Commentary: Cone‐Beam Computed Tomography: An Essential Technology for Management of Complex Periodontal and Implant Cases

A Comparison of Clinical and Radiological Parameters in the Evaluation of Molar Furcation Involvement in Periodontitis

“…Uz to, koristan je u postavljanju preciznije prognoze pojedinačnih zuba jer omogućuje 3D analizu okolne kosti koja utječe na proces donošenja odluka u parodontologiji, posebno u postupcima vođene regeneracije tkiva (21,22). Prema trenutačno dostupnim dokazima, Američka akademija za parodontologiju navodi da 2D rendgenska snimka svih zuba (status), u kombinaciji s kliničkim parodontnim sondiranjem, ostaje zlatni standard za sveobuhvatnu procjenu struktura parodonta (23). No vodeći su stručnjaci konsenzus panela zasnovanih na dokazima identificirali nekoliko scenarija u kojima bi primjena CBCT-a bila klinički korisna, uključujući i slučajeve kada je dijagnosticirana uznapredovala zahvaćenost furkacije (23).…”

“…Prema trenutačno dostupnim dokazima, Američka akademija za parodontologiju navodi da 2D rendgenska snimka svih zuba (status), u kombinaciji s kliničkim parodontnim sondiranjem, ostaje zlatni standard za sveobuhvatnu procjenu struktura parodonta (23). No vodeći su stručnjaci konsenzus panela zasnovanih na dokazima identificirali nekoliko scenarija u kojima bi primjena CBCT-a bila klinički korisna, uključujući i slučajeve kada je dijagnosticirana uznapredovala zahvaćenost furkacije (23). Iako postoji nekoliko studija in vivo i in vitro o procjeni točnosti CBCT-a u mjerenju parodontnih koštanih defekata, autori samo dviju studija ispitivali su učinkovitost CBCT-a u dijagnosticiranju zahvaćenosti furkacije i to usporedbom radiološkog s intraoperativnim mjerenjima (24,25).…”

“…At this time, a routine use of CBCT for the diagnosis and treatment of moderate-to-severe periodontitis does not appear to be warranted from radiation exposure and cost perspective (45). However, in selective cases a limited view of CBCT may be useful and should be considered as an adjunctive diagnostic method after a comprehensive periodontal examination as a useful and widely available tool that has the potential to improve today's standard of care by providing some significant changes in the course of treatment (23,45). For complicated cases when standard examination fails to provide sufficient information for diagnosis and/or treatment planning, CBCT may be added with the smallest available field of view and optimally selected exposure settings (41).…”

“…Additionally, it is helpful in determining more accurate prognosis for each tooth by allowing 3D analysis of the surrounding bone, which influences the decision making process in periodontology, especially for periodontal regeneration procedures (21,22). According to current available evidence, American Academy of Periodontology has stated that a 2D full-mouth radiograph combined with clinical periodontal probing remain the gold standard for a comprehensive evaluation of periodontal structures (23). However, experts on the best evidence consensus panel identified several scenarios where addition of CBCT imaging would be useful, including the scenario in which an advanced FI has been diagnosed (23).…”

“…According to current available evidence, American Academy of Periodontology has stated that a 2D full-mouth radiograph combined with clinical periodontal probing remain the gold standard for a comprehensive evaluation of periodontal structures (23). However, experts on the best evidence consensus panel identified several scenarios where addition of CBCT imaging would be useful, including the scenario in which an advanced FI has been diagnosed (23). Although there are several in vivo and in vitro studies in assessing the accuracy of CBCT in the measurement of periodontal bone defects, there are just two studies that have investigated the efficacy of CBCT in diagnosing FI by comparing its result to intrasurgical assessment (24,25).…”