Assessment of the dentate alveolar process with high resolution computed tomography

The present study was undertaken to determine quantitatively the accuracy of modern high-resolution computed tomography (HR-CT) in imaging periodontal defects in vitro by means of comparative radiological and histological studies. The soft tissue and metallic restorations were removed from four mandibular and maxillary jaw segments. Eighteen lingual and buccal defects of different dimensions were artificially created over the roots of the teeth. Dental radiographs and 1.0 mm contiguous axial and coronal HR-CT scans were obtained. Histological specimens were prepared in the same plane as the CT scans. A quantitative analysis of the periodontal regions on the CT scans was feasible when the alveolar bone was 0.5 mm thick. A visible periodontal ligament space was found to improve the reliability of the measurement of buccal or lingual bone plates up to 0.2 mm thick or of the artificial dehiscences. In the axial HR-CT scans, 70% of the artificial defects could be identified. and in the coronal scans, 50%. In contrast, none of the defects could be evaluated on conventional dental radiographs. It is concluded that HR-CT scanning could be useful in assessing buccal and lingual alveolar bone morphology and in diagnosing larger dehiscences.