title: Periodontal probing versus radiographs for the diagnosis of furcation involvement.
abstract: BACKGROUND
  Decisions in periodontal therapy for multirooted teeth are essentially based on accurate diagnosis of the furcation involvement (FI). Furcation probing (FP) is still the basic diagnostic measure, although the assessment may be difficult. The aim of this study is to evaluate the validity of FP and radiographic assessment of FI compared with visual assessment during open flap surgery (OFS).
  
  
  METHODS
  In this retrospective clinical cohort study, 215 participants with periodontal disease and at least one molar treated with OFS were enrolled, and a total of 834 molars were assigned for FI by FP and in radiographs analyzed by an experienced (EE) and less experienced examiner (LE). For the investigation, 143 panoramic radiographs (OPGs) and 77 intra-oral radiographs (I-Os) were evaluated.
  
  
  RESULTS
  The Class of FI by FP was confirmed in 56%, whereas 15% were overestimated and 29% underestimated. FI Class 0 and I had been detected with high probability (74% and 54%, respectively). Of all FI Class III, 57% were detected correctly by radiographs and 32% by FP. FP and OFS revealed a weighted κ-coefficient (κw) = 0.588; radiographs and OFS had κw = 0.542 (OPG κw = 0.555 and I-O κw = 0.521). The interrater reliability for radiographs was dependent on the experience of the examiner (EE κw = 0.618; LE κw = 0.426).
  
  
  CONCLUSIONS
  Experience in analyzing conventional radiographs increases the potential of correct diagnosis of advanced FI. The reliability of FP compared with radiographic assessment depends on the anatomy and location of the tooth. Both diagnostic tools should be used in cases of suspected FI.
authors.affiliation: Clinic of Conservative Dentistry and Periodontology, Christian-Albrechts-University of Kiel, Kiel, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Graetz
authors.forename: Anna
authors.initials: A
authors.lastname: Plaumann
authors.forename: Jan-Frederik
authors.initials: JF
authors.lastname: Wiebe
authors.forename: Claudia
authors.initials: C
authors.lastname: Springer
authors.forename: Sonja
authors.initials: S
authors.lastname: Sälzer
authors.forename: Christof E
authors.initials: CE
authors.lastname: Dörfer
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D017823:Furcation Defects / Q000145:classification / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008963:Molar / Q000000981:diagnostic imaging / Q000473:pathology; D010517:Periodontics / Q000295:instrumentation; D010808:Physical Examination / Q000706:statistics & numerical data; D016300:Radiography, Bitewing / Q000706:statistics & numerical data; D011862:Radiography, Panoramic / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012189:Retrospective Studies; D055815:Young Adult
keywords: Alveolar bone loss; diagnosis; diagnostic errors; furcation defects; periodontal attachment loss; radiology; x-rays