Detection of periodontal bone loss using cone beam CT and intraoral radiography

Objective: The aim of this study was to compare periapical radiographs with cone beam CT (CBCT) imaging in detecting and localizing alveolar bone loss by comparing linear measurements of the height, depth and width of the defects and identifying combined bone defects in tomographic images. Methods: The images were selected from a secondary database containing images of patients referred for periodontal evaluation. The sample consisted of 51 sites showing both horizontal and vertical bone loss, assessed by 3 trained examiners. Results: The results showed that there were no statistically significant differences between the imaging methods in terms of identification of the pattern of bone loss. However, there were differences between the two methods when the distance between the cemento-enamel junction (CEJ) and the alveolar crest (AC) was measured. When the distance between the CEJ and the deepest point and width of the defect were measured, the methods showed no statistically significant difference. In this study, 30.8% of the 39 teeth evaluated had combined bone defects. Conclusions: The two methods differ when detecting the height of the alveolar bone crest but present similar views of the depth and width of bone defects. CBCT was the only method that allowed for an analysis of the buccal and lingual/palatal surfaces and an improved visualization of the morphology of the defect. Dentomaxillofacial Radiology (2012) 41, 64-69. doi:10.1259/dmfr/13676777