TY - JOUR
T1 - Identify and Define All Diagnostic Terms for Periapical/Periradicular Health and Disease States
AU - Gutmann, James L.
AU - Baumgartner, J. Craig
AU - Gluskin, Alan H.
AU - Hartwell, Gary R.
AU - Walton, Richard E.
PY - 2009/12
Y1 - 2009/12
N2 - Introduction: The purpose of this in-depth investigation was to identify, clarify, and substantiate clinical terminology relative to apical/periapical/periradicular diagnostic states, which is used routinely in the provision of endodontic care. Furthermore, the information gleaned from this investigation was used to link diagnostic categories to symptoms, pathogenesis, treatment, and prognosis wherever possible, along with establishing the basis for the metrics used in this diagnostic process. Materials and Methods: Diagnostic terminologies and their relevance to clinical situations were procured from extensive historic and electronic searches and correlated with contemporary concepts in disease processes, clinical assessments, histologic findings (if appropriate), and standardized definitions that have been promulgated and promoted for use in the last 25 years in educational programs and test constructions and for third-party concerns. Results: In general, clinical terminology that is used routinely in the practice of endodontics is not based on the findings of scientific investigations. The diagnostic terms are based on assumptions by correlating certain signs, symptoms, and radiographic findings with what is presumed (not proven) to be the underlying disease process of a given clinical state. There were no studies that specifically tried to assess the accuracy of the metrics used contemporarily for the classification of clinical disease states. Conclusion: A succinct diagnostic scheme that could be described thoroughly, agreed on unanimously, coded succinctly for easy electronic input, and ultimately used for follow-up analysis would not only drive treatment modalities more accurately, but would also allow for future outcomes assessment and validation.
AB - Introduction: The purpose of this in-depth investigation was to identify, clarify, and substantiate clinical terminology relative to apical/periapical/periradicular diagnostic states, which is used routinely in the provision of endodontic care. Furthermore, the information gleaned from this investigation was used to link diagnostic categories to symptoms, pathogenesis, treatment, and prognosis wherever possible, along with establishing the basis for the metrics used in this diagnostic process. Materials and Methods: Diagnostic terminologies and their relevance to clinical situations were procured from extensive historic and electronic searches and correlated with contemporary concepts in disease processes, clinical assessments, histologic findings (if appropriate), and standardized definitions that have been promulgated and promoted for use in the last 25 years in educational programs and test constructions and for third-party concerns. Results: In general, clinical terminology that is used routinely in the practice of endodontics is not based on the findings of scientific investigations. The diagnostic terms are based on assumptions by correlating certain signs, symptoms, and radiographic findings with what is presumed (not proven) to be the underlying disease process of a given clinical state. There were no studies that specifically tried to assess the accuracy of the metrics used contemporarily for the classification of clinical disease states. Conclusion: A succinct diagnostic scheme that could be described thoroughly, agreed on unanimously, coded succinctly for easy electronic input, and ultimately used for follow-up analysis would not only drive treatment modalities more accurately, but would also allow for future outcomes assessment and validation.
KW - Apical
KW - diagnostic categories
KW - diagnostic terms
KW - periapical and periradicular disease
UR - http://www.scopus.com/inward/record.url?scp=70449650512&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=70449650512&partnerID=8YFLogxK
U2 - 10.1016/j.joen.2009.09.028
DO - 10.1016/j.joen.2009.09.028
M3 - Article
C2 - 19932340
AN - SCOPUS:70449650512
SN - 0099-2399
VL - 35
SP - 1658
EP - 1674
JO - Journal of endodontics
JF - Journal of endodontics
IS - 12
ER -