Reliability of orthopantamogram in lower third molar surgery: Inter- and intra-observer agreement

Abstract

A BSTRACT Context: The evaluation of relationship between the roots of impacted lower third molar (IL3M) and inferior alveolar nerve injury (IAN) with orthopantamogram (OPG) is mandatory before performing de-impaction surgery. An investigation is considered reliable if it can be reproduced by various examiners. Assessment of OPG is subjective and varies among examiners. OPG is reliable to clinicians if the interpretation is not a product of guess work. Aim: The aim of this study was to evaluate the magnitude of agreement among oral surgeons and oral radiologist in observing intimate relationship between IL3M and mandibular canal. Materials and Methods: OPGs were evaluated by two oral surgeons and one oral radiologist for nerve root relationship. All the three were from different institutions with 10–15 years of experience. The three observers were blinded from each other’s findings. A total of 127 OPGs were evaluated for inter-observer agreement. Fifty OPGs were evaluated after 60 days for intra-observer agreement. The agreement was evaluated based on Cohen’s κ statistics. Results: Our results denote that the interpretation of OPG among specialists is not in good agreement. We suggest development of methods to standardize evaluation of OPG and the exposure technique to improve inter-observer agreement among the dental specialists.

Inter-Rater Reliability among Dentists for Assessment of Angle of Impacted Third Molars on Orthopantomograms

“…Orthopantamograms (OPGs) have historically been used as a standardized evaluation technique to evaluate and arrange this surgical removal 14 . OPG is a common investigation to investigate to see how an impacted tooth relates with the mandible 15 . OPG remains among the most effective diagnostic methods for determining impacted lower third molar, according to reports.…”

“…There are still many people who employ the Rood and Shehab criterion, that focus on traditional radiographs 16 . There are differences in how different surgeons as well as other specialists understand the OPG 15 . Prabakaran conducted a survey to see whether oral radiologists & oral surgeons coincide when it comes to assessing the close nerve root relationships in OPG, which are regarded as warning indications 15 .…”

“…There are differences in how different surgeons as well as other specialists understand the OPG 15 . Prabakaran conducted a survey to see whether oral radiologists & oral surgeons coincide when it comes to assessing the close nerve root relationships in OPG, which are regarded as warning indications 15 . An essential component in the presurgical evaluation of impacted lower third molar is the incorporation of a clinical examination history as well as pertinent investigations 15 .…”

“…Prabakaran conducted a survey to see whether oral radiologists & oral surgeons coincide when it comes to assessing the close nerve root relationships in OPG, which are regarded as warning indications 15 . An essential component in the presurgical evaluation of impacted lower third molar is the incorporation of a clinical examination history as well as pertinent investigations 15 . The surgeons can forecast how challenging the procedure will be and detect numerous risks factors by interpreting radiographs of an impacted lower third molar as well as its surrounding tissues 17 .…”

Inter-Rater Reliability to the Assessment of Ramus Relationship of Mandibular Impacted Third Molar Among Denitsts: An Orthopantomographic Study

“…A study conducted by Sureshkannan P suggested that For such above indications in OPG, there was good inter-observer concordance and moderate to great intra-observer confidence for both operators. The assessment of the OPG for the aforementioned symptoms is generally accepted by the specialists and aids in determining the potential danger of nerve damage prior to surgery 10 . This could be ascribed to variations in how each observer saw the relationships between the nerve roots, the calibre of the OPG, and additional susceptibility variables like age, sex, as well as root curve.…”