Cone Beam Computed Tomography Versus Intraoral Digital Radiography in Detection and Measurements of Simulated Periodontal Bone Defects

The selection of a regenerative approach is primarily based on the configuration of the intrabony defect and esthetic risk of treatment. Accurate diagnosis of periodontal bone defects, such as vertical bone defects or furcation involvements, is a challenge for dental clinicians. A deficiency in comprehensive diagnosis may result in: 1) compromised prognosis of teeth; 2) changes in treatment plan; 3) unnecessary treatment; 4) longer treatment time; and 5) unanticipated treatment costs. Thus, it is very important to have access to accurate diagnostic tools that can aid clinicians in cultivating an appropriate treatment choice. Periodontal assessments utilizing both clinical and radiographic examinations allow for the establishment of an accurate diagnosis as well as subsequent treatment choices. Radiography plays an important role in periodontal diagnosis mainly because radiographs can reveal the amount and type of damage caused to the alveolar bone. Digital imaging technique has created challenging opportunities for dental radiographic diagnosis. Digora was the first digital system for dental radiography based on a photostimulable phosphor technology. E9ickholz et al. at 1999 compared linear measurements of interproximal bone loss on digitized radiographic images after application of different filters to the gold standard of intrasurgical measurements they concluded that all radiographic assessments on the digitized images came close to the intasurgical gold standard. 2D technologies do not allow for measurement of the bucco-lingual (B-L) width of the defect. Only the vertical height and the mesio-distal (M-D) width of the defect can be measured with 2D images. Use of 3D volumetric images and 2D images in artificial bone defects have shown that CBCT has a sensitivity of 80% to 100% in detection and classification of bone defects, while intraoral radiographs present a sensitivity of 63% to 67%. When compared with periapical and panoramic images, the CBCT has al