Accuracy and reliability of the expected root position setup on clinical decision making of root position at midtreatment

Abstract

Introduction: Accurate root position is imperative for successful orthodontic treatment that is stable and functional. Current methods to monitor root position are either inaccurate or use relatively high levels of radiation. A method to generate an expected root position (ERP) setup has been reported to have the potential to accurately evaluate root position with minimal radiation. The purpose of this study was to determine the accuracy and reliability of the clinical decisions made on root position using the ERP setup.

Methods: This retrospective study included 10 subjects who had pretreatment and midtreatment cone-beam computed tomography (CBCT) scans and study models. An ERP setup was generated for all patients at midtreatment. Four examiners assessed both the CBCT scan and ERP setup and made clinical decisions regarding the root position with each method. Cohen's kappa was determined to assess intraoperator and intermethod reliability. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated to determine the accuracy of the ERP setup.

Results: The kappa values for intraoperator reliability for both the CBCT scan and ERP setup fell within the 0.61-0.80 range. The kappa values for intermethod reliability between the CBCT scan and ERP setup fell within the 0.61-0.80 range for all tooth groups. The sensitivity of the ERP setup ranged from 0.72 to 0.90, specificity ranged from 0.89 to 0.97, positive predictive value ranged from 0.57 to 0.85, and negative predictive value ranged from 0.93 to 0.99.

Conclusions: This study demonstrated that the ERP setup, when compared with the gold standard CBCT scan, was accurate and reliable in making clinical decisions regarding root position at midtreatment.