Reliability Study of Pilloni and Rojas Classification of Furcation Involvement in Kerala Population: A Pilot Study

Aim: To evaluate the reliability of Pilloni and Rojas' classification system for assessing furcation involvement in maxillary and mandibular first molars. Materials and methods:The study was conducted on individuals seeking care at the outpatient department of the Department of Periodontics.The study was conducted as a pilot study with 60 samples, with a tooth as a sample.These patients were clinically examined for furcation involvement sites on the maxillary (three sites) and mandibular first molars (two sites) using a Naber's probe.Two other examiners were also recruited for the study.These same patients were also assessed clinically by these two examiners independently and blindly for the grades of furcation involvement.The study duration was 2 months.The interrater and intrarater reliability between the three examiners were calculated using kappa statistics, and the level of agreement was evaluated.Results: Kappa statistics were used to analyze intrarater and inter-rater agreement among the three examiners.The kappa values for inter-rater agreement between the primary investigator (PI) and examiner 1 (EX1) ranged from 0.401 upper first molar-mesiobuccal furcation (UFM-MBF) to 0.585 lower first molar-buccal furcation (LFM-BF), indicating moderate agreement.Similarly, the kappa values for PI vs examiner 2 (EX2) ranged from 0.26 (UFM-BF) to 0.716 (LFM-BF), showing fair to substantial agreement.When comparing examiner 1 (EX1) and examiner 2 (EX2) with the primary investigator (PI) using the intraclass correlation coefficient (ICC), the ICC values were 0.63 (PI-EX1) and 0.57 (PI-EX2), reflecting moderate agreement among the three examiners.Conclusion: Furcation lesions can be more accurately characterized as a consequence of the new system's ability to handle a wider range of situations.Our findings emphasize the importance of supplementing clinical detection with intraoral radiographs for the diagnosis of furcation lesions, aligning with the existing literature.Further prospective studies are needed to validate these findings and strengthen the evidence.Clinical significance: Comparing different classification systems and assessing their reliability enables a better understanding of their limitations and highlights the need to integrate both clinical and radiographic techniques for more precise diagnosis.This approach not only enhances the management of furcation lesions, but also lays the foundation for developing a comprehensive classification system that incorporates clinical and radiographic assessments along with their corresponding treatment strategies.