Effect of X-ray beam vertical angulation on radiographic assessment of alveolar crest level

Periodontal diseases are diagnosed and monitored by various methods. Probing pocket depth measurements and dental radiographs are two of the most commonly used methods. The aim of this study was to assess the effect of x-ray beam vertical angulation on radiographic assessment of alveolar crest level in five human mandibles. A standardized technique was used to take bitewing radiographs with -10 degrees, 0 degree and +10 degrees angulation of X-Ray beam. The range of the mean differences at individual sites was from 1.84 mm (0.58 +/- SD) to 3.70 mm (1.01 +/- SD). It was found that there was a wide range of over or underestimation of the alveolar crest level due to a change in beam angulation. It was concluded that, to monitor patients with periodontal disease or treatment outcomes, it is important to have reproducible images and bitewing film holders should be used to minimize the X-Ray beam angulation error in general dental practice.