Concordance of a Structured Orthopantomogram Reporting Tool Between Dental Practitioners, and Compared to Routine Reports Within a Regional and Remote Service

OBJECTIVES: Variability in interpreting orthopantomograms can have greater impact on regional and remote patients who experience poorer oral health, have reduced service access and incur greater costs, if referred to out-of-community services. Structured orthopantomogram reporting and specialist advice pathways may support more consistent image interpretation and clinical decision-making. This study evaluated the agreement of a structured orthopantomogram reporting tool between dentists and compared the information recorded using the tool with routine clinical reports. STUDY DESIGN: Pilot inter-rater concordance study. MATERIAL AND METHODS: The inter-rater and inter-method agreement relating to image quality, radiographic features, and the need for specialist review were assessed across 50 orthopantomogra. RESULTS: The structured tool was completed, on average, in 10.25 min (SD = 8.62), and yielded almost perfect agreement between the two dentists (κ(95%CI) = 0.89 [0.86-0.92]). Agreement across radiographic features ranged from substantial to perfect agreement, with lower agreement observed for whether a specialist referral was needed. Inter-method agreement between the structured tool and routine reports was fair (κ(95%CI) = 0.33 [0.29-0.37]), likely reflecting the greater level of detail prompted by the structured tool rather than differences in the quality of routine reporting practices. Half of the orthopantomograms were reviewed by a specialist, who determined only 6% warranted a referral. CONCLUSIONS: Structured reporting supports more consistent interpretation of orthopantomograms. A formalised specialist advice pathway may reduce unnecessary referrals to out-of-community services, and support dentists' confidence and consistency when completing orthopantomogram reports.