Comparison between Scanora panoramic radiography and bitewing radiography in the assessment of marginal bone tissue

To compare panoramic radiographs made with the Scanora dental program and bitewing radiographs in the assessment of marginal bone tissue.

Panoramic and posterior bitewing radiographs were made for 96 consecutive patients. Six observers assessed marginal bone level, and five observers identified the presence or absence of vertical bone defects and furcation involvements. Observer agreement was calculated.

Assessments of the marginal bone level with the two methods were identical for 57% of the sites. If a difference of one score was allowed, assessments for 95% of the sites were in agreement. Vertical bone defects and furcation involvement were detected with an agreement of 93%. Ranges of kappa indexes for intra-observer agreement on assessments of the marginal bone level were 0.37-0.46 in panoramic radiography and 0.31-0.55 in bitewing radiography. Ranges for agreement on detection of vertical bone defects were 0.52-0.63 and 0.47-0.56 and on detection of furcation involvements 0.64-0.79 and 0.66-0.77, respectively. The kappa index for inter-observer agreement on marginal bone level was 0.28 for panoramic and 0.29 for bitewing radiography. Corresponding figures for detection of vertical bone defects were 0.38 and 0.35 and for detection of furcation involvement 0.56 and 0.67.

For those sites or teeth that are possible to assess, the diagnostic information available with Scanora panoramic radiography is comparable to that with bitewing radiography for marginal bone tissue. Therefore, Scanora dental panoramic radiography is a valuable diagnostic alternative in the primary examination of the periodontal status.