Assessment of the Diagnostic Agreement Between Cone-Beam Computed Tomography and Intrasurgical Measurements for Detecting Grade II Buccal Furcation Involvement in Maxillary First Molars: Insights on Accuracy, Reliability, and Clinical Relevance.

BACKGROUND

The intricate anatomy and challenging accessibility of furcation involvement often complicate diagnosis, leading to tooth loss. This study evaluated the efficacy of cone-beam computed tomography (CBCT) for the early detection and management of furcation defects, particularly Grade II buccal furcations of maxillary first molars. CBCT measurements of width, depth, and height were compared with direct intrasurgical measurements to determine diagnostic accuracy.

METHODS

Thirty patients with 41 maxillary first molars with Grade II buccal furcations were clinically diagnosed using Nabers' probe and intraoral periapical radiographs. CBCT scans were performed before surgery, recording measurements for furcation morphology. Intrasurgical measurements were obtained using endodontic files and a digital Vernier caliper.

RESULTS AND DISCUSSION

CBCT measurements for all parameters were consistently lower than intrasurgical measurements, with statistically significant differences (p < 0.001). Most deviations ranged between -0.50 and 0.50 mm, indicating minimal clinical discrepancies. CBCT demonstrated excellent reliability for depth and height assessments, good reliability for width, and sensitivity in detecting furcation dimensions under 3 mm.

CONCLUSION

CBCT and intrasurgical measurements for furcation width, depth, and height differ significantly but remain clinically irrelevant (<1 mm). Strong agreement and correlation between CBCT and intrasurgical measurements support its use in pre-treatment diagnosis to improve surgical outcomes. Low-Field-of-view (FOV) CBCT reduces radiation exposure while enhancing image quality, making it ideal for diagnosing furcation defects. Despite differences between CBCT and intrasurgical values, CBCT proves to be a reliable diagnostic tool for predicting furcation morphology.