Observer performance in assessment of condylar position in temporomandibular joint radiograms

The condylar position at centric occlusion has been considered important in diagnosis of the temporomandibular joint. The present study describes inter- and intra-observer variation in radiographic assessment of condylar position. One radiogram obtained by using an individualized lateral oblique transcranial projection and three corrected sagittal tomograms from the lateral, central, and medial parts of the joint were selected from each of 31 patients. In the resulting 124 radiograms three observers assessed the position of the condyle as posterior, central, or anterior on two occasions, 3 months apart. Concordant reports for all three observers were found in 63%. The interobserver agreement two by two ranged between 69% and 79%, whereas the intraobserver agreement ranged between 81% and 90%. The observer variation and limitations of radiographic techniques should be considered when the therapeutic implication of condylar position is discussed.