Periodontal disease morbidity quantification. I. Optimal selection of teeth for periodontal bone loss surveys

The assessment of alveolar bone loss with bite-wing radiographs is attractive because bite wings are relatively convenient, inexpensive, and available. The choice of teeth used influences the validity of global bone loss assessments based on partial mouth measurements. The objective of this study was to validate periodontal bone loss indices based on a few teeth. The mandibular posterior teeth were considered as a basis for abbreviated indices. The optimum number of teeth included was evaluated, and the utility of abbreviated indices was determined experimentally. The teeth from 75 skulls were measured from the cemento-enamel junction (CEJ) to the alveolar bone at six locations per tooth. The subsets of teeth which best represent the average whole mouth bone loss were found with all-possible-subsets regression analysis. Bone loss data from 179 prehistoric skulls were used to test the validity of selected teeth indices. Bone loss measurements from the mandibular posterior areas were representative of full-mouth bone loss measurements. Mandibular second premolars plus any other mandibular posterior teeth were the optimal combination of tooth for an abbreviated index. This subset is suitable for use with bite-wing radiographs.