title: An Evaluation of Inter- and Intraobserver Reliability of Cone-beam Computed Tomography- and Two Dimensional-based Interpretations of Maxillary Canine Impactions using a Panel of Orthodontically Trained Observers.
abstract: To assess intra- and interobserver agreement when evaluating maxillary impacted canines using cone beam computed tomography (CBCT) and two-dimensional (2D) images through a panel of orthodontically trained observers.
  
  
  
  An adult skull with permanent dentition was employed to perform 15 simulated maxillary canine impactions. Two sets of 2D and three-dimensional (3D) radiographic images were acquired. A panel of assessors including 11 PhD and MSc postgraduate orthodontic students evaluated maxillary impacted canines using a standard questionnaire with 11 categorical variables. Kappa (K) statistics as well as Krippendorff's alpha (α) coefficients were used for the analysis of reliability.
  
  
  
  A high level of intraobserver agreement was found for both the CBCT- and 2D-based interpretations. The 11 observers demonstrated a higher interobserver agreement for the CBCT-based interpretations than that of the 2D-based interpretations (α = 0.68 and 0.38 respectively). The employed 3D classifications canines was found to be reliable among observers on CBCT images for the labiopalatal position (K = 0.87), mesiodistal position, vertical position, labiopalatal inclination and mesiodistal inclination (α = 0.95, 0.83, 0.84 and 0.92 respectively). The 2D-based interpretations were not in agreement among the 11 observers, except for the mesiodistal position (α = 0.88) and mesiodistal inclination (α = 0.88).
  
  
  
  The intraobserver agreement was high for both the 2D- and the CBCT-based interpretations. The interobserver agreement for the CBCT-based interpretations was remarkably higher than that of the 2D-based interpretations. The utilized CBCT-based 3D classifications for the location and inclination of maxillary impacted canines were found reliable among observers.
authors.affiliation: Department of Orthodontics, University of Damascus, Dental School, Damascus, Syria.
authors.forename: Hala K
authors.initials: HK
authors.lastname: Al-Homsi
authors.affiliation: Associate Professor, Department of Orthodontics, University of Damascus, Dental School, Damascus, Syria, Phone: 00963113141343 e-mail: myhajeer@gmail.com.
authors.forename: Mohammad Y
authors.initials: MY
authors.lastname: Hajeer
mesh_terms: D000328:Adult; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D003815:Dentists; D019229:Dentition, Permanent; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007180:Incisor / Q000000981:diagnostic imaging*; D008437:Maxilla / Q000000981:diagnostic imaging* / Q000601:surgery; D015588:Observer Variation; D011862:Radiography, Panoramic; D015203:Reproducibility of Results; D014095:Tooth, Impacted / Q000000981:diagnostic imaging* / Q000601:surgery
keywords: Interobserver reliability; Intraobserver reliability; Labiopalatal inclination; Labiopalatal position; Mesiodistal inclination; Mesiodistal position; Proximity; Resorption; Treatment plan; Vertical position