Accuracy of Parallel Periapical Versus Bitewing Radiographs in Determining the Level of Alveolar Bone Crest at the Posterior Area of the Jaws
Journal of Dental School,
Vol. 40 No. 2 (2022),
18 April 2023
,
Page 43-47
https://doi.org/10.22037/jds.v40i2.40278
Abstract
Objectives Periodontal clinical parameters are highly sensitive for the assessment of bone resorption, while radiographic images are highly specific. Two-dimensional parallel periapical (PA) and bitewing (BW) intraoral radiographs are used as adjuvant methods to assess bone resorption in periodontal diseases. The present study aimed to compare the efficacy of PA and BW radiographs in assessing marginal bone level.
Methods This cross-sectional study was conducted on 77 (52 females and 25 males) subjects with a mean age of 40.12±14.9 years with chronic periodontitis. Parallel PA and BW radiographs of patients, who required periodontal flap surgery or crown lengthening, were acquired, and evaluated. The distance between the alveolar bone crest (ABC) and the cemento-enamel junction (CEJ) was determined during surgery using the Williams probe. The same distance was measured in proximal areas on intraoral radiographs using Romexis Version 11.4. To evaluate intra-observer agreement, three observers re-evaluated the radiographs after a minimum of 1 week. Intra-class correlation coefficient (ICC) was applied to evaluate the inter- and intra-observer agreement. Data were analyzed using the Shapiro-Wilk test and paired t-test.
Results According to the results, the mean distance between the CEJ and ABC was 4.61±1.22 mm, and the mean distance on the PA and BW radiographs was 4.20±1.23 (P<0.001) and 4.02±1.06 mm (P<0.001), respectively. PA radiography was more accurate than BW radiography, although the difference was insignificant (P=0.182). The mean ICC value of the inter-observer agreement was 0.88 for BW and 0.87 for PA radiographs. The mean intra-observer agreement was 0.97 and 0.95 for BW and PA radiographs, respectively.
Conclusion The accuracy of PA radiography was higher than BW radiography. However, there was no significant difference regarding the accuracy of these two techniques in determining the level of ABC in the posterior area of the jaws.
- Radiography
- Dental
- Diagnosis
- Chronic Periodontitis
- Alveolar Bone Loss
How to Cite
References
Akesson L, Håkansson J, Rohlin M. Comparison of panoramic and intraoral radiography and pocket probing for the measurement of the marginal bone level. J Clin Periodontol. 1992; 19(5):326-32.
Albandar JM, Abbas DK, Waerhaug M, Gjermo P. Comparison between standardized periapical and bitewing radiographs in assessing alveolar bone loss. Community Dent Oral Epidemiol. 1985; 13(4):222-4.
Christiaens V, De Bruyn H, Thevissen E, Koole S, Dierens M, Cosyn J. Assessment of periodontal bone level revisited: a controlled study on the diagnostic accuracy of clinical evaluation methods and intra-oral radiography. Clin Oral Investig. 2018; 22(1):425-31.
Jenkins WM, Brocklebank LM, Winning SM, Wylupek M, Donaldson A, Strang RM. A comparison of two radiographic assessment protocols for patients with periodontal disease.Br Dent J. 2005; 198(9):565-9.
Van Der Stelt PF. Filmless imaging: the uses of digital radiography in dental practice. J Am Dent Asso. 2005; 136(10):1379-87.
Ivanauskaite D, Lindh C, Rangne K, Rohlin M. Comparison between Scanora panoramic radiography and bitewing radiography in the assessment of marginal bone tissue. Stomatologija. 2006; 8(1):9-15.
Ridao-Sacie C, Segura-Egea JJ, Fernández-Palacín A, Bullón-Fernández P, Ríos-Santos JV. Radiological assessment of periapical status using the periapical index: comparison of periapical radiography and digital panoramic radiography. Int Endod J. 2007; 40(6):433-40.
Jorgenson T, Masood F, Beckerley JM, Burgin C, Parker DE. Comparison of two imaging modalities: F-speed film and digital images for detection of osseous defects in patients with interdental vertical bone defects. Dentomaxillofac Radiol. 2007; 36(8):500-5.
Jeffcoat MK, Wang IC, Reddy MS. Radiographic diagnosis in periodontics. Periodontol 2000. 1995; 7(1):54-68.
Akarslan ZZ, Akdevelioğlu M, Güngör K, Erten H. A comparison of the diagnostic accuracy of bitewing, periapical, unfiltered, and filtered di, digital panoramic images for approximal caries detection in posterior teeth. Dentomaxillofac Radiol. 2008; 37(8):458-63.
Reed BE, Polson AM. Relationships between bitewing and periapical radiographs in assessing crestal alveolar bone levels. J Periodontol. 1984; 55(1):22-7.
Kim TS, Benn DK, Eickholz P. Accuracy of computer-assisted radiographic measurement of interproximal bone loss in vertical bone defects. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002; 94(3); 379-87.
Corbet EF, Ho DK, Lai SM. Radiographs in periodontal disease diagnosis and management. Aust Dent J. 2009; 54 :( Suppl 1): S27–43.
Naito T, Hosokawa R, Yokota M. Three-dimensional alveolar bone morphology analysis using computed tomography. J Periodontol. 1998: 69(5):584-9.
Haghanifar S, Jenabian N, Tajalli P. Accuracy of bitewing radiography in posterior teeth. Interdental bone resorption.JMDS. 2006; 30(3,4):201-6.
Kumar V. Different radiographic modalities used for detection of common periodontal and periapical lesions encountered in routine dental practice. J Oral Hyg Health. 2014;2(163):2332-0702.
Fowler PV, Al-Ani AH, Thompson JMD. Comparison of reliability of categorical and continuous scales for radiographic assessments of bone infill following secondary alveolar bone grafting. Cleft Palate Craniofac J. 2018; 55(2):269-75.
Ezoddini Ardakani Fّ, Molla R, Akbari S, Haerian Ardakani A, Javadi Shalmani J. A comparison of panoramic, periapical and bite wing radiographies in evaluation of alveolar bone loss in periodontitis. JSSU. 2007; 15(2):22-30.
Vandenberghe B, Jacobs R, Bosmans H. Modern dental imaging: a review of the current technology and clinical applications in dental practice. Eur Radiol. 2010: 20(11); 2637–55.
Moradi J, Poorsafar F, Khoshhal M, Vafaei F, Gholami L. A comparison of two radiographic techniques to determine the distance between the alveolar bone crest and cementoenamel junction in patients with chronic periodontitis. DJH. 2010: 1(2); 37-40.
Persson RE, Tzannetou S, Feloutzis AG, Brägger U, Persson GR, Lang NP. Comparison between panoramic and intraoral radiographs for the assessment of alveolar bone levels in a periodontal maintenance population. J Clin Periodontol. 2003; 30(9):833-9.
Tetradis S, Mallya SM , Takei HH. Radiographic Aids in the Diagnosis of Periodontal Disease.In: NewmanMG, Takei HH, Klokkevold PR, Carranza FA. Newman and Carranza’s Clinical Periodontology. 13th ed. Philadelphia. Saunders; 2018: P: 870-86.
Wenzel A, Hintze H, Mikkelsen L, Mouyen F. Radiographic detection of occlusal caries in non-cavitated teeth: a comparison of conventional film radiographs, digitized film radiographs, and RadioVisioGraphy. Oral Surg Oral Med Oral Pathol. 1991; 72(5):621-6.
Zhang W, Rajani S, Wang BY. Comparison of periodontal evaluation by cone-beam computed tomography, and clinical and intraoral radiographic examinations. Oral Radiol. 2018; 34(3): 208-18.
Tugnait A, Hirschmann PN, Clerehugh V. Validation of a model to evaluate the role of radiographs in the diagnosis and treatment planning of periodontal diseases. J Dent. 2006; 34(7):509–15.
Grossi S, Genco RJ, Machtet EE, Ho AW, Koch G, Dunford R, et al. Assessment of risk for periodontal disease. II. Risk indicators for alveolar bone loss. J Periodontol. 1995; 66(1):23-9.
Baksı BG. Measurement accuracy and perceived quality of imaging systems for the evaluation of periodontal structures. Odontology. 2008; 96(1):55-60.
Kelly GP, Cain RJ, Knowles JW, Nissle RR, Burgett FG, Shick RA, et al. Radiographs in clinical periodontal trials. J Periodontol. 1975; 46(7):381-6.
Soikkonen K, Wolf J, Tenkanen M. Clinical and panoramic assessment of marginal bone loss. A cadaver study. Proc Finn Dent Soc. 1990; 86(3-4):137-41.
Brägger U. Use of radiographs in evaluating success, stability, and failure in implant dentistry. Periodontol 2000. 1998; 17(1):77-88.
Pepelassi EA, Tsiklakis K, Diamanti‐Kipioti A. Radiographic detection and assessment of the periodontal endosseous defects. J Clin Periodontol. 2000; 27(4):224-30.
Rimondini L, Baroni C, Venturi M. Radiographic control in endodontics. Dental Cadmos. 1990; 58(19):46-8, 51-2.
Walsh TF, al-Hokail OS, Fosam EB. The relationship of bone loss observed on panoramic radiographs with clinical periodontal screening. J Clin periodontal. 1997; 24(3):153-7.
- Abstract Viewed: 284 times
- PDF Downloaded: 151 times