Comparison of periodontal evaluation by cone-beam computed tomography, and clinical and intraoral radiographic examinations
- 237 Downloads
Cone-beam computed tomography (CBCT) has been widely used in many fields of dentistry. However, little is known about the accuracy of CBCT for evaluation of periodontal status. The objective of this study was to compare and correlate periodontal assessments among CBCT, clinical attachment loss (CAL) measurement, and periapical (PA)/bitewing (BW) radiography.
Eighty patients (28 males, 52 females; age range, 19–84 years) from the University of Texas School of Dentistry at Houston were evaluated retrospectively. Measurements were taken on the central incisors, canines, and first molars of the right maxilla and left mandible. CAL was extracted from periodontal charts. The radiographic distance from the cementum–enamel junction (CEJ) to the alveolar crest was measured for tooth mesial and distal sites on PA/BW and CBCT images using MiPacs software and Anatomage Invivo software, respectively. One-way ANOVA and Pearson analysis were performed for statistical analyses.
The CEJ–crest distances for CBCT, PA/BW, and CAL were 2.56 ± 0.12, 2.04 ± 0.12, and 2.08 ± 0.17 mm (mean ± SD), respectively. CBCT exhibited larger values than the other two methods (p < 0.05). There were highly significant positive correlations among CBCT, PA/BW, and CAL measurements at all examined sites (p < 0.001). The Pearson correlation coefficient was higher for CBCT with CAL relative to PA/BW with CAL, but the difference was not significant (r = 0.64 and r = 0.55, respectively, p > 0.05).
This study validates the suitability of CBCT for periodontal assessment. Further studies are necessary to optimize the measurement methodology with CBCT.
KeywordsCone-beam computed tomography Clinical attachment loss Intraoral radiography Periodontal assessment
Compliance with ethical standards
Conflict of interest
Wenjian Zhang, Shazia Rajani, and Bing-Yan Wang declare that they have no conflict of interest.
Human rights statement
All procedures followed were in accordance with the ethical standards of the responsible national and institutional committees on human experimentation and with the Helsinki Declaration of 1964 and later versions. The Institutional Review Board (IRB) of the University of Texas Health Science Center at Houston approval was granted prior to the start of the study (HSC-DB-16-0398).
The study was a retrospective chart review, and the requirement for informed consent was waived under IRB approval.
- 22.Bragger U. Radiographic parameters: biological significance and clinical use. Periodontology. 2000;2005(39):73–90.Google Scholar
- 24.Mol A. Imaging methods in periodontology. Periodontology. 2000;2004(34):34–48.Google Scholar
- 37.Grimard BA, Hoidal MJ, Mills MP, Mellonig JT, Nummikoski PV, Mealey BL. Comparison of clinical, periapical radiograph, and cone-beam volume tomography measurement techniques for assessing bone level changes following regenerative periodontal therapy. J Periodontol. 2009;80:48–55.CrossRefPubMedGoogle Scholar
- 41.Takeshita WM, Iwaki LCV, Da Silva MC, Tonin RH. Evaluation of diagnostic accuracy of conventional and digital periapical radiography, panoramic radiography, and cone-beam computed tomography in the assessment of alveolar bone loss. Contemp Clin Dent. 2014;5:318–23.CrossRefPubMedPubMedCentralGoogle Scholar
- 42.Anter E, Zayet MK, El-Dessouky SH. Accuracy and precision of cone beam computed tomography in periodontal defects measurement (systematic review). J Indian Soc Period. 2016;20:235–43.Google Scholar
- 43.Feijo CV, Lucena JG, Kurita LM, Pereira SL. Evaluation of cone beam computed tomography in the detection of horizontal periodontal bone defects: an in vivo study. Int J Periodontics Restor Dent. 2012;32:e162–8.Google Scholar
- 48.White SC, Pharoah MJ. Oral radiology principles and interpretation. 7th ed. St. Louis: Elsevier; 2014.Google Scholar