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. 2008 May;16(5):525-30.
doi: 10.1007/s00520-007-0393-x. Epub 2008 Jan 15.

Post-radiation dental index: development and reliability

Mary P Walker  1 , Karen B Williams, Brian Wichman
Affiliations

Post-radiation dental index: development and reliability

Mary P Walker et al. Support Care Cancer. 2008 May.

Abstract

Goals of the work: The aim of this paper was to develop, validate, and assess the reliability of a clinical index for assessing post-radiation dentition breakdown.

Materials and methods: An expert panel of four dentists with expertise in post-radiation patient care, oral radiology, and mineralized tissues reviewed a series of clinical photographs (n = 60) depicting a wide range of post-radiation lesions varying in size, severity, and location. Based on panel input related to lesion severity rankings and cut-points along a continuum of destruction, a semiquantitative, ordinal lesion scale was developed. A companion scale was developed to account for existing restorations. The index was then reviewed by a separate panel of dental clinician/researchers for confirmation of face and content validity and was refined based on their input. Following index approval by the expert and confirmatory panels, the index was evaluated for test-retest reliability by two educator/clinicians. After a brief calibration session, examiners reviewed and independently scored a second series of lesion images (n = 60). One week later, the same examiners independently scored the same images displayed in a different order. Inter- and intra-rater reliability and agreement were assessed (Spearman r and Kappa statistic).

Main results: Respective to sessions 1 and 2, inter-rater reliability values were r = 0.97 and r = 0.98, with Kappa values of kappa = 0.93 and kappa = 0.95. Respective intra-rater reliability and agreement values were 0.99 and 0.98 (rater 1), and 0.98 and 0.95 (rater 2).

Conclusions: A new index was developed and subsequently demonstrated face validity and excellent inter- and intra-rater reliability for potentially evaluating the severity of post-radiation dentition breakdown.

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Figures

Figure 1
Figure 1
Post-radiation dental index clinical research form.
Figure 2
Figure 2
Representative post-radiation surface lesions scored 1–5.
See this image and copyright information in PMC

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