The relationship between radiographic and clinical changes in the periodontium

Change in clinical attachment level (CAL) and radiographic change in crestal bone height are often used to assess periodontal breakdown and disease progression. These two variables are also used to monitor the effect of treatment. The purpose of the present longitudinal study was to evaluate the cor...

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Bibliographic Details
Published in:Journal of periodontal research Vol. 32; no. 8; pp. 661 - 666
Main Authors: Machtei, Eli E., Hausmann, Ernest, Grossi, Sara G., Dunford, Robert, Genco, Robert J.
Format: Journal Article
Language:English
Published: Oxford, UK Blackwell Publishing Ltd 01.11.1997
Blackwell
Subjects:
Adult
Aged
Alveolar Bone Loss - diagnostic imaging
Alveolar Bone Loss - pathology
Alveolar Bone Loss - therapy
attachment loss
Biological and medical sciences
bone loss
correlation
Cross-Sectional Studies
Disease Progression
Evaluation Studies as Topic
Female
Follow-Up Studies
Humans
Investigative techniques, diagnostic techniques (general aspects)
Key words: disease progression
Longitudinal Studies
Male
Medical sciences
Middle Aged
Otorhinolaryngology. Stomatology. Orbit
Periodontal Attachment Loss - diagnostic imaging
Periodontal Attachment Loss - pathology
Periodontal Attachment Loss - therapy
Periodontal Pocket - diagnostic imaging
Periodontal Pocket - pathology
Periodontitis - diagnostic imaging
Periodontitis - pathology
Prospective Studies
Radiodiagnosis. Nmr imagery. Nmr spectrometry
Radiographic Image Enhancement
Regression Analysis
Sensitivity and Specificity
Human
Modification
Correlation
Radiodiagnosis
Stomatology
Alveolar bone
Parodontium
Loss
Exploration
Radiography
Symptomatology
Periodontal disease
Periodontitis
Follow up study
ISSN:0022-3484, 1600-0765
Online Access:Get full text
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Summary:Change in clinical attachment level (CAL) and radiographic change in crestal bone height are often used to assess periodontal breakdown and disease progression. These two variables are also used to monitor the effect of treatment. The purpose of the present longitudinal study was to evaluate the correlation between changes in CAL and alveolar bone loss. Following initial screening, 79 subjects with established periodontitis were monitored quarterly for 1 yr, using a pressure‐sensitive automated probe. CAL and relative attachment level (RAL) were recorded at 6 sites for each tooth. Radiographs were obtained at baseline and 1 yr. Crestal bone changes were determined using an image enhancement technique. Mean change in attachment level was 0.16 mm. Similarly, mean proximal bone loss measured radiographically was 0.16 mm. In 6.9% of all the sites, and 13.7% of all pooled interproximal sites, AL loss was in excess of the threshold defined as 2 s.d. of repeated measurements (mean 1.54 mm). Similar percentages of sites (12.9%) had radiographic evidence of proximal bone loss exceeding the threshold (0.55–1.08 mm). A site‐based analysis of active sites revealed an overall poor correlation between the 2 variables (kappa value=0.03) which was the result of a very poor sensitivity (0.16) despite a relatively good specificity (0.81). A patient‐based comparison of clinical and radiographical changes revealed an overall kappa value of 0.08, with sensitivity and specificity of 0.51 and 0.56, respectively. However, baseline CAL and crestal bone height showed good correlation (r=0.73; p=0.0001). It is suggested that changes in CAL and radiographic bone level progress somewhat independently. Over a short‐term period of time they might not follow the same course; however, in the long term, these differences seem to level off. For longitudinal monitoring of disease progression and response to therapy both methods may be needed; while for cross‐sectional evaluation and long‐term prospective studies, either variable may be used alone.
Bibliography:ark:/67375/WNG-Q89W18KT-W
istex:6196696A34353B95C0B8FD6A94E1836E0C5D187B
ArticleID:JRE661
ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-1
content type line 23
ISSN:0022-3484
1600-0765
DOI:10.1111/j.1600-0765.1997.tb00576.x