Evaluation of cone-beam computed tomography as a Prognostic Tool in periodontitis
DOI:
https://doi.org/10.5281/zenodo.22811648Keywords:
cone-beam CT, periodontitis, periodontal diagnosis, furcation defects, radiographic prognosisAbstract
Background: Periodontitis staging depends on measuring alveolar bone loss, yet periapical radiographs compress three-dimensional defects into one plane and underestimate intrabony and furcation lesions [4,2].
Objective: This review synthesizes evidence on cone-beam computed tomography (CBCT) as a prognostic tool in periodontitis: measurement accuracy, influence on treatment planning, and radiation-dose tradeoffs.
Methods: We synthesized in vitro, cadaveric, and clinical validation studies, treatment-planning impact studies, and dosimetry literature on CBCT periodontal defect assessment.
Findings: CBCT measurements of intrabony and furcation defects agree closely with surgical reference standards [6,7,9,11], and adding CBCT changes the chosen surgical plan in many complex furcation cases [15,16]; dose remains above periapical or panoramic radiography though below medical CT [21].
Conclusions: CBCT is an actionable prognostic tool when applied selectively to furcations and multiwall defects, but outcome-linked studies are still needed to confirm its added value over probing and 2D radiography [19,18].
References
Kassebaum, N.J., Bernabe, E., Dahiya, M., Bhandari, B., Murray, C.J.L., Marcenes, W. (2014) Global burden of severe periodontitis in 1990-2010: a systematic review and meta-regression. Journal of Dental Research, 93(11): 1045-1053. DOI: 10.1177/0022034514552491
Tonetti, M.S., Greenwell, H., Kornman, K.S. (2018) Staging and grading of periodontitis: framework and proposal of a new classification and case definition. Journal of Clinical Periodontology, 45(Suppl 20): S149-S161. DOI: 10.1111/jcpe.12945
Papapanou, P.N., Sanz, M., Buduneli, N., Dietrich, T., Feres, M., Fine, D.H., et al. (2018) Periodontitis: consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. Journal of Periodontology, 89(Suppl 1): S173-S182. DOI: 10.1002/JPER.17-0721
Corbet, E.F., Ho, D.K., Lai, S.M. (2009) Radiographs in periodontal disease diagnosis and management. Australian Dental Journal, 54(Suppl 1): S27-43. DOI: 10.1111/j.1834-7819.2009.01141.x
Scarfe, W.C., Farman, A.G. (2008) What is cone-beam CT and how does it work? Dental Clinics of North America, 52(4): 707-730. DOI: 10.1016/j.cden.2008.05.005
Mengel, R., Candir, M., Shiratori, K., Flores-de-Jacoby, L. (2005) Digital volume tomography in the diagnosis of periodontal defects: an in vitro study on native pig and human mandibles. Journal of Periodontology, 76(5): 665-673. DOI: 10.1902/jop.2005.76.5.665
Misch, K.A., Yi, E.S., Sarment, D.P. (2006) Accuracy of cone beam computed tomography for periodontal defect measurements. Journal of Periodontology, 77(7): 1261-1266. DOI: 10.1902/jop.2006.050367
Mol, A., Balasundaram, A. (2008) In vitro cone beam computed tomography imaging of periodontal bone. Dentomaxillofacial Radiology, 37(6): 319-324. DOI: 10.1259/dmfr/57711133
Walter, C., Weiger, R., Zitzmann, N.U. (2010) Accuracy of three-dimensional imaging in assessing maxillary molar furcation involvement. Journal of Clinical Periodontology, 37(5): 436-441. DOI: 10.1111/j.1600-051X.2010.01556.x
Qiao, J., Wang, S., Duan, J., Zhang, Y., Qi, X., Chen, L., et al. (2014) The accuracy of cone-beam computed tomography in assessing maxillary molar furcation involvement. Journal of Clinical Periodontology, 41(3): 269-274. DOI: 10.1111/jcpe.12150
Grimard, B.A., Hoidal, M.J., Mills, M.P., Mellonig, J.T., Nummikoski, P.V., Mealey, B.L. (2009) Comparison of clinical, periapical radiograph, and cone-beam volume tomography measurement techniques for assessing bone level changes following regenerative periodontal therapy. Journal of Periodontology, 80(1): 48-55. DOI: 10.1902/jop.2009.080289
Nikolic-Jakoba, N., Vasovic, M., Milic Lemic, A., Radunovic, M., Petrovic, S. (2021) Effect of section thickness on cone beam computed tomography-based measurements intrabony defects compared with clinical measurements. Journal of Periodontology, 92(8): 1160-1169. DOI: 10.1002/JPER.20-0338
Ozmeric, N., Kostioutchenko, I., Hagler, G., Frentzen, M., Jervoe-Storm, P.M. (2008) Cone-beam computed tomography in assessment of periodontal ligament space: in vitro study on artificial tooth model. Clinical Oral Investigations, 12(3): 233-239. DOI: 10.1007/s00784-008-0186-8
Braun, X., Ritter, L., Jervøe-Storm, P.M., Frentzen, M. (2014) Diagnostic accuracy of CBCT for periodontal lesions. Clinical Oral Investigations, 18(4): 1229-1236. DOI: 10.1007/s00784-013-1106-0
Walter, C., Kaner, D., Berndt, D.C., Weiger, R., Zitzmann, N.U. (2009) Three-dimensional imaging as a pre-operative tool in decision making for furcation surgery. Journal of Clinical Periodontology, 36(3): 250-257. DOI: 10.1111/j.1600-051X.2008.01367.x
Laky, M., Majdalani, S., Kapferer-Seebacher, I., Volf, I., Ulm, C., Moritz, A., et al. (2013) Periodontal probing of dental furcations compared with diagnosis by low-dose computed tomography: a case series. Journal of Periodontology, 84(10): 1740-1746. DOI: 10.1902/jop.2013.120698
AlJehani, Y.A. (2014) Diagnostic applications of cone-beam CT for periodontal diseases. International Journal of Dentistry, 2014: 865079. DOI: 10.1155/2014/865079
Eshraghi, V.T., Malloy, K.A., Tahmasbi, M. (2019) Role of cone-beam computed tomography in the management of periodontal disease. Dentistry Journal, 7(2): 57. DOI: 10.3390/dj7020057
du Bois, A.H., Kardachi, B., Bartold, P.M. (2012) Is there a role for the use of volumetric cone beam computed tomography in periodontics? Australian Dental Journal, 57(1): 33-39. DOI: 10.1111/j.1834-7819.2011.01659.x
Fleiner, J., Hannig, C., Schulze, D., Stricker, A., Jacobs, R. of (2013) Digital method for quantification of circumferential periodontal bone level using cone beam CT. Clinical Oral Investigations, 17(2): 389-396. DOI: 10.1007/s00784-012-0715-3
Ludlow, J.B., Ivanovic, M. (2008) Comparative dosimetry of dental CBCT devices and 64-slice CT for oral and maxillofacial radiology. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 106(1): 106-114.
Vandenberghe, B., Jacobs, R., Yang, J. (2007) Diagnostic validity (or acuity) of 2D CCD versus 3D CBCT-images for assessing periodontal breakdown. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 104(3): 395-401.
de Faria Vasconcelos, K., Evangelista, K.M., Rodrigues, C.D., Estrela, C., de Sousa, T.O., Silva, M.A. (2012) Detection of periodontal bone loss using cone beam CT and intraoral radiography. Dentomaxillofacial Radiology, 41(1): 64-69. DOI: 10.1259/dmfr/13676777
Published
Issue
Section
License
Copyright (c) 2026 Zola Okafor, et al.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Unless otherwise stated on the article, all content is published under the Creative Commons Attribution 4.0 International licence (CC BY 4.0). Anyone may share (copy and redistribute the material in any medium or format) and adapt (remix, transform, and build upon the material for any purpose, including commercially), on condition that they give appropriate credit to the authors and the journal, provide a link to the licence, and indicate if changes were made. Authors retain copyright.
