Inter and intra-operator reliability of Lekholm and Zarb classification and proposal of a novel radiomic data-driven clustering for qualitative assessment of edentulous alveolar ridges

IF 4.8 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Clinical Oral Implants Research Pub Date : 2024-04-17 DOI:10.1111/clr.14271
Giuseppe Troiano, Antonio Rapani, Francesco Fanelli, Federico Berton, Marino Caroprese, Teresa Lombardi, Khrystyna Zhurakivska, Claudio Stacchi
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Abstract

Objectives

The present study was conducted to evaluate the reproducibility of Lekholm and Zarb classification system (L&Z) for bone quality assessment of edentulous alveolar ridges and to investigate the potential of a data-driven approach for bone quality classification.

Materials and Methods

Twenty-six expert clinicians were asked to classify 110 CBCT cross-sections according to L&Z classification (T0). The same evaluation was repeated after one month with the images put in a different order (T1). Intra- and inter-examiner agreement analyses were performed using Cohen's kappa coefficient (CK) and Fleiss' kappa coefficient (FK), respectively. Additionally, radiomic features extraction was performed from 3D edentulous ridge blocks derived from the same 110 CBCTs, and unsupervised clustering using 3 different clustering methods was used to identify patterns in the obtained data.

Results

Intra-examiner agreement between T0 and T1 was weak (CK 0.515). Inter-examiner agreement at both time points was minimal (FK at T0: 0.273; FK at T1: 0.243). The three different unsupervised clustering methods based on radiomic features aggregated the 110 CBCTs in three groups in the same way.

Conclusions

The results showed low agreement among clinicians when using L&Z classification, indicating that the system may not be as reliable as previously thought. The present study suggests the possible application of a reproducible data-driven approach based on radiomics for the classification of edentulous alveolar ridges, with potential implications for improving clinical outcomes. Further research is needed to determine the clinical significance of these findings and to develop more standardized and accurate methods for assessing bone quality of edentulous alveolar ridges.

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Lekholm 和 Zarb 分级在操作员之间和操作员内部的可靠性,以及用于无牙槽嵴定性评估的新型放射学数据驱动聚类的建议
本研究旨在评估 Lekholm 和 Zarb 分类系统(L&Z)用于无牙槽嵴骨质评估的可重复性,并研究数据驱动骨质分类方法的潜力。一个月后再次进行同样的评估,并将图像按不同顺序排列(T1)。分别使用科恩卡帕系数(CK)和弗莱斯卡帕系数(FK)对检查者内部和检查者之间的一致性进行分析。此外,还从来自相同的 110 张 CBCT 的三维无齿嵴块中提取了放射学特征,并使用 3 种不同的聚类方法进行无监督聚类,以确定所获数据中的模式。两个时间点的检查者之间的一致性很小(T0 的 FK:0.273;T1 的 FK:0.243)。基于放射学特征的三种不同的无监督聚类方法以相同的方式将 110 张 CBCT 分为三组。本研究表明,基于放射组学的可重复数据驱动方法可用于无牙槽嵴的分类,对改善临床结果具有潜在的意义。要确定这些研究结果的临床意义,并为评估无牙槽嵴骨质量开发更标准化、更准确的方法,还需要进一步的研究。
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来源期刊
Clinical Oral Implants Research
Clinical Oral Implants Research 医学-工程:生物医学
CiteScore
7.70
自引率
11.60%
发文量
149
审稿时长
3 months
期刊介绍: Clinical Oral Implants Research conveys scientific progress in the field of implant dentistry and its related areas to clinicians, teachers and researchers concerned with the application of this information for the benefit of patients in need of oral implants. The journal addresses itself to clinicians, general practitioners, periodontists, oral and maxillofacial surgeons and prosthodontists, as well as to teachers, academicians and scholars involved in the education of professionals and in the scientific promotion of the field of implant dentistry.
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