Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Dentist, Private practice, Mashhad, Iran.
Clin Exp Dent Res. 2024 Dec;10(6):e70042. doi: 10.1002/cre2.70042.
Alveolar bone loss (ABL) and periodontal lesions are common diseases that have an undeniable effect on teeth maintenance and health. Current diagnostic methods include probing, intraoral radiography, and panoramic radiography; each has its limitations. In this study, we aimed to assess the diagnostic accuracy of panoramic radiography in the diagnosis of interdental ABL.
In this cross-sectional study, panoramic and cone-beam computed tomography (CBCT) images from 80 patients were collected from the archives of an oral and maxillofacial radiology center. The amount of ABL was obtained by measuring the distance from the Cemento-Enamel Junction (CEJ) to the alveolar bone crest on both panoramic and CBCT images. Patients were divided into healthy (ABL ≤ 2 mm) and diseased (2 mm < ABL) groups in terms of periodontal disease.
There was no statistically significant difference in the average ABL in the premolar, maxillary molar, and mandibular molar areas between the two techniques. However, in other areas, the ABL size was significantly lower in the panoramic view (p < 0.05). Also, the panoramic technique correctly recognized 89.1% of normal and 88.4% of ABL cases. The overall accuracy of panoramic radiography in the diagnosis of ABL was 85%, indicating the good accuracy of this technique. In maxilla, the highest diagnostic accuracy of the panoramic technique was in the molars, and the lowest was in the incisors. In the mandible, the highest and lowest diagnostic accuracy of the panoramic technique was related to molars and premolars, respectively. According to the kappa statistic, there was a significant good to very good agreement between the two types of techniques in all maxillary areas (p < 0.001).
Panoramic radiography is accurate in showing ABL. Measuring ABL in the posterior mandibular areas in panoramic radiographs is quite reliable; however, in general, digital panoramic radiography shows less ABL than the actual amount.
牙槽骨丧失（ABL）和牙周病是常见疾病，对牙齿的维持和健康有不可否认的影响。目前的诊断方法包括探查、口腔内放射摄影和全景放射摄影；每种方法都有其局限性。在本研究中，我们旨在评估全景放射摄影在诊断牙间 ABL 中的诊断准确性。
在这项横断面研究中，从口腔颌面放射学中心的档案中收集了 80 名患者的全景和锥形束 CT（CBCT）图像。通过在全景和 CBCT 图像上测量从牙釉质-牙骨质界（CEJ）到牙槽嵴的距离来获得 ABL 量。根据牙周病，将患者分为健康（ABL≤2mm）和患病（2mm<ABL）两组。
两种技术在磨牙、上颌前磨牙和下颌前磨牙区域的平均 ABL 没有统计学上的显著差异。然而，在其他区域，全景视图中的 ABL 尺寸明显较低（p<0.05）。此外，全景技术正确识别了 89.1%的正常和 88.4%的 ABL 病例。全景放射摄影诊断 ABL 的总体准确性为 85%，表明该技术具有良好的准确性。在上颌，全景技术的诊断准确性最高的是磨牙，最低的是切牙。在下颌，全景技术的诊断准确性最高和最低的分别与磨牙和前磨牙有关。根据 Kappa 统计，在所有上颌区域，两种技术之间都存在显著的良好到非常好的一致性（p<0.001）。
全景放射摄影在显示 ABL 方面是准确的。在全景放射片中测量下颌后牙区的 ABL 相当可靠；然而，一般来说，数字全景放射摄影显示的 ABL 比实际量少。
