Accuracy of Tomography Images in the Assessment of Bone Cover

Objectives: The cone beam computed tomography (CBCT) is still underutilized in periodontal diagnosis, besides little documented. The CBCT images serve as a guide for an accurate assessment on the height of the alveolar bone and the possible presence of bone defects. Purpose: The aim of the present study was to establish the diagnostic accuracy of the CBCT in the evaluation of bone cover, using different voxels.
Methods: Material and Methods: Five dry skulls were clinically evaluated to detect bone defects in the anterior teeth. Were identified 63 bone defects in 180 thirds of twelve anterior teeth, analyzed with a digital caliper rule. CBCT images of the maxilla and mandible were assessed by two observers, which identified the presence or absence of bone coverage in each region. Then, axial and parassagital images of buccal bone wall of the sample were classified according to a specific protocol, referring the type of bone cover or the absence of it. All data were tabulated and analyzed by Mc Nemar and Kappa tests, adopting the value of p≤0, 05.
Results: Results: In the evaluation of axial and parassagital reconstructions together, with voxel 0.2, 95.24% of the sites with absence of bone cover were diagnosed through images by CBTC, by two assessors, whose agreement was substantial (parassagital reconstructions, K=0.652; axial, K=0.756). In the evaluation of axial and parassagital reconstructions together, with voxel 0.076, 93,89% of sites with absence of bone cover were diagnosed through images by TCFC, by two assessors, whose agreement was almost perfect (parassagital reconstructions, K=0,875; axial, K=0,889).
Conclusions: Conclusion: CBTC offers high sensitivity, specificity and diagnostic accuracy of bone cover. It is necessary a multiplanar dynamic evaluation to confirm diagnosis and treatment strategies in Dentistry. Not always will gain diagnostic reducing progressively the size of the voxel.