Diagnostic Accuracy of CBCT for Aggressive Periodontitis

Abstract

Cone beam computed tomography (CBCT) is an indispensable diagnostic imaging tool for dento-alveolar examination. CBCT scanning has become a valuable imaging modality in the field of Periodontology for the detection of very small osseous defects. A patient reported to the department of Periodontology with a complaint of loose teeth. Clinical and direct digital radiographic (DDR) examination revealed advanced periodontal destruction, but failed to diagnose the morphology of generalized osseous defects, around all the surfaces of each tooth. CBCT images were obtained for detailed examination of each and every osseous defect around all the teeth. Patient was then diagnosed with generalized aggressive periodontitis. Flap surgery was performed in order to eliminate the periodontal pockets, exposing and degranulating the osseous defects. Actual measurements of surgically exposed osseous defects were compared with that seen in CBCT images and found to be exactly identical. CBCT has proved to be as accurate in measuring osseous defects as direct measurements with a periodontal probe. Buccal and lingual periodontal defects that could not be diagnosed by conventional radiography can be identified with CBCT.

Computer-assisted identification of the gingival sulcus and periodontal epithelial junction on high-frequency ultrasound images

“…Both X-rays and cone beam computed tomography yield information only on vertical and horizontal bone atrophies. While cone beam computed tomography provides more information than periapical X-rays [29], it cannot be used for regular periodontal checkups because of the high doses of radiation required for a proper evaluation.…”

From manual periodontal probing to digital 3‐D imaging to endoscopic capillaroscopy: Recent advances in periodontal disease diagnosis

“…CBCT has been shown to be a reliable imaging technique in evaluating the maxillofacial area for oral and periodontal surgeries, dental implant planning and endodontic treatment . CBCT has shown greater diagnostic accuracy in detecting periodontal defects when compared to digital intraoral radiography . Clinical studies showed that CBCT is highly accurate in measuring periodontal bony defects, relative to the gold standard, direct probing (bone sounding) in chronic and aggressive periodontitis .…”

“…Another study reported that CBCT can successfully provide accurate and high‐quality radiographic images for visualizing the periodontal ligament space . Thus, CBCT has been found to be a useful adjunct for periodontal diagnosis and treatment planning . However, CBCT has mostly been limited to imaging hard tissue due to the low contrast resolution of soft tissue .…”

“…[54][55][56] CBCT has shown greater diagnostic accuracy in detecting periodontal defects when compared to digital intraoral radiography. [57][58][59] Clinical studies showed that CBCT is highly accurate in measuring periodontal bony defects, relative to the gold standard, direct probing (bone sounding) in chronic and aggressive periodontitis. 57,[60][61][62][63] Moreover, it has been demonstrated that 3-D radiographic imaging by CBCT provides high accuracy in detecting and evaluating the amount of periodontal tissue lost in the furcation areas.…”

Tomografia computadorizada no planejamento cirúrgico em Periodontia: revisão de literatura

“…6 Em Periodontia, a investigação clínica relativa a medição linear de defeitos intraósseos periodontais por TCFC ainda não é uma rotina e existem poucos relatos. 7,8 As radiografias periapicais, interproximais e panorâmicas são frequentemente empregadas para analisar e diagnosticar níveis ósseos periodontais, no entanto, fornecem apenas uma imagem bidimensional e podem depreciar o real aspecto e profundidade do defeito ósseo. A geometria de projeção do feixe de raios X, por muitas vezes, causa distorção e aumento da imagem, o que dificulta a obtenção de uma análise fidedigna da crista óssea alveolar.…”