Comparative Evaluation of Cone Beam Computed Tomography and Surgical Measurements of Periodontal Bone Defects in Periodontitis Patients: An In Vivo Study

Aim: The present study aimed to evaluate the accuracy of noninvasive cone beam computed tomography (CBCT) in the estimation of periodontal bone defects and compare it with that of measurements obtained by invasive surgical exploration using open flap debridement procedure for the evaluation of bony topography. Materials and methods: Bone defects in 384 sites with moderate-to-severe periodontitis from eight patients were considered. Probing depth was measured in the following six sites in the selected teeth: mesiobuccal (MB), mesiopalatal (MP)/mesiolingual (ML), buccal (B), palatal (P)/ lingual (L), distobuccal (DB) and distopalatal (DP)/distolingual (DL). The bone defects were measured from CBCT images followed by surgical intervention at all six sites. Data were recorded and statistically analyzed. Results: There was no significant difference observed between CBCT and surgical intervention. However, surgical intervention was found to have higher mean values than the CBCT measurements. The Pearson correlation showed a significantly positive correlation (p < 0.05) between CBCT and surgical intervention in all sites except L/P site. Additionally, there were negative correlations observed for all sites except B and L/P sites; however, these were not statistically significant. Moreover, there were significant differences (p < 0.05) observed between anterior and posterior sites measured via CBCT except for the MB site. On the other hand, a comparison between anterior and posterior teeth measured via surgical interventions showed significant differences (p = 0.0001) in all measured sites. Conclusion: A significant correlation has been observed between measurements acquired from CBCT and surgical intervention for the anterior teeth. On the contrary, no significant correlation was observed for the posterior teeth. Clinical significance: Overlapping and the absence of 3D information are two of traditional radiography’s main drawbacks. Surgerical exposure can yield precise information, but it gives less time to plan the kind of periodontal regeneration that will be needed. The accuracy and feasibility of CBCT have been established.