Diagnostic Accuracy of Intraoral, Extraoral and Cone Beam Computed Tomography (CBCT)-Generated Bitewings for...

This study aimed to evaluate the diagnostic accuracy of intraoral bitewings (IB), extraoral bitewings (EB) generated from panoramic radiographs and cone beam computed tomography (CBCT) scans, using both 180° and 360° rotation protocols, for detecting approximal dental caries and periodontal bone loss.

Fifty human teeth accounting for one hundred interproximal surfaces in three partially/fully dentate dry human mandibles were evaluated for carious lesions, alveolar bone levels, and interdental vertical bone defects in the posterior region. Intraoral bitewings were acquired using photostimulable phosphor (PSP) sensors with a KaVo LM/CM109 X-ray tube (70 kVp, 7 mA, 0.125 s; KaVo, Charlotte, NC, USA). Extraoral bitewings were obtained using a J. Morita panoramic unit (90 kVp, 7 mA, 5.5 s; J. Morita, Irvine, CA, USA). CBCT scans were performed with a J. Morita 3D Accuitomo system (90 kVp, 7 mA, 40×40 mm field of view (FOV), Hi-Res Mode) under both 180° and 360° rotation protocols. A single board-certified oral and maxillofacial radiologist assessed the presence and severity of caries and conducted linear measurements of alveolar bone levels. Diagnostic findings were compared across imaging modalities.

No statistically significant differences were observed among the intraoral, extraoral, and CBCT imaging modalities regarding the detection of carious lesions and linear measurements of periodontal bone loss.

Extraoral bitewings generated from panoramic radiographs and CBCT (180° and 360°) scans demonstrated diagnostic accuracy comparable to intraoral bitewings for the detection of approximal caries and periodontal bone defects.