Site-specific assessment of radiographic interdental bone loss as proposed in the recent classification of periodontal diseases: Potential impact of location, severity, and clinical training

Abstract

Abstract Aim To site-specifically assess the extent of IBL, as proposed in recent classification of periodontal diseases, from ortopantomographs (OPGs) in a site-specific manner and to analyze the potential impact of location and the course of dental education on the interpretation of IBL and the level of agreement. Methods IBL% was measured by 4th term (T4) (n = 5), 5th term (T5) (n = 5) dental students and post-graduate (PG) (n = 5) examiners from a total of 5907 anterior and 4678 posterior sites in the OPGs. IBL% was evaluated from mesial and distal aspects of the index teeth (#11, #21, #31, #41, #16, #26, #36 and #46) according to the following scale; 0: no IBL, 1: IBL = < 15%, 2: IBL = 15–33%, 3: IBL > 33%. The level of agreement among researchers was analyzed by using Kappa coefficient and McNemar-Bowker test. Results The total agreement of all examiners was substantial (κ = 0.79, p < 0.001) and PG examiners showed almost perfect intra-group agreement (κ = 0.93, p < 0.001). The agreement between T4 and T5 was slight (κ = 0.19, p < 0.001), whereas PG and the other two groups showed fair inter-group agreement (κ = 0.32 and 0.25, respectively; p < 0.001. Although the highest agreement was found in the lower posterior (κ = 0.81), lower anterior κ = 0.80 and upper anterior and upper posterior κ = 0.75. The agreement in Stage III-IV was higher than in Stage I. Conclusion Considering the experience level of the examiner, OPG is a useful tool in IBL% measurement for periodontal evaluation but it seems that the findings in the anterior region should be confirmed with intraoral radiographs.