Gijs Berghuis1, Jan Cosyn2,3, Hugo De Bruyn2,4, Geert Hommez2, Melissa Dierens2, Véronique Christiaens2. 1. Oral Health Sciences, Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium. gijsberghuis@hotmail.com. 2. Oral Health Sciences, Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium. 3. Oral Health Research Group (ORHE), Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090, Brussels, Belgium. 4. Department of Dentistry- Implantology and Periodontology, Research Institute Health Sciences, Radboud University Medical Center, Philips Van Leydenlaan 25, 6525 EX, Nijmegen, The Netherlands.
Abstract
BACKGROUND: The aims of this study were (1) to determine the accuracy, sensitivity, and specificity of panoramic and peri-apical radiographs in diagnosing furcation involvement, as well as (2) to evaluate the possible impact of clinical experience on these diagnostic parameters. METHODS: An existing radiographic dataset of periodontitis patients requiring implant surgery was retrospectively examined for furcation involvement. Criteria for inclusion were the presence of a CBCT, panoramic and peri-apical radiograph of the site of interest within a one-year time frame. All furcation sites were classified using the CBCT, which was considered as the gold standard, according to Hamp's index (1975). Ten experienced examiners and 10 trainees were asked to assess furcation involvement for the same defects using only the corresponding panoramic and peri-apical radiographs. Absolute agreement, Cohen's weighted kappa, sensitivity, specificity and ROC-curves were analyzed. RESULTS: The study sample included 60 furcation sites in 29 multi-rooted teeth from 17 patients. On average, 20/60 furcations were correctly classified according to the panoramic radiographs, corresponding to a weighted kappa score of 0.209, indicating slight agreement. Similarly, an average of 19/60 furcations were correctly classified according to the peri-apical radiographs, corresponding to a weighted kappa score of 0.211, also indicating slight agreement. No significant difference between panoramic and peri-apical radiography was found (P = 0.903). When recategorizing FI Grades into 'no to limited FI' (FI Grade 0 and I) and 'advanced FI' (FI Grade II and III), the panoramic and peri-apical radiography showed low sensitivity (0.558 and 0.441, respectively), yet high specificity (0.791 and 0.790, respectively) for identifying advanced FI. The ROC-curves for the panoramic and peri-apical radiographs were 0.79 and 0.69 respectively. No significant difference was found between experienced periodontists and trainees (P = 0.257 versus P = 0.880). CONCLUSION: Panoramic and peri-apical radiography are relevant tools in the diagnosis of FI and provide high specificity. Ideally, they are best used in combination with furcation probing, which shows high sensitivity. Furthermore, clinical experience does not seem to improve the accuracy of a radiological diagnosis of furcation sites. TRIAL REGISTRATION: Patient radiographic datasets were retrospectively analyzed.
BACKGROUND: The aims of this study were (1) to determine the accuracy, sensitivity, and specificity of panoramic and peri-apical radiographs in diagnosing furcation involvement, as well as (2) to evaluate the possible impact of clinical experience on these diagnostic parameters. METHODS: An existing radiographic dataset of periodontitispatients requiring implant surgery was retrospectively examined for furcation involvement. Criteria for inclusion were the presence of a CBCT, panoramic and peri-apical radiograph of the site of interest within a one-year time frame. All furcation sites were classified using the CBCT, which was considered as the gold standard, according to Hamp's index (1975). Ten experienced examiners and 10 trainees were asked to assess furcation involvement for the same defects using only the corresponding panoramic and peri-apical radiographs. Absolute agreement, Cohen's weighted kappa, sensitivity, specificity and ROC-curves were analyzed. RESULTS: The study sample included 60 furcation sites in 29 multi-rooted teeth from 17 patients. On average, 20/60 furcations were correctly classified according to the panoramic radiographs, corresponding to a weighted kappa score of 0.209, indicating slight agreement. Similarly, an average of 19/60 furcations were correctly classified according to the peri-apical radiographs, corresponding to a weighted kappa score of 0.211, also indicating slight agreement. No significant difference between panoramic and peri-apical radiography was found (P = 0.903). When recategorizing FI Grades into 'no to limited FI' (FI Grade 0 and I) and 'advanced FI' (FI Grade II and III), the panoramic and peri-apical radiography showed low sensitivity (0.558 and 0.441, respectively), yet high specificity (0.791 and 0.790, respectively) for identifying advanced FI. The ROC-curves for the panoramic and peri-apical radiographs were 0.79 and 0.69 respectively. No significant difference was found between experienced periodontists and trainees (P = 0.257 versus P = 0.880). CONCLUSION: Panoramic and peri-apical radiography are relevant tools in the diagnosis of FI and provide high specificity. Ideally, they are best used in combination with furcation probing, which shows high sensitivity. Furthermore, clinical experience does not seem to improve the accuracy of a radiological diagnosis of furcation sites. TRIAL REGISTRATION: Patient radiographic datasets were retrospectively analyzed.
Authors: Jack G Caton; Gary Armitage; Tord Berglundh; Iain L C Chapple; Søren Jepsen; Kenneth S Kornman; Brian L Mealey; Panos N Papapanou; Mariano Sanz; Maurizio S Tonetti Journal: J Periodontol Date: 2018-06 Impact factor: 6.993
Authors: Maurice Ruetters; Holger Gehrig; Ti-Sun Kim; Valentin Bartha; Thomas Bruckner; Franz Sebastian Schwindling; Anna Felten; Christopher Lux; Sinan Sen Journal: Sci Rep Date: 2022-04-26 Impact factor: 4.996