Evaluation of Periodontal Infrabony Defect Topography via CBCT and Comparisons with Direct Intrasurgical Measurements

Area of Science:

• Periodontology
• Oral and Maxillofacial Radiology
• Dental Imaging

Background:

• Two-dimensional periapical radiographs (PAs) provide limited insight into 3D periodontal infrabony defects.
• Cone beam computed tomography (CBCT) offers superior visualization of defect morphology.
• Accurate assessment of infrabony defects is crucial for effective periodontal treatment planning.

Purpose of the Study:

• To evaluate the agreement between CBCT and direct intrasurgical measurements (ISs) for infrabony defect characteristics.
• To compare the diagnostic accuracy of CBCT and PAs against ISs.
• To assess defect depth, width, type, and extension using different imaging modalities.

Main Methods:

• Intrasurgical and radiographic assessments of 26 infrabony defects in 17 patients.
• Comparison of defect depth, width, type, and extension between ISs, CBCT, and PAs.
• CBCT analysis primarily utilized axial reconstructions; angle measurements compared CBCT and PAs.

Main Results:

• CBCT showed no significant differences from ISs for mean depth (-0.11 ± 0.49 mm) and width (-0.07 ± 0.41 mm), with high agreement (ICC 0.938 and 0.923).
• PAs had a significant difference from ISs for width (-0.36 ± 0.73 mm; p = 0.002).
• CBCT demonstrated high agreement with ISs for defect type (κ = 0.819) and extension (κ = 0.855), outperforming PAs.

Conclusions:

• CBCT is a valid and reliable tool for assessing periodontal infrabony defects.
• CBCT exhibits strong concordance with intrasurgical measurements for defect depth and width.
• CBCT's assessment of defect type and extension surpasses that of traditional periapical radiographs.