Observer agreement in the radiographic assessment of mental foramen appearance on panoramic radiographs

Abstract

Objective: The aim of this study was to examine the interobserver’s variability in radiographic interpretation of variable appearances of mental foramen from panoramic radiograph. Materials and Methods: Four examiners; two dental radiologists, one oral surgeon and one dental implantologist independently evaluated 100 panoramic radiographs for appearance of the mental foramen according to Yosue and Brooks classification. The level of agreement was calculated using Kappa statistics. Results: The most frequent appearance of mental foramen was the continuous and separated type for both sides. Diffuse type of the foramen was identified in a few cases, almost at a similar rate of the invisible ones. Fair to moderate agreement among the four observers have been demonstrated. The agreement in the interpretation varied, ranging from 0.34 to 0.49. There was considerable variability between the four examiners. This variation in interpretation was independent of the observers experience but dependent on individual’s selection of reference anatomical landmarks for identification of the mental foramen. Conclusion: The panoramic images may not be considered a reliable method to identify the appearance of mental foramen.