Comparing the Diagnostic Efficacy of Intraoral Radiography and Cone Beam Computed Tomography Volume Registration in the Detection of Mandibular Alveolar Bone Defects

Publication date: Available online 2 January 2019

Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

Author(s): Peter T. Green, André Mol, Antonio J. Moretti, Donald A. Tyndall, Heidi B. Kohltfarber

Abstract

Objectives

(1) Compare bone loss detection accuracy with intraoral radiography (IO) and registered cone beam computed tomography (CBCT); (2) assess repeatability with both modalities; (3) determine factors affecting defect detection; (4) determine effect of bucco-lingual bone thickness on defect detection.

Study Design

Six observers viewed IOs and CBCTs pre- and post-defect to determine defect presence and extent. Receiver operating characteristic (ROC), sensitivity, specificity, logistic regression, odds ratio, intraclass correlation coefficient and weighted kappa were used.

Results

CBCT and IO mean ROC A_z were not statistically different (0.90 vs. 0.81, p=0.06). CBCT had higher sensitivity than IO (0.85 vs. 0.63, p=0.01) but similar specificity (0.91 vs. 0.84, p=0.45). Bone thickness, imaging modality, and observer had significant effects on defect detection (p<0.001). Odds ratios for CBCT vs. IO were 2.29 for diagnostic accuracy and 1.52 for bucco-lingual bone thickness. There was moderate agreement between observers and substantial agreement within observers for detection of defects and measurement of extent.

Conclusions

CBCT showed equivalent diagnostic efficacy and specificity for defect detection and higher sensitivity than IO. CBCT more than doubles the odds of accurate defect assessment compared to IO. Odds of bone loss detection increase approximately 50% per millimeter of bucco-lingual alveolar bone loss.

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