Observer agreement in the assessment of mandibular trabecular bone pattern from panoramic radiographs

OBJECTIVES To study the observer agreement in the assessment of trabecular pattern of the mandible from panoramic radiographs. METHODS Seven observers were asked to classify the trabecular pattern of 100 edentulous regions of the mandible in 80 randomly selected panoramic radiographs into one of five grades with the aid of a written description and reference images. Intra- and interobserver agreement was calculated as overall agreement and Kappa index. RESULTS The intra-observer agreement varied between 65% and 79%. The Kappa index for intra-observer agreement was moderate for three observers and substantial for four. For all seven observers, it varied according to the grade of trabecular bone pattern, but the majority deviated from each other by only one grade. CONCLUSION The relatively high rates of observer agreement indicate that panoramic radiography can be used for the clinical assessment of the trabecular pattern of the mandible.