Evaluation of Interrater Agreement in Determining the Prevalence of Iatrogenic Factors as a Graduation Project

Abstract

BACKGROUND
 A healthy periodontium forms the basis of an aesthetic and functional dentition. Due to the reciprocal dynamic relationship between restorative dentistry and periodontal health, iatrogenic factors arising from restorative procedures are likely to have a negative effect on the periodontium. Awareness of these factors among dentistry students can lead to more progress in taking precautions and being careful against iatrogenic factors. Thus, the aim of this study was to evaluate failures in restorative treatments using panoramic radiographs as a graduation project.
 METHODS
 A total of 2622 PRs were randomly screened. After applying the exclusion criteria, 776 digital images containing at least one iatrogenic factor were analyzed. The measurement of the interrater agreement was calculated using Cohen's kappa coefficient.
 RESULTS
 This study included a sample size of 776 patients aged 18-85 years (435 females and 341 males). Most of the patients were in their 40s (27,45%). A total of 1662 treated teeth containing iatrogenic factors that may have possible negative effects on the periodontium were analyzed. Most of the teeth with improper restoration margins were more common in the maxillary molar region and also had bone loss. In addition, among the iatrogenic factors associated with endodontic treatment, inadequate root canal filling was observed the most, while perforation was the least. Interrater agreements were recorded at statistically significant levels of perfect, substantial and fair.
 CONCLUSIONS
 It is of great importance for dental students to increase their awareness by evaluating iatrogenic factors clinically and radiographically before graduation. Students also have the opportunity to test their knowledge, attitudes and skills that will be required after graduation, together with the academicians assigned to them as supervisors for the graduation projects.