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.