Development of an Index for a Tooth to Receive a Full-Coverage Crown.

Abstract

To develop a system for assessment of the status of a tooth to receive a full coverage crown and depict it on a measurable scale, and to validate its use by assessing examiner reproducibility. The index was developed based on the inputs from experts in the field with a consensus on factors (4 periodontal, 2 endodontic, and 4 prosthodontic), stages of severity (stage 1 to stage 4), assigned scores, and relative weights pertaining to varied clinical scenarios. Based on the selection of factor-stage combination, an overall tooth crownability index (TCI) score along with three-factor scores were computed. The validation study included clinical and radiological assessment of cases based on the index criteria by four independent examiners (periodontist, prosthodontist, endodontist, and general practitioner). Forty teeth were assessed. The distribution of repeated selection by the examiners was quite identical to the initial (kappa = 0.93). There was no statistically significant difference in the mean scores of examiners in TCI and factorial scores. An excellent agreement between the measurements was observed among the examiners (ICC =0.993; Crohnbach α = 0.993). A tooth crownability index has been developed for a tooth to receive a full coverage crown which has an excellent agreement and good reproducibility among the examiners. TCI will serve as a baseline tool in treatment plan decision-making based on the status of the teeth and in research for evaluating the efficacy of various treatment options available (standard criteria for outcome assessment).