Abstract：
BACKGROUND: This survey aimed to determine the consensus amongst endodontic specialists in North America and practitioners worldwide to diagnose the pulp and periapical conditions of selected case scenarios encountered in daily practice using the American Association of Endodontists (AAE) pulpal and periapical diagnostic terms. Secondly, an attempt was made to suggest modifications in terms accordingly.
METHODS: A survey designed by two endodontic educators was sent to endodontists in North America and clinicians worldwide through an electronic database. The survey included socio-demographic questions followed by the clinical and radiographic presentations of four clinical scenarios. The participants were then requested to provide the pulpal and the periapical diagnosis of 11 teeth presented in these cases (22 answers in total/participant) using the AAE diagnostic terminology. Cases were designed to include 12 pulpal/periapical conditions as control (non-controversial conditions) and ten so-called controversial conditions. A proportion threshold of 10% was required for any diagnostic term to be reported in this survey. The participants were divided into two groups based on the region of endodontic training and/or practice to \'Specialised North American\' or \'International Practitioners,\' and their results were statistically compared using chi-squared tests (p < .05).
RESULTS: The survey included 421 participants. 74% were endodontists, and 46.1% were amongst the \'Specialised North American\' group and 53.9% amongst the \'International Practitioners\'. Eleven of 12 control conditions had an almost complete agreement amongst the participants regarding the diagnostic terms selected, ranging between 82% and 96%, with no other diagnostic term exceeding the 10% threshold. All the controversial conditions yielded more than one diagnostic term selected/condition that exceeded the 10% threshold for groups (\'Specialised North American\' and \'International practitioners\'). There were no differences in the diagnostic terms selected between the two groups; however, the weight for each term varied between the groups in some cases.
CONCLUSIONS: There is a lack of consensus amongst clinicians, regardless of their training and region of practice, on the appropriate diagnostic terms to be used in particular clinical conditions. More diagnostic terms and modifications in the current terms may be required to establish a more reliable diagnostic terminology.
METHODS: A survey designed by two endodontic educators was sent to endodontists in North America and clinicians worldwide through an electronic database. The survey included socio-demographic questions followed by the clinical and radiographic presentations of four clinical scenarios. The participants were then requested to provide the pulpal and the periapical diagnosis of 11 teeth presented in these cases (22 answers in total/participant) using the AAE diagnostic terminology. Cases were designed to include 12 pulpal/periapical conditions as control (non-controversial conditions) and ten so-called controversial conditions. A proportion threshold of 10% was required for any diagnostic term to be reported in this survey. The participants were divided into two groups based on the region of endodontic training and/or practice to \'Specialised North American\' or \'International Practitioners,\' and their results were statistically compared using chi-squared tests (p < .05).
RESULTS: The survey included 421 participants. 74% were endodontists, and 46.1% were amongst the \'Specialised North American\' group and 53.9% amongst the \'International Practitioners\'. Eleven of 12 control conditions had an almost complete agreement amongst the participants regarding the diagnostic terms selected, ranging between 82% and 96%, with no other diagnostic term exceeding the 10% threshold. All the controversial conditions yielded more than one diagnostic term selected/condition that exceeded the 10% threshold for groups (\'Specialised North American\' and \'International practitioners\'). There were no differences in the diagnostic terms selected between the two groups; however, the weight for each term varied between the groups in some cases.
CONCLUSIONS: There is a lack of consensus amongst clinicians, regardless of their training and region of practice, on the appropriate diagnostic terms to be used in particular clinical conditions. More diagnostic terms and modifications in the current terms may be required to establish a more reliable diagnostic terminology.
摘要：
背景：这项调查旨在确定北美牙髓专家和世界各地的从业者之间的共识，以使用美国牙髓学家协会（AAE）牙髓和根尖周诊断术语来诊断日常实践中遇到的选定病例的牙髓和根尖周状况。其次,有人试图提出相应的修改建议。
方法：由两名牙髓教育者设计的调查通过电子数据库发送给北美的牙髓医生和全世界的临床医生。调查包括社会人口统计学问题，然后是四种临床情景的临床和影像学表现。然后要求参与者使用AAE诊断术语提供牙髓和在这些情况下提出的11颗牙齿的根尖周诊断（总共22个答案/参与者）。病例的设计包括12种牙髓/根尖疾病作为对照（无争议的疾病）和10种所谓的有争议的疾病。本次调查中报告的任何诊断术语都需要10%的比例阈值。根据牙髓训练和/或“专业北美”或“国际从业者”的实践地区，参与者分为两组，\'和他们的结果使用卡方检验进行统计学比较（p<0.05）。
结果：调查包括421名参与者。74%是牙髓医生,46.1%属于“北美专业”群体，53.9%属于“国际从业者”。12个控制条件中有11个在参与者中对所选择的诊断术语几乎完全一致。在82%到96%之间，没有其他诊断术语超过10%阈值。所有有争议的条件都产生了超过10％的组（\'专业北美\'和\'国际从业者\'）阈值的条件选择一个以上的诊断术语。两组之间选择的诊断术语没有差异；然而，在某些情况下，每个术语的权重在组间不同。
结论：临床医生之间缺乏共识，无论他们的训练和实践地区，在特定临床条件下使用的适当诊断术语。可能需要更多的诊断术语和对当前术语的修改以建立更可靠的诊断术语。
方法：由两名牙髓教育者设计的调查通过电子数据库发送给北美的牙髓医生和全世界的临床医生。调查包括社会人口统计学问题，然后是四种临床情景的临床和影像学表现。然后要求参与者使用AAE诊断术语提供牙髓和在这些情况下提出的11颗牙齿的根尖周诊断（总共22个答案/参与者）。病例的设计包括12种牙髓/根尖疾病作为对照（无争议的疾病）和10种所谓的有争议的疾病。本次调查中报告的任何诊断术语都需要10%的比例阈值。根据牙髓训练和/或“专业北美”或“国际从业者”的实践地区，参与者分为两组，\'和他们的结果使用卡方检验进行统计学比较（p<0.05）。
结果：调查包括421名参与者。74%是牙髓医生,46.1%属于“北美专业”群体，53.9%属于“国际从业者”。12个控制条件中有11个在参与者中对所选择的诊断术语几乎完全一致。在82%到96%之间，没有其他诊断术语超过10%阈值。所有有争议的条件都产生了超过10％的组（\'专业北美\'和\'国际从业者\'）阈值的条件选择一个以上的诊断术语。两组之间选择的诊断术语没有差异；然而，在某些情况下，每个术语的权重在组间不同。
结论：临床医生之间缺乏共识，无论他们的训练和实践地区，在特定临床条件下使用的适当诊断术语。可能需要更多的诊断术语和对当前术语的修改以建立更可靠的诊断术语。
