title: Comparison of clinical values between cone beam computed tomography and conventional intraoral radiography in periodontal and infrabony defect assessment.
abstract: OBJECTIVE
  The use of CBCT for periodontal diagnosis and treatment plan is limited. The aim of this study is to compare the assessment of periodontal conditions and infrabony defects between conventional intraoral radiography (IOR) and CBCT.
  
  
  METHODS
  The study included 25 subjects who had periodontitis and at least two infrabony defects. All subjects received clinical periodontal examination, IOR and CBCT. Three periodontists assigned periodontal diagnosis and prognosis of each tooth. For teeth with infrabony defects, the number of defect walls and treatment was determined. IOR and CBCT assessment was compared.
  
  
  RESULTS
  There were 666 teeth and 123 infrabony defects. The overall concordance between IOR and CBCT for periodontal diagnosis, prognosis, infrabony defect type and infrabony defect treatment were 79.3%, 69.5%, 44.7% and 64.2%, respectively. IOR underestimated diagnosis, prognosis and the number of infrabony defect walls at 16.4%, 24% and 37.4%, respectively. IOR and CBCT had poor concordance for periodontal regeneration (43.3%). Tooth extraction was more prevalent when assessed by CBCT (35.0% vs 22.7%). CBCT had excellent interexaminer agreement (Fleiss' kappa 0.87-0.94) and higher percentage of complete agreement among examiners than IOR for all assessments.
  
  
  CONCLUSIONS
  IOR underestimated the severity and prognosis of periodontal disease. CBCT was superior to IOR for evaluation of infrabony defect morphology and treatment. CBCT provides excellent agreement among examiners on periodontal and infrabony defect assessment.
authors.affiliation: 1 Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Supreda
authors.initials: S
authors.lastname: Suphanantachat
authors.affiliation: 1 Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Keenna
authors.initials: K
authors.lastname: Tantikul
authors.affiliation: 1 Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Suphot
authors.initials: S
authors.lastname: Tamsailom
authors.affiliation: 2 Department of Radiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Pasupen
authors.initials: P
authors.lastname: Kosalagood
authors.affiliation: 1 Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Kanokwan
authors.initials: K
authors.lastname: Nisapakultorn
authors.affiliation: 1 Department of Periodontology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Kanoknadda
authors.initials: K
authors.lastname: Tavedhikul
mesh_terms: D000328:Adult; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging* / Q000473:pathology; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010510:Periodontal Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D011379:Prognosis; D019252:Radiography, Dental, Digital / Q000379:methods*
keywords: CBCT; diagnosis; intraoral radiography; periodontitis; prognosis