Interference of partial visual analysis of root filling quality and apical status on retreatment decisions.
OBJECTIVE
The presence of periapical radiolucency has been used as a criterion for endodontic treatment failure. However, in addition to the inherent limitations of radiographic examinations, radiographic interpretations are extremely subjective. Thus, this study investigated the effect of partial analysis of root filling quality and periapical status on retreatment decisions by general dentists.


METHODS
Twelve digitalized periapical radiographs were analyzed by 10 observers. The study was conducted at three time points at 1-week intervals. Radiographs edited with the Adobe Photoshop CS4 software were analyzed at three time points: first, only root filling quality was analyzed; second, only the periapical areas of the teeth under study were visualized; finally, observers analyzed the unedited radiographic image. Spearman's coefficient was used to analyze the correlations between the scores assigned when the periapical area was not visible and when the unedited radiograph was analyzed, as well as between the scores assigned when root fillings where not visible and when the unedited radiograph was analyzed. Sensitivity, specificity, positive and negative predictive values between partial images and unedited radiographs were also used to analyze retreatment decisions. The level of significance was set at 5%.


RESULTS
The visualization of the root filling on the unedited radiograph affected the interpretation of the periapical status and the technical quality of the fillings has a greater influence on the general dentist's decision to prescribe endodontic retreatment than the periapical condition.


CONCLUSIONS
In order to make endodontic diagnosis, radiographic interpretation process should not only emphasize technical aspects, but also consider biological factors.
Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil. remorgental@hotmail.com
Renata Dornelles
RD
Morgental
Régis Burmeister dos
RB
Santos
Cassiano Kuchenbecker
CK
Rösing
Taís do Amaral
Tdo A
Chanin
José Antônio Poli de
JA
Figueiredo
D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D015588:Observer Variation; D010483:Periapical Diseases / Q000000981:diagnostic imaging* / Q000628:therapy*; D011861:Radiography, Dental; D012016:Reference Values; D019233:Retreatment; D012389:Root Canal Obturation; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D019227:Tooth Apex / Q000000981:diagnostic imaging*; D017211:Treatment Failure