The sensitivity, specificity, and reliability of radiographic periapical diagnosis of posterior teeth

Purpose. The purpose of this study was to define the percent accuracy sensitivity, specificity, and reliability of periapical radiographic diagnosis of periapical inflammatory disease. Method, A total of 140 cases were reviewed under ideal viewing conditions by 6 observers. For each case, observers determined whether periapical disease was evident and rated the confidence of their interpretation. Results, The mean percent accuracy was 70.2%. The mean sensitivity and specificity were 0.65 and 0.78, respectively. The intraclass correlation coefficients for intraobserver and interobserver reliability were 0.66 and 0.54, respectively. Conclusion, Specificity of periapical radiographic diagnosis is higher than sensitivity. These results support the current guideline for selective use of periapical views based on patient symptoms and clinical signs. Finally, dentists have a good degree of reliability on repeated evaluations, but only fair agreement when compared with other dentists reading the same radiograph.