Long-term reliability and observer comparisons in the radiographic diagnosis of periapical disease.
OBJECTIVE
The aim of this study was to evaluate and compare the long-term diagnostic consistency of two examiners, an endodontist and a radiologist, and to make comparisons with findings recorded by an observer with more recent scientific and clinical experience in endodontics.


METHODS
Three groups, each consisting of 20 full mouth series of intraoral radiographs, with 79, 93 and 85 endodontically-treated roots, respectively, were successively evaluated for periapical disease. Evaluations were at first performed separately by the three observers. Disagreement and difficult, borderline cases were subjected to joint evaluation. Intra- and interexaminer comparisons were made. For two of the observers the observations were compared with findings recorded several years before for the same cases in the same radiographs.


RESULTS
The intra- and interobserver long-term reliability of the two original examiners resulted in 83% overall agreement, the kappa values were 0.54, 0.57 and 0.53. Comparisons between all three observers disclosed 82%, 85% and 86% agreement and kappa values 0.55, 0.58 and 0.60. The joint evaluations and decisions did not indicate a dominating influence from any of the observers.


CONCLUSIONS
The long-term reliability of the two original observers was judged as being satisfactory. All three observers judged the overall disease status of the material in the same way. The joint discussions of selected cases might reduce observer variation to an acceptable level, avoid a number of false recordings and increase the reliability and validity of the findings.
Molven
O
O
Department of Odontology, School of Dentistry, University of Bergen, Arstadveien 17, N-5009 Bergen, Norway..
Halse
A
A
Fristad
Inge
I
D006801:Humans; D015588:Observer Variation; D010483:Periapical Diseases / Q000000981:diagnostic imaging*; D011859:Radiography; D015203:Reproducibility of Results; D019553:Tooth, Nonvital / Q000000981:diagnostic imaging