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Development and Validation of Grading System for Assessing the Periradicular Region of Primary Teeth on Intraoral
Nitesh Tewari1, Mugilan Ravi2, Partha Haldar3
1Division of Pediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India.
Purpose:
To develop and validate a grading system for assessing the periradicular region of primary teeth on intraoral periapical radiographs.
Methods:
A mixed-methods approach was employed, comprising three phases: (1) Development of the grading system through a systematic literature review and analysis of 300 radiographs, (2) Delphi exercise with 20 expert pediatric dentists assessed face and content validity, and statistical measures such as Content Validity Index (CVI) and Content Validity Ratio (CVR) were calculated, and (3) Initial user feedback (n = 50) for acceptability, time taken, and accuracy of grading were assessed after grading 10 radiographs.
Results:
A pool of 41 items was devised after phase 1. Two rounds of deliberations by the Delphi group resulted in 49 items for inclusion, with ≥ 85% expert agreement and high content validity (CVR ranging from 0.7-1.0). The majority (60%) of the feedback group found the developed index to be acceptable. The correct response rate was 29.6% while it was 43% for the retest. The mean time taken for grading 10 radiographs was 51.12 ± 7.84 min, which decreased to 44.2 ± 4.47 min during the retest.
Conclusion:
A novel grading system with high face and content validity was developed. Further evaluation of the feasibility and reliability is required prior to regular use.
