Studies on the relationship between changes in radiographic bone height and probing attachment

Abstract

The aim of this investigation was to determine the relationship between loss of radiographic crestal bone height and probing attachment loss. As part of this aim, we are introducing a new method for determination of a threshold for significant probing attachment loss which takes into account the error contributed by alteration in tissue tone. 57 adults with established periodontitis were selected. Radiographs were taken using the Rinn alignment system. Crestal change was determined from bone height measurements on digitized images of pairs of radiographs using the "side-by-side" technique of analysis developed recently by us. Probing attachment loss was measured using the Florida electronic probe system. Radiographic and probing measurements were made at baseline and after 1 year. No treatment was given during this period. A direct and significant relationship was observed between radiographic bone loss and probing attachment loss on a site basis (p = 0.0001, r2 = 0.018) and between subject means (p = 0.0014, r2 = 0.16). Radiographic and probing attachment change at all categories of sites, dichotomously classified as to not changing or loosing indicated 13% of sites were loosing by measurement of radiographic change and 9.6% were loosing by measurement of attachment change. Concordance in radiographic and attachment level change was found in 82% of sites examined. The relative diagnostic import of change in probing attachment or change in radiographic bone height requires treatment outcome studies based on use of diagnostic information of the 2 measuring techniques used singly and in combination.

Is Radiologic Assessment of Alveolar Crest Height Useful to Monitor Periodontal Disease Activity?

“…In most cases, assessment of periodontal disease status is now performed using periodontal probing (with clinical attachment-loss measurements made in relation to a fixed anatomical landmark, usually the CEJ) and/or alveolar bone levels from intraoral radiographs. Both of these techniques are vulnerable to errors [12, 13, 14]. While periodontal probing remains the gold standard for periodontal assessment, it has several limitations regarding reproducibility and sensitivity, depending on the degree of edema and probing technique (for example, probing force, angle of the probe, size of the probe and probe calibration [that can differ from one brand to another]), making the detection of small changes difficult [15].…”

Radiographic Measures of Chronic Periodontitis and Carotid Artery Plaque

“…Radiographic measurement of alveolar bone is an accurate method for assessment of periodontitis [11][12][13] and compares favorably with clinical measures of periodontitis. 14 The panoramic radiograph can be performed in a few minutes in relative patient comfort compared with 20 to 30 minutes for a complete clinical oral evaluation. Interestingly, Ravon et al have shown a high degree of correlation between carotid artery calcifications and CP severity, both determined from the same panoramic radiograph.…”

“…14 However, to date, radiographs have not been used to assess CP in research studies of subclinical atherosclerosis. The present crosssectional study was undertaken to measure CP radiographically and to determine the association with carotid artery plaque in a stroke-free community-based cohort.…”

Relationships Between Longitudinal Changes in Radiographic Alveolar Bone Height and Probing Depth Measurements: Data From Postmenopausal Women

“…Jeffcoat 2 reported a strong concordance between presence or absence of probing attachment loss and bone loss. In contrast to these reports, Hausmann et al 3 and Machtei et al 4 found only very weak relationships between changes in radiographic bone height and probing attachment level.…”