目的:评估目前使用的六种基于根尖摄影的方法之间的一致性,以测量下颌第一磨牙中根的根管曲率,由两名具有不同熟练程度的考官评估。
方法:使用平行技术对41个人类下颌第一磨牙的非牙髓治疗的中骨根进行了射线照相。两名独立观察员(牙髓学和放射学专家以及最后一年的牙科学生)使用Schneider(1971年,口腔外科,口腔医学,口腔病理学和口腔放射学,32,271),Weine(1982,牙髓治疗),Berbert和Nishiyama(1994年,RevistaGachaúchadeOdontologa,356),Luitenetal.(1995年,牙髓学杂志,21,26),Hankins和ElDeeb(1996,牙髓学杂志,22,123)和Pettiette等人。(1999年,牙髓学杂志,25,230)。使用组内相关系数评估检查者和检查者之间的可靠性。采用单向方差分析进行重复测量检验,比较不同方法测得的曲率角的差异,其次是Tukey的事后分析。使用科恩d方法计算效果。要确定方法之间的协议,使用Bland-Altman分析。显著性水平设定为5%。
结果:对于所考虑的六种方法,观察者的一致性非常好(>0.81)。对于方法之间的角度比较,施耐德与韦恩(35.77°)和路透与汉金斯(35.14°)的最大差异,而差异>10°的角度百分比最高的是Weine与Luiten和Berbert与Pettiette(90%),而Weine与Hankins的比较频率最低(15%)。在五个比较中发现了极好的一致性:Weine与Luiten(0.940),伯伯特对佩蒂特(0.917),韦恩与佩蒂特(0.907),Luiten对Pettiette(0.904)和Berbert对Luiten(0.812)。与施耐德的方法相比,其他方法显示出随着角度变得更加尖锐,差异增加的趋势。其他方法表现出线性差异,保持恒定的更小和更大的角度。
结论:对于单独评估的所有方法,可靠性都很好。比较Schneider与Weine以及Luiten与Hankins时,发现曲率角的最大差异。Weine和Luiten达成了很好的协议,Berbert对Pettiette,Weine对Pettiette,Luiten对Pettiette和Berbert对Luiten。在存在撕裂的情况下,施耐德法灵敏度较低。
OBJECTIVE: To evaluate the agreement between six currently available periapical radiography-based methods for measuring the root canal curvatures in mesial roots of mandibular first molars, assessed by two examiners with different proficiency levels.
METHODS: Non-endodontically treated mesial roots of 41 human mandibular first molars were radiographed using the parallelling technique. Two independent observers (a specialist in endodontics and radiology and a final-year dental student) assessed their root canal curvature using the methodologies described by Schneider (1971, Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 32, 271), Weine (1982, Endodontic therapy), Berbert and Nishiyama (1994, Revista Gaúcha de Odontología, 356), Luiten et al. (1995, Journal of Endodontics, 21, 26), Hankins and ElDeeb (1996, Journal of Endodontics, 22, 123) and Pettiette et al. (1999, Journal of Endodontics, 25, 230). Intra- and inter-examiner reliability was assessed using the intraclass correlation coefficient. The differences in curvature angle measured by the different methods were compared using the one-way anova for repeated measures test, followed by Tukey\'s post hoc analysis. The effect was calculated using the Cohen\'s d method. To determine the agreement between methods, the Bland-Altman analysis was used. The significance level was set at 5%.
RESULTS: Agreement for the observers was excellent (>0.81) for the six methods considered. For the angle comparisons between methods, the maximum differences were for Schneider versus Weine (35.77°) and Luiten versus Hankins (35.14°), whilst the highest percentage of angles with a difference >10° were Weine versus Luiten and Berbert versus Pettiette (90%) and the comparison Weine versus Hankins presented with the lowest frequency (15%). Excellent agreement was found for five comparisons: Weine versus Luiten (0.940), Berbert versus Pettiette (0.917), Weine versus Pettiette (0.907), Luiten versus Pettiette (0.904) and Berbert versus Luiten (0.812). Compared to Schneider\'s method, the other methods showed a tendency of increasing difference as the angles became more acute. The other methods exhibited linear differences, remaining constant for smaller and larger angles.
CONCLUSIONS: Reliability was excellent for all methods assessed separately. Maximum differences in curvature angles were found when comparing Schneider versus Weine and Luiten versus Hankins. Excellent agreement was found for Weine versus Luiten, Berbert versus Pettiette, Weine versus Pettiette, Luiten versus Pettiette and Berbert versus Luiten. In the presence of dilacerations, the method by Schneider was less sensitive.