Intraradicular Appearances Affect Radiographic Interpretation of the Periapical Area

No research exists evaluating the influences of specific variables such as obturation length, radiodensity, or the presence of voids on interpretation of periradicular area. The purpose of this study was to evaluate the effects of obturation length, radiodensity, and the presence of voids on the radiographic interpretations of periapical areas.

In a Web-based survey, 3 test image groups of variable obturation lengths, radiodensities, and numbers of voids were presented to observers for evaluation of the periapical areas. Intracanal areas of the images were altered by using Adobe Photoshop to create 3 test image groups. Each observer reviewed 2 control images and 1 image from each test image group. Responses were recorded in a 5-point Likert-type scale. Within each test image group, the periapical areas were identical. Kruskal-Wallis, Mann-Whitney U, and Cliff's delta statistical tests were used to analyze results.

A total of 748 observer responses were analyzed. Significant differences (P ≤ .01) in the median Likert-type scale responses were identified between the following paired groups: 3 mm short and 1 mm short, 3 mm short and flush, lower radiodensity and higher radiodensity, lower radiodensity and intermediate radiodensity, no voids and several voids, and several voids and single void. Effect sizes ranged from 0.19 to 0.41.

Significant differences were noted within all 3 test image groups: length, radiodensity, and presence of voids. Length of obturation had the largest effect on interpretation of the periapical area, with the 3 mm short radiographic obturation length image interpreted less favorably.