title: Evaluation of alveolar crest bone loss via premolar bitewing radiographs: presentation of a new method.
abstract: OBJECTIVE
  This study aimed to assess the interdental bone level in premolar bitewing radiographs while retracting the cheeks.
  
  
  METHODS
  Seventy-two horizontal bone defects were created on dried mandibles and maxillae. The distance from the bone level to the cement-enamel junction of premolars was detected by a modified digital caliper (considered the gold standard). The reliability of all radiographs was assessed by intraclass correlation coefficient (ICC), and the validity was compared to the gold standard using the analysis of variance test. P-values less than 0.05 were considered statistically significant.
  
  
  RESULTS
  This study showed that the reliability of radiographs without a cheek simulator and with 0.16 second exposure time was significantly higher than that of the two other groups (ICC=0.96 compared to 0.93 and 0.88, respectively). The results from the radiographs without a cheek simulator and with 0.16 second exposure time were more similar to the gold standard measures than those of the two other groups, although the difference was not statistically significant.
  
  
  CONCLUSIONS
  Retracting the buccal soft tissue plays an important role in increasing the accuracy of radiographs in detecting the interdental alveolar bone level and produces more accurate results than increasing the exposure time, although it does not have a significant role in reliability of results.
authors.affiliation: Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Yaser
authors.identifier: 0000-0003-3200-0905
authors.initials: Y
authors.lastname: Safi
authors.affiliation: Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Mahdi
authors.identifier: 0000-0002-6131-2791
authors.initials: M
authors.lastname: Kadkhodazadeh
authors.affiliation: Endodontics Department, Dental Branch, Islamic Azad University, Tehran, Iran.
authors.forename: Pooria
authors.identifier: 0000-0002-9810-9076
authors.initials: P
authors.lastname: Safai
authors.affiliation: Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad
authors.identifier: 0000-0002-9068-9758
authors.initials: M
authors.lastname: Esmaeelinejad
authors.affiliation: Department of Oral and Maxillofacial Pathology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Nafiseh
authors.identifier: 0000-0002-9043-6726
authors.initials: N
authors.lastname: Shamloo
keywords: Alveolar bone loss; Bitewing radiography; Cheek