Cone-beam computed tomography performance in measuring periodontal bone loss

The present study aimed to evaluate the performance of cone-beam computed tomography (CBCT) in assessing periodontal bone loss. If effective, CBCT could potentially be a more comfortable and accurate way to evaluate this disease. One hundred and eighty tooth sites from 13 patients were included. Clinical attachment level (CAL) was measured, then CBCT images were acquired prior to periodontal surgery. Three periodontists measured the distance between the cemento-enamel junction and alveolar bone crest at the mesio-buccal, mid-buccal, disto-buccal, mesio-lingual/palatal, mid-lingual/palatal, and disto-lingual/palatal sites. Comparisons of measurements were made among three methods. Inter-observer and intra-observer variances were also analyzed. Statistically significant differences were found between CBCT and CAL + 2.04 mm (P = 0.000), as well as intra-surgical evaluation (P = 0.001). All sites showed differences in CBCT versus intra-surgical measurement and versus CAL + 2.04 comparisons, except the buccal sites (P = 0.187 and 0.147, respectively). This study indicates that the results of CBCT do not agree with results of intra-surgical measurement. As a result, CBCT should be used with caution and only when necessary, to avoid radiation hazards.