A controlled study on the accuracy and precision of intra-oral radiography in assessing interproximal bone defect morphology around teeth and implants.
Purpose: The primary objective of the present controlled study was to determine the accuracy and precision of intra-oral radiography in assessing interproximal bone defect morphology in patients suffering from periodontal disease as well as in patients with peri-implantitis. A secondary objective was to evaluate the possible impact of clinical experience on accuracy and precision.
Materials and methods: The study sample comprised a total of 99 interproximal bony defects (40 patients) needing surgical treatment. Forty-nine defects were periodontal (17 patients), while the remaining 50 were peri-implant defects (23 patients). Following reflection of a mucoperiostal flap and removal of granulation tissue the type of bone defect as classified by Goldman and Cohen (1958) was determined. This intra-surgical registration was considered the true bone defect morphology. For each interproximal site an intra-oral radiograph was taken. Twenty clinicians determined the bone defect morphology on each intra-oral radiography twice with a wash-out period of 3 months.
Results: Using the Goldman and Cohen (1958) classification, the overall accuracy of intra-oral radiography in assessing interproximal bone defect morphology was slight for teeth/implants (k= 0.132/ k= 0.126). Duplicate evaluation indicated fair precision (k= 0.369/ k= 0.355). Pooling 1-, 2- and 3-wall defects into 1 category had a positive impact on accuracy (k= 0.254/ k= 0.387) as well as on precision (k= 0.504/ k= 0.560). A significant difference between experienced clinicians and trainees was never found (P³ 0.285).
Conclusion: Intra-oral radiography lacks accuracy for assessing interproximal bone defect morphology around teeth and implants, especially when a detailed classification is used. Clinical experience does not seem to influence this.