Cone beam computed tomography (CBCT) in periodontal diseases: a Systematic review based on the efficacy model

Abstract

Background: Periodontal diseases are prevalent among adult populations. Its diagnosis depends mainly on clinical findings supported by radiographic examinations. In previous decades, cone beam computed tomography has been introduced to the dental field. The aim of this study was to address the diagnostic efficacy of cone-beam computed tomographic (CBCT) imaging in periodontics based on a systematic search and analysis of the literature using the hierarchical efficacy model. Methods: A systematic search of electronic databases such as PubMed, Scopus, Web of Science, and Cochrane was conducted in February 2019 to identify studies addressing the efficacy of CBCT imaging in Periodontics. The identified studies were subjected to pre-identified inclusion criteria followed by an analysis using a hierarchical model of efficacy (model) designed for an appraisal of the literature on diagnostic imaging modality. Four examiners performed the eligibility and quality assessment of relevant studies and consensus was reached in cases where disagreement occurred. Results: The search resulted in 64 studies. Of these, 34 publications were allocated to the relevant level of efficacy and quality assessments wherever applicable. The overall diagnostic accuracy of the included studies showed a low or moderate risk of bias and applicability concerns in the use of CBCT. In addition, CBCT is accurate in identifying periodontal defects when compared to other modalities. The studies on the level of patient outcomes agreed that CBCT is a reliable tool for the assessment of outcomes after the treatment of periodontal defects. Conclusion: CBCT was found to be beneficial and accurate in cases of infra-bony defects and furcation involvements.

A Cone Beam CT Study on the Correlation between Crestal Bone Loss and Periapical Disease

“…However, in a more recent literature review, it was found that there is an increase in the available evidence supporting the use of CBCT in the management of periodontal disease, especially in preoperative planning and follow-up of regenerative surgical treatment, even though it is not recommended as a standard of care [ 38 ]. In a systematic review on the use of CBCT in periodontal disease, it was found to be accurate in the management of both infrabony defects and furcation lesions [ 39 ]. It can also be justifiable to use CBCT when assessing periodontal diseases around complex structures like maxillary molars [ 14 ].…”

Effect of Perforated Versus Non-perforated Collagen Barrier Membranes in Combination with Nano-micro composite Bone Grafts in the Regeneration of Intrabony Defects: A Randomized Clinical Trial

“…CBCT was found to be beneficial and accurate in cases of infrabony defects and furcation involvements. (59) The image acquisition was performed using i-CAT next generation (Imaging sciences international, Hatfield, PA, USA) with exposure parameters 120 kVp, 5 mA, 0.2 mm voxel size, 26 seconds scanning time and field of view was limited to the mandibular arch (5 X 10 cm). The radiographic scanning was repeated six months after the surgery using the same parameters.…”

Influence of Root Canal Fillings on Alveolar Bone Crest Level—An Observational Cross Sectional CBCT Analysis

“…The realistically achievable spatial resolution for images offering no visible blurring or moving artefacts is about 0.25-0.5 mm in-vivo [29]. Nevertheless, CBCT analysis is a reliable diagnostic tool for assessing bone level, and thus also allows appropriate periodontal treatment planning, as actual bone level correlates with the clinical situation well [15,17,30,31]. Even its suitability for assessing the cemento-enamel junction of teeth under clinical conditions has been proven [32].…”