Observer Performance in Qualitative Assessments of CONDYLAR Position

Material Methods: TCRs were obtained with a head positioner by one experienced clinician on the MIP and maximal opening position MOP. One hundred and seventy TCRs of 85 persons with the signs and symptoms of temporomandibular disorders (TMDs) were examined by an experienced and two inexperienced observers in temporomandibular joint (TMJ) radiographs. The measurements were made twice within two weeks. The positions of condyles were categorized into three different ways for maximal intercuspal position. On maximal opening position, the position of condyle was classified according to the relationship between the most superior part of the condylar head and the prominence of articular eminence. Weighted Kappa Statistic was used determine the intra and inter-observers agreements.

Results: The intra-observer agreements were substantial for classifications 1, 2 and 3 on MIP. The intra-observer agreement was substantial for MOP. The inter-observers agreement ranged fair to moderate on MIP. The overall inter-observers kappa value was 0.38 on MIP.

Conclusions: Simplistic assessment methods or broad classifications are advised in the subjective evaluation of condylar position. Clinical experience about the assessment of TMJ radiographs has an important effect on the evaluations of condyle position. The effects of minimal variations of condylar position on clinical condition should be investigated in condyle position. Although the intra-observer concordance is substantial in assessment of condylar positions inter-observer agreements ranged fair-moderate both on MIP and MOP. Quantitatively determining methods is necessary to confirm the reliability of subjective measurements for condyle position.