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Intra-observer reliability regarding removal of asymptomatic third molars
O Kostopoulou1, M R Brickley, J P Shepherd
1Department of Oral Surgery, Medicine and Pathology, University of Wales College of Medicine, Heath Park, Cardiff.
British Dental Journal
|July 31, 1998
Summary
Dentists
Area of Science:
- Dentistry
- Oral Surgery
- Evidence-Based Practice
Background:
- Asymptomatic third molars often present management dilemmas.
- Decisions regarding prophylactic removal lack consistent evidence.
Purpose of the Study:
- To assess the reliability of dental practitioners' decisions on removing asymptomatic third molars.
- To evaluate the consistency of risk assessment for pathology in these cases.
Main Methods:
- 10 oral surgeons and 18 family dentists reviewed 36 periapical radiographs of asymptomatic mandibular third molars.
- Practitioners used visual analogue scales to predict pathology risk and recommend removal, with repeat assessments after one month.
Main Results:
- While initial and repeat assessments showed correlation, agreement on removal necessity was low (Kappa values 0.54 for oral surgeons, 0.41 for family dentists).
- Significant shifts in risk assessment occurred between the two assessments for most cases.
Conclusions:
- Treatment decisions for asymptomatic third molars are not consistently rational or evidence-based.
- Prophylactic removal decisions lack reliability without further high-quality evidence on disease prediction.