Non-surgical Management of Large Periapical Lesions with the Agreement Evaluation of the Methods

Aim: The aim of this study is to evaluate the agreement between three routinely used non-surgical management techniques for large periapical lesions namely the treatments with Calcium hydroxide, Mineralo-Trioxide Aggregate and Bio-dentine.

Methods: Data was collected from 60 patients at the Department of Restorative Dentistry, Faculty of Dental Sciences, University of Peradeniya. The variables age, gender and area of the infected region before and after the treatment and the treatment type were considered. Two homoscedastic and heteroscedastic Mixed-effects models were fitted and the agreement between three treatments were assessed using Concordance Correlation Coefficient (CCC) and Total Deviation Index (TDI).

Results: CCC value calculated for treatment types 1 & 2, 1 & 3 and 2 & 3 are (0.905, 0.909, 0.874) for homoscedastic model and (0.989, 0.990, 0.975) for heteroscedastic model. Further, corresponding TDI values for homoscedastic and heteroscedastic models are (3.148, 4.390, 1.647) and (2.963, 4.388, 1.457) respectively.

Conclusions: Since all the CCC values are close to 1 and TDI values are low, there is a strong agreement between all three treatments and hence they be used interchangeably. Moreover, the agreement between Treatments with Calcium hydroxide and Bio-dentine is higher compared to the agreements between the other treatments. (i.e., Calcium hydroxide with Mineralo-Trioxide Aggregate and Biodentine with Mineralo-Trioxide Aggregate).