Defense Date
2024
Document Type
Thesis
Degree Name
Master of Science in Dentistry
Department
Dentistry
First Advisor
Garry Myers
Second Advisor
Ana Andrada
Third Advisor
Robert Reinhart
Fourth Advisor
Caroline Carrico
Abstract
Objective: The purpose of this study was to determine observer accuracy and agreement in detecting carriers using preoperative radiographs, as well as to identify potential radiographic indicators for the presence of carriers.
Methods: A chart review was conducted for patients seen at the VCU graduate endodontic clinic. Eligible cases included previously treated teeth that were nonsurgically retreated, with and without identified carriers. 100 cases were identified, including 61 carrier and 39 non-carrier cases. Preoperative radiographs were randomized, and evaluators assessed each case for the presence of carrier-based obturation. Evaluators included three endodontists, one general dentist, and four endodontic residents. Statistical analysis was performed to assess the accuracy, as well as interobserver agreement, of detecting carrier-based obturation radiographically.
Results: The endodontist group demonstrated the highest sensitivity (56%), specificity (82%), PPV (84%), and NPV (54%). The endodontist group also demonstrated the highest Kappa score at 0.39, indicating a “fair” level of inter-group agreement. The apical third was reported to be the radiographic region of most value in determining presence of a carrier, with no difference in tooth type. Evaluators reported three factors in their identification of carriers: small preparation size, overextended obturation, and differences in radiopacity throughout the canal system.
Conclusion: While some radiographic features may be predictive of CBO, the present study found no significant correlation between radiographic presentation and the clinician’s ability to accurately detect the presence of carriers. With increased clinical experience in endodontics and radiographic interpretation, the ability to identify carrier cases also increased.
Rights
© Robert William Rudnicki
Is Part Of
VCU University Archives
Is Part Of
VCU Theses and Dissertations
Date of Submission
5-3-2024