A Comparison of two radiographic techniques to determine the distance between alveolar bone crest and cementoenamel junction in patients with chronic periodontitis

Statement of the problem: Diagnosis of periodontal diseases without any accurate radiograph is inadequate. Bitewing (BW) and periapical (PA) radiographic techniques are commonly used to assess alveolar bone crest (ABC) level which is crucial in the evaluation of periodontal disease. Purpose: The purpose of this study was to compare the precision of BW and PA radiographs in determining the distance between the alveolar bone crest (ABC) and cemento-enamel junction (CEJ). Materials and Methods: This study evaluated 80 interproximal surfaces in patients suffering from chronic periodontitis. BW and PA radiographs were taken from posterior teeth of each patient and the distance between CEJ to ABC was measured on them. The real distance was determined during surgery by means of a periodontal probe. Statistical analysis was done by paired t-test. Results: According to this study the mean real distance between CEJ and ABC was found to be 4.266±1.467 mm, and the mean distances on BW and PA radiographs were 4.014±1.488 and 3.826±1.483 mm respectively. These results showed that on average the distance measured on BW radiograph appeared to be 0.252 mm (6%) lower than the real distance (p=0.000) and 0.44mm (10%) less in the PA technique (p=0.002). Conclusion: The bitewing technique is more accurate in the assessment of the alveolar bone crest level compared with the PA technique.