Revisiting Orstavik’s PAI score to produce a reliable and reproducible assessment of the outcomes of endodontic treatments in routine practice

Abstract

Introduction Orstavik's periapical index is widely used for radiographic assessment of periapical status. This study analyses the reliability and reproducibility of a modified guide for the interpretation of the periapical index (PAI) scores recorded by undergraduate students. Materials and Method Two groups of 4th‐year students were asked to assess the PAI scores of 100 X‐rays two or three times depending on the group. The reliability of their judgment was evaluated by comparing the students' assessments to those of a standard, based on the evaluations made by three teachers. Short‐term stability was evaluated for two lengths of interval separating the Test and Retest phases, respectively, 1 week for Group 1 and 2 weeks for Group 2. Long‐term stability was evaluated by having Group 1 repeat the Retest phase after 15 months. Results Overall mean success rates ranged from 61% to 65% according to the student group and the study phase. Intergroup comparisons showed no statistical difference. The reliability of the PAI score evaluation by students was excellent in both groups. Short‐term and long‐term stability were also excellent regardless of the duration of the interval between the study's phases. Discussion The image misinterpretations are discussed according to the study phases and the PAI score values. Conclusion Undergraduate students can be trained to use the modified guide for scoring PAI for self‐evaluation of the outcomes of the root canal treatments and re‐treatments they are asked to perform during their clinical sessions.

Endodontic versus coronal treatment quality on the periapical status

“…The periapical radiographs were independently examined by an experienced endodontist and a general dentist. Prior to the study onset, 120 periapical radiographs (not included in the analysis) were used to calibrate the examiners (7). The reproducibility of the scores was assessed by Cohen kappa statistics (for inter-and intra-observer agreement) at day 0, month 1, and month 6.…”

Comparison of Clinical-related Characteristics of Endodontic Patients Before and During the COVID-19 Pandemic

“…The periapical status was determined using the PAI suggested by Orstavik et al (10), in which the periapical section on a radiograph is scored as below: Teeth with more than one root were categorized according to the root with the highest score. The periapical status of all 674 teeth involved in this study were analysed radiographically.…”

Indexes for periapical health evaluation - A review

“…Average success rates of 61-65% were noted for the student's group and study phase. Hence, the reliability of the PAI assessment for the undergraduates was considered excellent (17).…”