Periodontal probing vs computed tomography: the accuracy and benefit for a proper diagnosis of periodontal disease

Aim: The aim of this study was to compare manual periodontal probing with Computed Tomography imaging measures in the same patient to detect and localize alveolar bone loss by comparing linear measurements of the height, depth and width of the defects and identifying combined bone defects. Material and Methods: Thirty-eight patients with generalized chronic periodontitis were recruited. For each patient the examination consisted of 51 sites showing both horizontal and vertical bone loss (clinical examinations, periapical radiographs), and a CT scan that was performed and assessed by 3 trained examiners. Clinical recommendations comprised a minimal (e.g. supportive periodontal treatment) and a maximal invasive therapy (e.g. extraction and implant placement), based on clinical additional CT data and recommendations. Moreover, the probabilities of saving costs or time, and the numbers needing treatment were analysed with a cumulative distribution function. Results: The results showed that there were no statistically significant differences between the imaging methods in terms of identification of the pattern of bone loss. Overall, 79% of the CT data was confirmed by the pre and intra-surgical findings (95% confidence interval: 0.576–1.0). While 9% of the sites were underestimated, (CBCT less than pre and intra-surgical value), in only 12% of the sites did the CT data lead to an overestimation compared with the pre and intra-surgical analysis (the molar furcation sites). Conclusion: CT images compared to clinical examination demonstrates a high level of accuracy in assessing the loss of periodontal tissue and classifying the degree only in sites with furcation involvement.