Assessment of the trabecular pattern before endosseous implant treatment - Diagnostic outcome of periapical radiography in the mandible

Objectives. To study the diagnostic outcome of periapical radiography in the assessment of the bone trabecular pattern of the mandible. Study design. Mandibular autopsy specimens were radiographed. Seven observers assessed the radiographs with the aid of a proposed classification with and without reference images and the classification presented by Lekholm and Zarb. Accuracy was estimated on the basis of morphometric measurements of trabecular bone volume. Observer agreement was calculated as the estimated probability of agreement between and within observers and as Kappa index. Results. With the classification proposed by us, the overall accuracy was 58% with and 50% without reference images. The accuracy for assessing dense trabeculation was higher (78%) than that for sparse trabeculation (28%). The accuracy of the proposed classification by Lekholm and Zar was not possible to evaluate. The interobserver agreement varied between 49% and 64% and the intraobserver agreement between 75% and 86%. Conclusion. A new classification with reference images is recommended to assess the trabecular pattern in periapical radiographs before implant treatment.