Dentomaxillofacial Radiology, Vol 24, Issue 3 165-168, Copyright © 1995 by British Institute of Radiology
Observer variation in the radiographic assessment of the bone level on the buccal and lingual surfaces of mandibular molars
C. Gurgan, K. Grondahl and
Department of Periodontology, Faculty of Odontology, University of Goteborg, Sweden.
OBJECTIVES: To assess accuracy and precision of observers' diagnostic
performance in locating the buccal/lingual bone level using conventional
periapical radiographs. METHODS: Standardized radiographs of molar regions
of 10 dried mandibles were obtained. The bone crest on buccal and lingual
surfaces of first and second molars was then marked with thin lead foil
strips and fresh radiographs taken. A series of increasingly extensive
furcation defects was created by sequential bone removal and radiographs
with and without markers obtained after each step. The radiographs without
indicators were presented to 10 observers on two separate occasions and the
most apically located bone level marked on a transparent film. The distance
between observers' markings and 'true' bone level on the radiographs was
determined. RESULTS: There was wide interobserver variation which increased
as the bone loss increased. Lack of consistency was largely attributable to
intra-observer variation except when a furcation defect was present. The
underestimation of bone loss became more marked as the amount of bone loss
increased. CONCLUSIONS: Radiographic determination of bone loss on buccal
and lingual surfaces is associated with a considerable lack of accuracy and
precision, both of which get worse as bone loss increases.
