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Post-radiation dental index: development and reliability

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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 κ = 0.93 and κ = 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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Acknowledgments

This study was supported by the National Institutes of Health/National Institute of Dental Craniofacial Research Grant K23 DE01623. The authors thank Paulette Spencer, Brenda Bohaty, Christos Angelopoulos, Nadeem Dallal, Chris Rice, Mary Lynn Froeschle, Kathy Dockter, and Susan McMillen for their assistance with this project.

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Authors and Affiliations

  1. Departments of Oral Biology and Restorative Dentistry, University of Missouri-Kansas City School of Dentistry, Kansas City, MO, USA

    Mary P. Walker

  2. Department of Behavioral Science, UMKC School of Dentistry, Kansas City, MO, USA

    Karen B. Williams

  3. Kansas City Cancer Centers, Overland Park, KS, USA

    Brian Wichman

Authors
  1. Mary P. Walker
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  2. Karen B. Williams
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  3. Brian Wichman
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Correspondence to Mary P. Walker.

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Walker, M.P., Williams, K.B. & Wichman, B. Post-radiation dental index: development and reliability. Support Care Cancer 16, 525–530 (2008). https://doi.org/10.1007/s00520-007-0393-x

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  • DOI: https://doi.org/10.1007/s00520-007-0393-x

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