Coronal and Intraradicular Appearances Affect Radiographic Perception of the Periapical Region.
BACKGROUND
The influence of the radiographic appearances of the coronal and intraradicular areas on periapical radiographic interpretation has been minimally evaluated in dentistry and endodontics. The purpose of this study was to evaluate the effects that the coronal and intraradicular radiographic appearance has on endodontists' radiographic interpretations of periapical areas.


METHODS
In a split-group study design using an online survey format, 2 pairs of digital periapical radiographic images were evaluated by 2 groups (A and B) of endodontist readers for the presence of a periapical finding. The images in each pair were identical except that 1 image of each image pairs had coronal restorations and/or root canal fillings altered using Adobe Photoshop software (Adobe Systems, San Jose, CA). The periapical areas were not altered. Using a 5-point Likert scale, the endodontist readers were asked to "Please evaluate the periapical area(s)." A Mann-Whitney U test was used to statistically evaluate the difference between the groups. Significance was set at P < .01.


RESULTS
There were 417 readers in group A and 442 readers in group B. The Mann-Whitney U test showed a significant difference in the responses between the groups for both image pairs (P < .01).


CONCLUSIONS
Because the periapical areas of the image pairs were unaltered, the differing coronal and intraradicular areas of the radiographs appear to have influenced endodontists' interpretations of the periapical areas. This finding has implications for all radiographic outcome assessments.
Private Practice, Butte, Montana.
Julie W
JW
Strong
Graduate Endodontics, Saint Louis University, St Louis, Missouri; Center for Advanced Dental Education, Saint Louis University, St Louis, Missouri; Illinois Air National Guard.
Karl F
KF
Woodmansey
Graduate Endodontics, Saint Louis University, St Louis, Missouri; Center for Advanced Dental Education, Saint Louis University, St Louis, Missouri; Private Practice, Durango, Colorado.
John A
JA
Khademi
Graduate Endodontics, Saint Louis University, St Louis, Missouri; Center for Advanced Dental Education, Saint Louis University, St Louis, Missouri. Electronic address: Hattonjf@slu.edu.
John F
JF
Hatton
D006801:Humans; D010486:Periapical Tissue / Q000000981:diagnostic imaging*; D019252:Radiography, Dental, Digital; D011862:Radiography, Panoramic; D019227:Tooth Apex / Q000000981:diagnostic imaging
Dental radiography; diagnosis; endodontics; interpretation; outcomes; perception