Cone beam computed tomography (CBCT) for diagnosis and treatment planning in periodontology: systematic review update

Objectives To update the findings of a systematic review from the year 2016 on the evidence for the accuracy and potential benefits of cone beam computed tomography (CBCT) in periodontal diagnostics. Material and methods A systematic literature search was performed and the criteria for PICO, PRISMA and risk of bias assessment were applied. Only clinical trials (> 10 patients) conducted in humans on periodontal bone loss, i.e. vertical and/or horizontal or furcation involvement, in CBCT compared with clinical and/or conventional radiographic measures were included. Results From 1152 articles identified, 11 case series on furcations and eight on vertical and/or horizontal bone loss were included. The studies showed moderate risk of bias and heterogeneous study designs. The agreement between non-surgical clinical or two-dimensional radiographic assessments of horizontal, vertical or interfurcal bone loss and CBCT measurements was analysed in 11 studies and was low in six studies with comparable study designs. A high accuracy (80–84%) of CBCT measurements compared with intra-surgical findings of furcation involvement was observed in four studies. Comparing CBCT with intra-surgical measurements of vertical or horizontal bone loss, an accuracy between 58 and 93% was found in four out of six studies. Three studies were analysed and indicated benefits of CBCT in decision making and/or a reduction of treatment costs and time in teeth of interest. Conclusions The findings provide additional evidence for the accuracy of CBCT in assessing periodontal bone loss. Clinical relevance CBCT is an accurate diagnostic tool in periodontology, which needs to be carefully considered in certain situations.