title: Evaluation of diagnostic accuracy of conventional and digital periapical radiography, panoramic radiography, and cone-beam computed tomography in the assessment of alveolar bone loss.
abstract: BACKGROUND
  To evaluate the diagnostic accuracy of different radiographic methods in the assessment of proximal alveolar bone loss (ABL).
  
  
  METHODS
  ABL, the distance between cement-enamel junction and alveolar bone crest, was measured in 70 mandibular human teeth - directly on the mandibles (control), using conventional periapical radiography with film holders (Rinn XCP and Han-Shin), digital periapical radiography with complementary metal-oxide semiconductor sensor, conventional panoramic, and cone-beam computed tomography (CBCT). Three programs were used to measure ABL on the images: Image tool 3.0 (University of Texas Health Sciences Center, San Antonio, Texas, USA), Kodak Imaging 6.1 (Kodak Dental Imaging 6.1, Carestream Health(®), Rochester, NY, USA), and i-CAT vision 1.6.20. Statistical analysis used ANOVA and Tukey's test at 5% significance level.
  
  
  RESULTS
  The tomographic images showed the highest means, whereas the lowest were found for periapical with Han-Shin. Controls differed from periapical with Han-Shin (P < 0.0001). CBCT differed from panoramic (P = 0.0130), periapical with Rinn XCP (P = 0.0066), periapical with Han-Shin (P < 0.0001), and digital periapical (P = 0.0027). Conventional periapicals with film holders differed from each other (P = 0.0007). Digital periapical differed from conventional periapical with Han-Shin (P = 0.0004).
  
  
  CONCLUSIONS
  Conventional periapical with Han-Shin film holder was the only method that differed from the controls. CBCT had the closest means to the controls.
authors.affiliation: Department of Dentistry, Federal University of Sergipe, Aracaju, Brazil.
authors.forename: Wilton Mitsunari
authors.initials: WM
authors.lastname: Takeshita
authors.affiliation: Department of Dentistry, State University of Maringá, Maringá, Brazil.
authors.forename: Lilian Cristina
authors.initials: LC
authors.lastname: Vessoni Iwaki
authors.affiliation: Department of Dentistry, State University of Maringá, Maringá, Brazil.
authors.forename: Mariliani Chicarelli
authors.initials: MC
authors.lastname: Da Silva
authors.affiliation: Department of Dentistry, State University of Maringá, Maringá, Brazil.
authors.forename: Renata Hernandes
authors.initials: RH
authors.lastname: Tonin
keywords: Alveolar bone loss; cone-beam computerized tomography; conventional periapical radiography; diagnosis; panoramic radiography