Design and validation of three questionnaires for cephalometric estimation of abnormal third molar eruption
DOI:
https://doi.org/10.5281/zenodo.21967090Keywords:
surveys and questionnaires; questionnaire design; validation studies as topic; cephalometry; molar third; tooth eruption; risk assessmentAbstract
Introduction: abnormal third molar eruption is a frequent problem in stomatology, but there is a lack of validated instruments that integrate clinical and cephalometric factors to predict its occurrence, which limits informed decision-making and prevention.
Objective: to design and validate three expert-directed questionnaires corresponding to the exploratory, construction, and validation phases of a risk scale for the cephalometric estimation of abnormal third molar eruption.
Method: a technological innovation study conducted between January and July 2025. Four phases were followed: literature review, pilot design with artificial intelligence, content validation through consultation with 15 experts (evaluated according to a competence scale), and external pilot testing. Cronbach's alpha and Kendall's W coefficients were used to assess internal consistency and agreement.
Results: 18 variables structured into five categories were identified. The questionnaires showed acceptable to good internal consistency (α: 0.756 – 0.875). Inter-expert agreement progressively increased (Kendall's W: 0.264 – 0.500; p<0.05). The pilot test demonstrated wording clarity above 75%, response time between 9 and 11 minutes, and absence of technical issues, with only one item modified.
Conclusions: the three questionnaires demonstrated adequate psychometric properties that support their validity for use in research aimed at developing predictive scales for cephalometric stratification of abnormal third molar eruption.
Downloads
References
Rodríguez del Toro M, González Espangler L, Romero García LI. Caracterización epidemiológica, clínica y cefalométrica del brote anormal de los terceros molares. Medicentro Electrónica [Internet]. 2023 [citado 12 Mar 2026];27(1). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1029-30432023000100004&lng=es
Gay-Escoda C, Sánchez-Torres A, Borrás-Ferreres J, Valmaseda-Castellón E. Third molar surgical difficulty scales: systematic review and preoperative assessment form. Med Oral Patol Oral Cir Bucal [Internet]. 2022 [citado 10 Mar 2026]; 27(1):e68-e76. DOI: https://doi.org/10.4317/medoral.24951
González Espangler L, Romero García LI, Soto Cantero LA. Predicción cefalométrica del brote anormal de los terceros molares en radiografías panorámicas. An Acad Cienc Cuba [Internet]. 2024 [citado 10 Mar 2026]; 14(4):e2877. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S2304-01062024000400020&lng=es&tlng=es
Bhansali SP, Bhansali S, Tiwari A. Review of difficulty indices for removal of impacted third molars and a new classification of difficulty indices. J Maxillofac Oral Surg [Internet]. 2021 [citado 12 Mar 2026];20(2):167-179. DOI: https://doi.org/10.1007/s12663-020-01452-6
Nuñez Peña LC, González-Espangler L, Peña-Sisto M, Garbey-Pierre Y. Escala de competencia para la evaluación de candidatos a expertos. MEDISAN [Internet]. 2025 [citado 12 Mar 2026]; 29:e5353. Disponible en: https://medisan.sld.cu/index.php/san/article/view/5353
Herrera Masó JR, Calero-Ricardo JL, González Rangel MÁ, Collazo Ramos MI, Travieso González Y. El método de consulta a expertos en tres niveles de validación. Rev Habanera Cienc Méd [Internet]. 2022 [citado 12 Mar 2026]; 21(1):e4711. Disponible en: https://revhabanera.sld.cu/index.php/rhab/article/view/4711
Kynoch K, Ramis MA, de Moel-Mandel C, Fernandez R, Khalil H. Development of a comprehensive tool to assess rigor when evaluating quality improvement projects. J Eval Clin Pract [Internet]. 2025 [citado 12 Mar 2026]; 31(4):e70193. DOI: https://doi.org/10.1111/jep.70193
Alaze A, Finne E, Razum O, Miani C. A questionnaire for a conceptual framework and interdisciplinary public health research using the Delphi technique-development and validation. Front Public Health [Internet]. 2025 [citado 12 Mar 2026]; 13:1436569. DOI: https://doi.org/10.3389/fpubh.2025.1436569
Durán CE, Azermai M, Vander Stichele RH. Systematic review of anticholinergic risk scales in older adults. Eur J Clin Pharmacol [Internet]. 2013 [citado 12 Mar 2026]; 69(7):1485-1496. DOI: https://doi.org/10.1007/s00228-013-1499-3
Ahmed Elkhidir Babikir MM, Abdalla Ibrahim FI, Osman Elhassan HH, Elhaj FA, Hamid Zain Elabdin SO, Sidahmed Mohammed SA, et al. Predicting intracranial hypertension in traumatic brain injury using AI: a systematic review of algorithms and their clinical integration potential. Cureus [Internet]. 2025 [citado 15 Dic 2025]; 17(4):e83267. DOI: https://doi.org/10.7759/cureus.83267
Kose J, Kesse-Guyot E, Duquenne P, Hercberg S, Galan P, Touvier M, et al. Development of multimorbidity indexes based on common mental health conditions. Int J Public Health [Internet]. 2025 [citado 12 Dic 2025]; 70:1607952. DOI: https://doi.org/10.3389/ijph.2025.1607952
Löchner J, Carlbring P, Schuller B, Torous J, Sander LB. Digital interventions in mental health: an overview and future perspectives. Internet Interv [Internet]. 2025 [citado 12 Dic 2025]; 40:100824. DOI: https://doi.org/10.1016/j.invent.2025.100824
Honma Y, Tsutsui T, Sakamaki W, Higuchi A, Nakamura E, Torii S. Exploring the link between calcaneal apophysis maturation and heel pain in youth baseball players. Orthop J Sports Med [Internet]. 2024 [citado 12 Dic 2025]; 12(10):23259671241253861. DOI: https://doi.org/10.1177/23259671241253861
Crawford J, Morfaw F, Ahmad F, Thabane L, Frisina A. The colon cancer screening behaviours survey for South Asians: a pilot study of feasibility and psychometric evaluation. J Patient Rep Outcomes [Internet]. 2020 [citado 12 Dic 2025]; 4(1):12. DOI: https://doi.org/10.1186/s41687-019-0160-z
Overgaard FG, Lauridsen HH, Damkjær M, Ebbesen AR, Hestbæk L, Konner MB, et al. Development of a standardized patient-reported clinical questionnaire for children with spinal pain. BMC Med Res Methodol [Internet]. 2025 [citado 12 Dic 2025]; 25(1):2. DOI: https://doi.org/10.1186/s12874-024-02449-2
Wolf MG, Ihm E, Maul A, Taves A. The response-process-evaluation method: a new approach to survey-item validation. Adv Methods Pract Psychol Sci [Internet]. 2025 [citado 12 Dic 2025]; 8(3):1-20. DOI: https://doi.org/10.1177/25152459251353135
Aho-Glele U, Bouabida K, Kooijman A, Popescu IC, Pomey MP, Hawthornthwaite L, et al. Developing the first pan-Canadian survey on patient engagement in patient safety. BMC Health Serv Res [Internet]. 2021 [citado 12 Dic 2025]; 21(1):1099. DOI: https://doi.org/10.1186/s12913-021-07089-6
Boynton PM. Administering, analysing, and reporting your questionnaire. BMJ [Internet]. 2004 [citado 12 Dic 2025]; 328(7452):1372-1375. DOI: https://doi.org/10.1136/bmj.328.7452.1372
Godfrey EM, Schwartz MR, Stukovsky KDH, Woodward D, Magaret AS, Aitken ML. Web-based survey piloting process as a model for developing and testing past contraceptive use and pregnancy history: cystic fibrosis case study. JMIR Form Res [Internet]. 2023 [citado 12 Dic 2025]; 7:e46395. DOI: https://doi.org/10.2196/46395
Zhao Y, Jalloh S, Lam PK, Kwarshak YK, Mbuthia D, Misago N, et al. Development and validation of a new measurement instrument to assess internship experience of medical doctors in low-income and middle-income countries. BMJ Glob Health [Internet]. 2023 [citado 16 Nov 2025]; 8(11):e013399. DOI: https://doi.org/10.1136/bmjgh-2023-013399
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Lian Cristino Nuñez Peña, Esther Mayor Guerra, Yurima Trupman Hernández, Daniel Arias Nieves
This work is licensed under a Creative Commons Attribution 4.0 International License.
