title: Influence of clinical experience on the radiographic determination of endodontic working length.
abstract: OBJECTIVE
  To determine the influence of clinical experience on the accuracy and consistency of estimation of radiographic working length (WL) for the root canal treatment of single-rooted teeth.
  
  
  METHODS
  Forty conventional WL periapical radiographs that included variations in file length were selected. They were digitally scanned and arranged in PowerPoint presentations on CDs. These were distributed to three assessor groups; fourth-year undergraduates at two stages of training (Groups 1 and 2) and endodontic postgraduates (Group 3). Participants were asked to determine the adjustment needed in millimetres to position the file tip at the correct WL for each image. A gold standard file position was provided by three experienced endodontists. For inter-group comparison of scores, the Kruskal-Wallis, ANOVA and post hoc Bonferroni tests were used. Evaluation of intra-examiner consistency was with the Kappa test. To evaluate intra-group consistency, the Wilcoxon signed rank test was used to compare the frequency of weighted correct scorings.
  
  
  RESULTS
  File adjustments of Group 3 were significantly more accurate than those of Group 1 (P = 0.006). The scores of Group 3 were also better than those of Group 2, although the difference was not significant. When the scores of the undergraduate groups were compared, the difference was not statistically significant. The consistency of the groups was not affected by a 2-week pause between assessments, and no definite pattern could be detected across any of the groups with the Kappa test.
  
  
  CONCLUSIONS
  Clinical experience after graduation influenced the accuracy of estimating the adjustments needed for correct radiographic WL of single-rooted teeth. The most experienced group was significantly more accurate than the other groups.
authors.affiliation: Division of Endodontics, Department of Conservative Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: O S
authors.initials: OS
authors.lastname: Alothmani
authors.forename: L T
authors.initials: LT
authors.lastname: Friedlander
authors.forename: B D
authors.initials: BD
authors.lastname: Monteith
authors.forename: N P
authors.initials: NP
authors.lastname: Chandler
mesh_terms: D001641:Bicuspid / Q000000981:diagnostic imaging; D002983:Clinical Competence; D003481:Cuspid / Q000000981:diagnostic imaging; D003786:Dental Pulp Cavity / Q000000981:diagnostic imaging*; D004497:Education, Dental; D004499:Education, Dental, Graduate; D004708:Endodontics / Q000193:education; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007180:Incisor / Q000000981:diagnostic imaging; D015588:Observer Variation; D016300:Radiography, Bitewing / Q000379:methods*; D019252:Radiography, Dental, Digital / Q000379:methods; D018915:Root Canal Preparation / Q000295:instrumentation / Q000379:methods*; D013335:Students, Dental