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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Vydané v:	Journal of periodontal research Ročník 32; číslo 8; s. 661 - 666
Hlavní autori:	Machtei, Eli E., Hausmann, Ernest, Grossi, Sara G., Dunford, Robert, Genco, Robert J.
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	Oxford, UK Blackwell Publishing Ltd 01.11.1997 Blackwell
Predmet:	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
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Popis
Shrnutí:	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.
Bibliografia:	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