avveolar bone loss determination
Post on 14-Apr-2018
225 Views
Preview:
TRANSCRIPT
-
7/30/2019 avveolar bone loss determination
1/17
Lira-Junior R, Freires Id, de Oliveira IL,da
Silva ES, da Silva S, de Brito RL J Indian Soc
Periodontol 2013;17:87-90
Comparative study between twotechniques for alveolar bone loss
assessment: A pilot study
-
7/30/2019 avveolar bone loss determination
2/17
Objective:
To conduct a comparative study between twotechniques for assessment of alveolar bone loss.
-
7/30/2019 avveolar bone loss determination
3/17
Materials and Methods:
Absolute and relative techniques were evaluated.The sample consisted of 16 radiographs
supposed to meet a single criterion:
The reference points applied (Cementum-enamel
junction (CEJ) alveolar bone crest and root apex)
should be visible. Bone height was measured in
the selected radiographs as the percentage of
root length through both techniques
-
7/30/2019 avveolar bone loss determination
4/17
Data were submitted to the Statistical Packagefor Social Science software.
Results obtained by both methods were
converted into bone loss index values and then
categorized.
Sensitivity and specificity of the relative
technique, compared to the absolute technique,
were calculated. Wilcoxon test and the Bland and
Altmans method were employed for
comparisons.
Significance level was set at 5%.
-
7/30/2019 avveolar bone loss determination
5/17
Results:
For the absolute and relative techniques, meansof bone loss index were respectively of 4.81
(2.25) and 4.75 (1.80). Bone loss index 6
(alveolar bone loss 50%) was found in 5 (31.2%)
teeth, in the absolute technique, and in 4 (25%)teeth, according to the relative technique.
There was no statistically significant difference
between both methods (P>0.05).
-
7/30/2019 avveolar bone loss determination
6/17
According to the Bland and Altmans method, itwas verified a bias of 0.06, and limits of upper
and lower agreement of, respectively, 1.58 and
1.45.
Sensitivity of 0.8 and specificity of 1 were found
for the relative technique compared to the
absolute one.
-
7/30/2019 avveolar bone loss determination
7/17
Conclusion:
There was no significant difference between thetechniques evaluated, and the relative technique
was found to be reliable for measuring alveolar
bone loss.
-
7/30/2019 avveolar bone loss determination
8/17
Absolute technique
We measured, in millimeters, the distancebetween CEJ and
the alveolar bone crest, as well as the distance
between CEJ
and the root apex.
Bone loss percentage was determined by the
difference between those distances multiplied by
100.All measurements were made in different days
within a dark ambience on the negatoscope by a
single previously trained examiner, with the aid of
a needle point compass and a millimeter ruler.
-
7/30/2019 avveolar bone loss determination
9/17
Relative technique
It was conducted by using the Schei ruler.
It is a transparent plastic ruler stamping 1 mm
thickness along its margins and 10 equidistant
lines radiating from a central point, each one
representing a bone loss equivalent to 10%.
The marking of 1 mm thickness represents the
distance between CEJ and the alveolar crest in
normal humans without bone loss.
-
7/30/2019 avveolar bone loss determination
10/17
Schei ruler - representative image
-
7/30/2019 avveolar bone loss determination
11/17
This technique results in the determination ofbone loss as a percentage of the original bone
level, starting 1 mm below CEJ, regardless root
length, its extension in the radiograph and
direction of the X-rays beam.
The bone crest level was defined as the point
along the root where an intact lamina was found.
As for the absolute technique, data were
registered in a form. For both techniques, after 30
minutes of evaluation, a 15-minute break was
respected to avoid eyestrain.
-
7/30/2019 avveolar bone loss determination
12/17
DISCUSSION Radiographic assessment complements the
periodontal clinical examination, contributing tothe establishment of a diagnosis and beingeffective for a retrospective analysis of
periodontal disease evolution. Numerous scientific evidences have aroused
attention to the importance of clinical andradiological follow-up of periodontal patients.
Nonetheless, there is still no consensus on thebest technique for measuring bone level.
This study was designed in order to analyze thedifferences between two techniques for alveolarbone loss assessment
-
7/30/2019 avveolar bone loss determination
13/17
Wolf B, Von Bethlenfalvy E, Hassfeld S, Staehle HJ, Eickholz P:
Reliability of assessing interproximal bone loss by digital
radiography: intrabony defects. J Clin Periodontol 2001; 28: 869
878.
The aim of the present study was to assess thereproducibility and validity of linear measurements ofinterproximal bone loss in intrabony defects ondigitized radiographic images after application ofdifferent filters and magnifications.
In this study, the chosen digital manipulations (filters:spreading, structure) of radiographic images failed toresult in statistically significantly more reproducible or
valid measurements of interproximal bone loss withinintra-bony defects when compared to the digitized butunchanged images. All radio-graphic assessments onthe digitized images except for use of enhancement ofgrey level differences (structure) came close to the
intrasurgical gold standard.
-
7/30/2019 avveolar bone loss determination
14/17
When comparing techniques, the absolute onemeasured greater alveolar bone loss than the relative,but without statistically significant difference.
Although evaluating different methods, Teeuw et al.found that an analyzer software measured a greater
extent of bone loss than the Schei technique, but nostatistically significant difference was found as well.
Albandar and Abbas[compared three techniques formeasuring bone loss (absolute, Scheisand Bjornstechniques (bone level as a percentage of the tooth).
Absolute technique was found to demonstrate ease ofreading, while the Scheis technique demonstratedgreater ability to detect changes in bone level.
-
7/30/2019 avveolar bone loss determination
15/17
Benn DK: A review of the reliability of radiographic
measurements in estimating alveolar bone changes. J
Clin Periodontol 1990; 17: 14-21.
Despite tlieir widespread use, denta! radiographshave numerous shortcomings for measuring
alveo!ar bone changes. In order to develop
guide!ines for improving the re!iability of
radiographic measurements, factors affecting theformation of an image v^^ere reviewed.
These were considered regarding the design of a
clinica! monitoring system, capab!e of detecting
the loss of smal! amounts of a!veo!ar bone crestfrom serial fi!ms
-
7/30/2019 avveolar bone loss determination
16/17
it appears that routine screening of patients bygeneral dental practitioners for small amounts of
bone loss is unlike!y to be successfu! without the
use of
(i) repositionab!e stentless film holders to
standardise the irradiation geometry,
(ii) a very accurate reproducible measuring
technique which
(iii) wil! probably require an automatic computer-
based measuring system.
-
7/30/2019 avveolar bone loss determination
17/17
top related