Diagnostic accuracy of periapical radiograph, cone beam computed tomography, and intrasurgical linear measurement techniques for assessing furcation defects: a longitudinal randomised controlled trial



The aim of this study was to evaluate the accuracy of cone beam computed tomography (CBCT), periapical radiograph, and intrasurgical linear measurements in the assessment of molars with furcation defects.

Materials and methods

This parallel, single-blinded, randomised controlled trial (RCT) consisted of 22 periodontitis patients who had molar with advanced furcation involvement (FI). All patients followed the same inclusion criteria and were treated following the same protocol, except for radiographic evaluation (CBCT vs. periapical). This study proposed and evaluated five parameters that represent the extent and severity of furcation defects in molars teeth, including CEJ-BD (clinical attachment loss), BL-H (depth), BL-V (height), RT (root trunk), and FW (width).


There were no statistically significant differences between CBCT and intrasurgical linear measurements for any clinical parameter (p > 0.05). However, there were statistically significant differences in BL-V measurements (p < 0.05) between periapical and intrasurgical measurements in maxillary molars. Meanwhile, the sensitivity were 62.8% and 56.9% for CBCT and periapical, respectively.


Overall, when compared to the intrasurgical measurements, CBCT provided better diagnostic, sensitivity, and quantitative information on CAL, height, depth, and width of the furcation defects than periapical radiograph.

Clinical relevance

An accurate presurgical furcation diagnostic can guide the clinicians from the stage of diagnosis to definitive management so that unnecessary periodontal surgical interventions can be prevented.

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The work was supported by LESTARI Research Grant, Universiti Teknologi MARA, Malaysia (600-IRMI 5/3/LESTARI (011/2019)).

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Corresponding author

Correspondence to Nurul Ain Mohamed Yusof.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study were in accordance with the Ethical Committee of Universiti Teknologi MARA (REC/295/17) and registered with the Identification of Randomised Controlled Clinical Trials worldwide registry (ISRCTN89375372). This study was conducted following the ICH Good Clinical Practice Guidelines, Malaysia Good Clinical Practice Guidelines, and the Declaration of Helsinki.

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Informed consent was obtained from all individual participants included in the study.

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Yusof, N.A.M., Noor, E., Reduwan, N.H. et al. Diagnostic accuracy of periapical radiograph, cone beam computed tomography, and intrasurgical linear measurement techniques for assessing furcation defects: a longitudinal randomised controlled trial. Clin Oral Invest 25, 923–932 (2021). https://doi.org/10.1007/s00784-020-03380-8

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  • Accuracy
  • Cone beam computed tomography
  • Furcation defect
  • Periapical radiograph