Clinical and radiographic periodontal parameters: Comparison with software generated CBCT measurements

Periodontal diagnosis relies mainly on clinical assessment and radiographic images. The increasing accuracy of CBCT images and the corresponding advancement in computer software for data extraction can be of great help in periodontal diagnosis for bone loss and furcation defects. Thus, the aim of this study was to compare direct surgical measurements to data extracted from periapical radiographs and CBCT by means of software (coPeriodontix™ and Blue Sky Plan ® ) in order to assess the accuracy delivered by these software. Ten patients were included in the study, the number of teeth selected for measurements ranged from one to 10 per patient. Overall: i- 251 measures were included for comparison of linear measurements between surgical and CBCT, ii- 69 measures were compared between surgical and periapical radiographs, iii- 20 furcation defects were recorded peroperatively for comparison with CBCT and periapical radiographs data. All CBCT scans and X-rays were acquired within a maximum period of 1 month prior to surgery. Clinical linear measurements were performed at 6 sites for each tooth, from the cemento-enamel junction to the marginal bone level at the Buccal, Buccal-Mesial, Buccal-Distal, Lingual, Lingual-Mesial, and Lingual-distal side. Furcation defects were recorded according to the classification of Hamp in 1975. Differences between data acquired from these 3 modalities were analyzed. Intra-surgical measurements were considered as “gold standard”. Statistical significance was found between the three modalities concerning linear measurements. CBCT showed less bone loss while intra-surgical measurements showed more bone loss. Furcation defects were similar between CBCT and intra-surgical measurement (P value=1). Intra-oral radiographs showed 38.88% accuracy for furcation defects. The coPeriodontix™ tended to underestimate the real bone loss. The Blue Sky Plan ® accurately depicted the true furcation defect.