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Web-Based Decision Support System for Managing Periapical Radiolucencies in Root-Filled Teeth: Development and
Dalia Bottini1, Francesc Abella Sans1, Jose Antonio Gonzalez Sanchez1
1Department of Endodontics, Universitat International de Catalunya, School of Dentistry, Sant Cugat del Valles, Barcelona, Spain.
Journal of Dental Education
|March 3, 2025
Summary
A new web-based clinical decision support system (CDSS) application, DentalHelp, significantly impacted dental students' management choices for periapical radiolucencies. The tool demonstrated effectiveness in aiding decision-making for these complex dental cases.
Area of Science:
- Dentistry
- Oral Radiology
- Clinical Decision Support Systems
Background:
- Periapical radiolucencies associated with root-filled teeth require careful management decisions.
- Dental students' diagnostic and management agreement can vary.
- Web-based clinical decision support systems (CDSS) offer potential solutions for standardizing care.
Purpose of the Study:
- To assess the agreement in managing periapical radiolucencies among dental students.
- To evaluate the impact of a new web-based CDSS (DentalHelp) on management decisions.
- To compare decision-making agreement with and without the CDSS.
Main Methods:
- 110 dental students evaluated 10 complex cases with clinical data, radiographs, and CBCT scans.
- Students made management choices and assessed decision difficulty, first without, then with the DentalHelp app.
- Cohen's Kappa index measured agreement in management choices and decision difficulty before and after CDSS use.
Main Results:
- Significant changes in management choices were observed when students used the CDSS (p < 0.05).
- A global Kappa of 0.21 indicated weak general agreement in management.
- Poor agreement (Kappa = 0.07) was found for decision-making difficulty with and without the app.
Conclusions:
- The DentalHelp web app effectively assisted dental students in clinical decision-making.
- The CDSS showed potential in improving consistency for managing periapical radiolucencies.
- Further research may explore broader implementation and long-term impacts of CDSS in dental education.
