Software-supported periodontal diagnostics with 3D CBCT compared with conventional 2D panoramic imaging and clinical diagnostics: a prospective study.

Aim: The objective of the present study was the software-supported evaluation of the measurement accuracy between CBCT and panoramic radiographs in the assessment of the periodontal bone level in patients with periodontitis, and the comparison of this with clinical periodontal parameters.

Materials and methods: Twenty patients with severe periodontitis (stage III to IV) were evaluated clinically and radiographically (panoramic radiographs and CBCT). Diagnostic interpretation comprised three blinded investigators with different levels of experience. Specific software-basing measurement procedure evaluated radiologic distances for the mesial, central, and distal bone levels on the oral and vestibular sides of the teeth investigated and furcation upper and lower boundary. Jaw localization, anatomical region of interest, the number of roots, and the experience of the observers were evaluated. All measurements were carried out twice by the same observers within a 6-week interval.

Results: Slightly higher measurement deviations (SD) in the range of 0.47 (0.40) mm were found for CBCT evaluation compared with panoramic imaging. Pearson correlation analysis showed statistically strong positive correlation for the mesial and distal aspects, and moderate positive correlation was found for the investigated furcations between both radiographic modalities. Compared with the clinical reference, the mean total error of measurement (SD) was larger for panoramic imaging (0.66 [0.48] mm) than for CBCT (0.27 [0.08] mm) for all three observers.

Conclusions: Software-supported CBCT analysis delivers better diagnostic information about the bony periodontal conditions of the patient compared with 2D radiographs. However, it remains unclear if this additional information leads to better periodontal outcomes.