Comparison between Cone-Beam Computed Tomography and intraoral radiography to diagnose periodontal-bone defect and treatment response

The purpose of this study was to explore the diagnostic value of CBCT in the determination of periodontal bone loss of infrabony defects. Twenty-one non-smoking adult subjects with a total of 38, periodontal bone defects were evaluated. To be eligible to participate in the study, patients had to have: at least one infrabony defect (distance between alveolar crest and base of the defect) with interproximal probing ≥ 5mm, attachment loss ≥3mm and intraoral periapical radiographs were taken to confirm the presence of suitable bony defects to be included in the study. Direct digital intraoral radiography (RVG) and CBCT were taken at the site of the bone defect. Periodontal bone defect will be measured from the cemento-enamel junction (CEJ) to the alveolar crest (AC) and from the cement-enamel junction (CEJ) to the bottom of the defect. Patients were instructed in self-performed plaque control measures, three weeks before surgery, full mouth supra-gingival and sub-gingival debridement and root planning of all quadrants were performed. Two weeks following initial cause-related therapy, periodontal reevaluation was performed to confirm those sits indicated for periodontal surgery. Periodontal flap surgery was performed for the patients. Periodontal bone defect from the cemento-enamel junction (CEJ) to the alveolar crest (AC) and from the cement-enamel junction (CEJ) to the bottom of the defect was measured as the gold standard by Williams probe (Hu-Friedy, Chicago, USA). After measurements, bone restorative steps were done if necessary and measurement were repeated after 6 months of treatment.The findings of the present investigation demonstrated a statistically significant difference between cone-beam computed tomography and intraoral radiography.  In addition, a statistically significant difference between intraoral radiography and intra-surgical measurements of bone defects was detected. However, cone-beam computed tomography and intra-surgical measurements did not record the difference statistically significant difference. Furthermore, there was a high degree of correlation between intra-surgical and CBCT measurements of bone defects.