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Quality Assessment of KEDOO Criteria and Coll and Sadrian Criteria in Evaluation of Root Canal Obturation:A
Mehak Behal1, Ruchika Kundra1, Mebin George Mathew1
1Department of Pediatric and Preventive Dentistry, Christian Dental College, Ludhiana, Punjab, India.
Aim And Background:
The success of pulpectomy in primary teeth depends significantly on the quality of root canal obturation. While the Coll and Sadrian criteria have traditionally been used to evaluate obturation at the tooth level, they do not assess individual canal fill quality or detect voids. The recently introduced KEDOO classification offers a canal-specific approach. This study aimed to compare the diagnostic performance of the KEDOO classification with the traditional Coll and Sadrian criteria in assessing obturation quality in primary molars.
Methods:
A retrospective observational study was conducted using digital periapical radiographs of pulpectomized primary molars from children aged 4-9 years. Each radiograph was evaluated using both the Coll and Sadrian criteria and the KEDOO classification. The Coll and Sadrian criteria assessed obturation at the level of the entire tooth, whereas the KEDOO classification evaluated each canal separately and also identified the presence of voids. Chi-square analysis was used to compare the classifications, and intrarater reliability was measured using Cohen's kappa.
Results:
Out of 234 retrieved radiographs, 132 met the inclusion criteria and were analyzed. According to the Coll and Sadrian criteria, 62% of mandibular and 77.4% of maxillary molars were classified as optimally filled. In contrast, the KEDOO classification showed lower optimal fill rates at the canal level: 32.9 and 49.4% for mandibular mesial and distal canals, and 35.8, 32.1, and 69.8% for maxillary mesial, distal, and palatal canals, respectively. Voids were detected in 49.4% of mandibular and 50.9% of maxillary molars. Intrarater reliability was perfect for Coll and Sadrian (κ = 1.00) and almost perfect for KEDOO (κ = 0.815).
Conclusion:
The KEDOO classification provides a more detailed, canal-specific, and diagnostically sensitive evaluation of obturation quality in primary teeth. As it evaluates each canal individually and detects voids, it offers improved precision over traditional methods.
Clinical Significance:
Incorporating the KEDOO classification into pediatric endodontic practice may enhance the accuracy of obturation assessment, enable early detection of suboptimal fillings, and contribute to improved long-term treatment outcomes.
