法（1995，牙髓学杂志，21，26）、Hankins 和 ElDeeb（1996，牙髓学杂志，22，123）和 Pettiette 等人（1999，牙髓学杂志，25，230）评估其根管曲率。使用组内相关系数评估检查者内部和检查者之间的可靠性。使用重复测量方差分析比较不同方法测量的曲率角度的差异，然后使用 Tukey 的事后分析。使用 Cohen 的 d 方法计算效果。为了确定方法之间的一致性，使用 Bland-Altman 分析。显著性水平设为 5%。
对于考虑的六种方法，观察者的一致性极好（>0.81）。对于方法之间的角度比较，最大差异为 Schneider 与 Weine（35.77°）和 Luiten 与 Hankins（35.14°），而差异>10°的角度比例最高的是 Weine 与 Luiten 和 Berbert 与 Pettiette（90%），而 Weine 与 Hankins 的比较显示出最低的频率（15%）。在五种比较中发现了极好的一致性：Weine 与 Luiten（0.940）、Berbert 与 Pettiette（0.917）、Weine 与 Pettiette（0.907）、Luiten 与 Pettiette（0.904）和 Berbert 与 Luiten（0.812）。与 Schneider 方法相比，其他方法随着角度变得更陡峭而显示出差异增大的趋势。其他方法表现出线性差异，对于较小和较大的角度保持不变。
所有单独评估的方法都具有极好的可靠性。在比较 Schneider 与 Weine 和 Luiten 与 Hankins 时，发现曲率角度的最大差异。在 Weine 与 Luiten、Berbert 与 Pettiette、Weine 与 Pettiette、Luiten 与 Pettiette 和 Berbert 与 Luiten 之间发现了极好的一致性。在存在扭曲的情况下，Schneider 方法的敏感性较低。
