Diagnostic accuracy of periapical radiograph, cone beam computed tomography, and intrasurgical linear measurement techniques for assessing furcation defects: a longitudinal randomised controlled trial

Clin Oral Investig. 2021 Mar;25(3):923-932. doi: 10.1007/s00784-020-03380-8. Epub 2020 Jun 14.

Abstract

Objectives: The aim of this study was to evaluate the accuracy of cone beam computed tomography (CBCT), periapical radiograph, and intrasurgical linear measurements in the assessment of molars with furcation defects.

Materials and methods: This parallel, single-blinded, randomised controlled trial (RCT) consisted of 22 periodontitis patients who had molar with advanced furcation involvement (FI). All patients followed the same inclusion criteria and were treated following the same protocol, except for radiographic evaluation (CBCT vs. periapical). This study proposed and evaluated five parameters that represent the extent and severity of furcation defects in molars teeth, including CEJ-BD (clinical attachment loss), BL-H (depth), BL-V (height), RT (root trunk), and FW (width).

Results: There were no statistically significant differences between CBCT and intrasurgical linear measurements for any clinical parameter (p > 0.05). However, there were statistically significant differences in BL-V measurements (p < 0.05) between periapical and intrasurgical measurements in maxillary molars. Meanwhile, the sensitivity were 62.8% and 56.9% for CBCT and periapical, respectively.

Conclusions: Overall, when compared to the intrasurgical measurements, CBCT provided better diagnostic, sensitivity, and quantitative information on CAL, height, depth, and width of the furcation defects than periapical radiograph.

Clinical relevance: An accurate presurgical furcation diagnostic can guide the clinicians from the stage of diagnosis to definitive management so that unnecessary periodontal surgical interventions can be prevented.

Keywords: Accuracy; Cone beam computed tomography; Furcation defect; Periapical radiograph.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Cone-Beam Computed Tomography
  • Furcation Defects* / diagnostic imaging
  • Furcation Defects* / surgery
  • Humans
  • Molar / diagnostic imaging
  • Molar / surgery
  • Oral Surgical Procedures*
  • Periodontitis*