Cone Beam Computed Tomography Used in the Assessment of the Alveolar Bone in Periodontitis

Abstract

Objectives: The aim of our study was to highlight the advantages of using Cone Beam Computed Tomography in the study of the extent of the alveolar bone loss, compared to the conventional intraoral radiography and to prove the boon of the CBCT scans for establishing the correct periodontal diagnosis. Material and methods: A total of 16 patients with age between 35-55 years old, and a minimum of 8 teeth per dental arcade, presenting peridontal clinical symptomatology were selected. We used a custom periodontal chart that included the measuring of the gingival recession and the pocket depth in 6 points for 16 teeth, 8 maxillary teeth and 8 mandibulary teeth in all cases. For the radiographic evaluation we used CBCT imaging and intraoral radiography. Results: CBCT scans offers the possibilities of measuring with accuracy the alveolar bone loss on mesial, distal vestibular and oral sides. It provides images with the exact position of the bone and also the expediency to assess the correct diagnosis. Retroalveolar radiography offers just a hint of the possible position of the alveaolar bone in all cases the anatomical details were offered by CBCT. Conclusions: A correct periodontal diagnosis using conventional radiography is not possible because of the superimposition of the anatomical structures. The importance of CBCT imaging is no longer disputed, at the present time it is the best radiographic investigation available.

Volumetric Cone Beam Computed Tomography for the Assessment of Oral Manifestations in Systemic Sclerosis: Data from an EUSTAR Cohort

“…Periodontal status was appreciated by periodontal probing depth (PPD), the distance from the gingival margin to the base of the gingival sulcus, and by clinical attachment level (CAL), the distance on the buccal or labial surface from the cementoenamel junction to the base of the gingival sulcus [14,15,16,17,31,32]. We used a custom periodontal chart that included the measurement of the gingival recession and the pocket depth in 4 points (mesiobuccal, distobuccal, mesiolingual, and distolingual) for each tooth, assessed with a periodontal probe marked in millimeter intervals [21]. The presence of periodontal disease in a given tooth was defined as either a PPD > 3 mm or a CAL ≥ 5.5 [14,15,16,17,30,31].…”

“…Radiographically, PDL occurs as the radiolucent space between the lamina dura and the tooth root; its normal width ranges between 0.15 mm and 0.21 mm and decreases with age [21]. The presence of a widened PDL was recorded on both panoramic radiographs and CBCT and appreciated as widening near the coronal portion of the root or in the periapical region in either one of both sides of the root [14,15,16,17].…”

“…PDL represents the soft tissue between the inner wall of the alveolar pocket and the roots of the teeth, consisting mainly of type I collagen and connecting the cementum of teeth to the gingivae and alveolar bone [14,15,16,17,19,21].…”

“…Various papers have rated the frequency of such imaging abnormalities in SSc, mainly using two-dimensional radiographs [9,14,15,16,17,20], while the performance of Cone Beam Computed Tomography (CBCT) was assessed in few case reports [21,22,23].…”

“…Since three-dimensional (3-D) data reconstruction of the intraoral conditions using digital tools provide additional evidence to detect damaging manifestations within the oral cavity and is actually extensively used in the dental field for recognizing the location and severity of lesions in small anatomical regions (two or three teeth), we supposed that 3-D CBCT may also be useful to identify and, therefore, to better characterize scleroderma-related oral pathology [21,22,23].…”