Diagnostic validity (or acuity) of 2D CCD versus 3D CBCT-images for assessing periodontal breakdown

doi:10.1016/j.tripleo.2007.03.012

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology

Volume 104, Issue 3, September 2007, Pages 395-401

https://doi.org/10.1016/j.tripleo.2007.03.012 Get rights and content

Objective

The objective of this study was to compare 2-dimensional intraoral digital images with 3-dimensional cone beam CT (CBCT) in assessment of periodontal bone levels and defects.

Methods

Thirty periodontal bone defects of 2 adult human skulls (with soft tissue or substitute) were evaluated by using intraoral digital radiography and CBCT. Digital radiographs were made with a size #2 CCD sensor and a 60-kV DC x-ray unit, with 0.28, 0.42, or 0.56 mAs as respective exposure settings. For CBCT, jawbone images were obtained at 120 kV and 23.87 mAs. Periodontal bone levels and defects on both imaging modalities were assessed and compared to the gold standard. Delineation of lamina dura, crater defect, furcation involvements, contrast, and bone quality were also analyzed.

Results

Linear measurement deviations of periodontal bone levels from the gold standard ranged from 0.19 to 1.66 mm for intraoral radiography versus 0.13 to 1.67 mm for CBCT. Accuracy was not significantly different between both imaging modalities (P = .161). Intraoral radiography scored significantly better for contrast, bone quality, and delineation of lamina dura, but CBCT was superior for assessing crater defects and furcation involvements (P = .018).

Conclusions

CBCT images allowed comparable measurements of periodontal bone levels and defects as intraoral radiography. CBCT images demonstrated more potential in the morphological description of periodontal bone defects, while the digital radiography provided more bone details. These findings may offer perspectives for further studies on periodontal diagnostics, prognostics, and presurgical planning with CBCT.

Section snippets

Materials and Methods

Thirty periodontal bone levels or defects of 2 adult human skulls, a cadaver head and a dry skull, were evaluated by using intraoral digital radiography (CCD, Schick Technologies, Long Island City, NY) and CBCT (I-Cat, 12 bit, Imaging Sciences International, Hatfield, PA). The upper and lower jaws of the cadaver head were fixed with 10% formalin and functioned as a clinical subject. The adult human dry skull was covered with a soft tissue substitute, Mix D,³⁰ and used as a simulation.

For the

Statistical Analysis

Bone levels of the selected sites, measured on the digital intraoral images, were compared with the gold standards. Exposure settings, imaging methods, and observers were used as independent variables and bone levels and defects as the dependent ones. The gold standard was obtained by averaging the scores of 2 observers. Intraclass correlation showed no observer effect for these scores.

The acquired data were first scanned for outliers and tested for normality. As normality could not be found

Linear bone level measurements

Table I shows absolute linear measurement deviations of periodontal bone levels from the gold standard. The deviations for intraoral radiography ranged from 0.19 to 1.66 mm and 0.13 to 1.67 mm for CBCT. Further analyses revealed no significant difference between the 2 imaging modalities (P = .161, Table II). The currently applied range of exposure settings for intraoral radiography yielded no significant difference in accuracy performance (P = .425, Table II) as such that it was justified to

Discussion

As seen in the results, linear bone level measurements were similar with 2D intraoral digital and 3D CBCT images. Both imaging modalities had same over- and underestimation rates for periodontal bone defects. Bone craters and furcation involvements were better depicted on CBCT than on intraoral images. This could be because the CBCT provides multiplaner slices and 3D information. However, because of the lower resolution, CBCT scored less than the intraoral images in contrast, bone quality, and

Conclusion

CBCT allowed similar periodontal bone level measurements as digital intraoral radiography. Bone craters and furcation involvements were better depicted on CBCT, while contrast, bone quality, and details of lamina dura scored better on digital intraoral radiography. A selective use of both imaging modalities might thus aid periodontal diagnosis and treatment planning. However, selection criteria are needed to define the conditions and specific indications for use of 2D and/or 3D imaging

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Oral and maxillofacial radiologyDiagnostic validity (or acuity) of 2D CCD versus 3D CBCT-images for assessing periodontal breakdown

Objective

Methods

Results

Conclusions

Section snippets

Materials and Methods

Statistical Analysis

Linear bone level measurements

Discussion

Conclusion

Dent Clin North Am

Dent Clin North Am

J Dent

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

Eur J Radiol

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

Accuracy of radiographic assessment of interproximal bone loss in intrabony defects using linear measurements

Eur J Oral Sci

Imaging of periimplant bone levels of implants with buccal bone defects

Clin Oral Implants Res

Effect of x-ray beam vertical angulation on radiographic assessment of alveolar crest level

Indian J Dent Res

Radiographic parameters: biological significance and clinical use

Periodontol 2000

Imaging methods in periodontology

Periodontol 2000

A review of the reliability of radiographic measurements in estimating alveolar bone changes

J Clin Periodontol

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Dentomaxillofac Radiol

Advances in measurements of periodontal bone and attachment loss

Monogr Oral Sci

Final report of the minosquare concerted action

Imaging: new versus traditional technological aids

Int Dent J

Future trends in dental radiology

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

Oral and maxillofacial radiology
Diagnostic validity (or acuity) of 2D CCD versus 3D CBCT-images for assessing periodontal breakdown