Justification for the use of CBCT in the evaluation of bone support in periodontal disease.

Abstract

Periodontal disease signs are detected by clinical and radiographic examination. First choice radiographic examinations are conventional radiographies, which complement clinical information. However, radiographies may bring limited information because of structure superimposition, which occurs because of two-dimensional reproduction of three-dimensional structures. To overcome this, emerges the possibility to use cone-beam computed tomography. This produces images in all three-dimensions of space of periodontal bone support structures, usually with higher dose of ionizing radiation than conventional radiographies. Therefore, cone-beam computed tomography indication must be justified. The hierarchical model of diagnostic efficacy and practice guidelines support the indication of cone-beam computed tomography for periodontal bone support evaluation in patients with infrabony and furcation defects, also considering the utility in planning and control of regenerative surgical treatments. Literature recommends cone-beam computed tomography only when clinical and conventional radiographic evaluation does not provide necessary information for a correct diagnosis and treatment planning, so it is not indicated as a first choice imagining method.