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. 2020 Apr;36(2):135-140.
doi: 10.1007/s11282-019-00387-0. Epub 2019 Apr 19.

Reliability of marginal bone level measurements on digital panoramic and digital intraoral radiographs

Kristina Hellén-Halme  1 , Agneta Lith  2 , Xie-Qi Shi  3
Affiliations

Reliability of marginal bone level measurements on digital panoramic and digital intraoral radiographs

Kristina Hellén-Halme et al. Oral Radiol. 2020 Apr.

Abstract

Objectives: The aim of this study was to evaluate the reliability of bitewing and panoramic radiographs in marginal bone level measurements in terms of inter- and intra-observer agreement.

Methods: Fifty paired bitewing and panoramic images were used. Eight observers measured marginal bone level at the mesial and distal surfaces of tooth 25 and tooth 35. Thus, in total 100 radiographs of 400 measurements were obtained for each observer. To evaluate intra-observer agreement, three observers re-evaluated the radiographs after a minimum of 1 month. Intra-class correlation coefficient (ICC) was applied to evaluate the inter- and intra-observer agreement. The t test was applied to assess possible difference in measurement between bitewing and panoramic radiographs.

Results: The mean ICC value of inter-observer agreement was 0.85 for bitewing and 0.66 for panoramic radiographs. The mean intra-observer agreement was 0.92 and 0.76 for bitewing and panoramic radiographs, respectively. There was no statistically significant difference between bitewing and panoramic radiographs in measurements of marginal bone level on maxillary tooth 25, whereas a statistically significant difference was found between the two image modalities on mandible tooth 35.

Conclusion: Bitewing examination should be the choice of image modality for assessment of marginal bone level at premolar region due to good to excellent reliability and low radiation dose. However if a panoramic radiograph already exists, a rough estimation of marginal bone level at premolar region is clinically acceptable bearing in mind that the bone height of the mandible premolar region might be overestimated as compared to bitewing radiograph.

Keywords: Digital radiology; Intraoral image; Marginal bone level; Observer variations; Panoramic image.

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Conflict of interest statement

None of the authors has any conflict of interest for this study.

Figures

Fig. 1
Fig. 1
Illustration of the linear correlations between measurements performed using bitewing and panoramic radiographs for tooth 25
Fig. 2
Fig. 2
Illustration of the linear correlations between measurements performed using bitewing and panoramic radiographs for tooth 35
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