Reliability of the Kindelan scoring system for alveolar bone grafting with and without a pre-graft occlusal radiograph in patients with cleft lip and palate

We aimed to compare the reliability of the Kindelan system using one postoperative radiograph to assess the success of alveolar bone grafts with the use of two occlusal radiographs (before and after operation). This retrospective reliability study took place at Glasgow Dental Hospital cleft unit, and two examiners scored 84 radiographs two weeks apart. The sample was taken from a database of patients having alveolar bone grafts between 2007 and 2010. They had an upper anterior occlusal radiograph taken before the graft and another at a mean of 6 months (range 3-12 months) postoperatively. Kappa scores were used to measure intraobserver and interobserver agreement. Intraexaminer agreement ranged from good to very good using one or two radiographs, and interexaminer agreement ranged from moderate to good for both systems. Reliability when scoring with either one or two radiographs was similar, and ranged from good to very good.