Low dose cone beam computed tomography versus high dose cone beam computed tomography in measuring furcation involvements: (diagnostic accuracy study)

Document Type : Original Article

Authors

1 1- Oral & Maxillofacial Radiology Department, Faculty of Dentistry, British University in Egypt, Cairo, Egypt

2 Oral and Maxillofacial Radiology Department, Faculty of Dentistry, Cario univ., Cairo, Egypt

3 Faculty of informatics and Computer Science, British University in Egypt

4 Oral & Maxillofacial Radiology Department, Faculty of Oral and Dental Medicine, MUST

10.21608/ajbs.2025.434932.1157

Abstract

Accurate diagnosis of furcation defect is essential in periodontal therapy planning. Cone beam computed tomography (CBCT) provides three-dimensional visualization, but higher radiation doses remain a concern. This study aims to assess and compare the diagnostic accuracy of low-dose CBCT (LD-CBCT) and high-dose CBCT (HD-CBCT) in detecting and measuring furcation defect using a pig mandible. Detection and accurate assessment of periodontal disease is important to determine the tooth prognosis and treatment. Radiographic assessment provides information about the pattern and extent of the furcation defect. CBCT provides unique 3D images used for diagnosis and treatment plans, but its use in periodontology not well-reviewed as there is few numbers of studies searched about the role of CBCT in periodontology. Fifteen molars from nine pig mandibles with naturally occurring and simulated furcation involvements were scanned using both LD-CBCT and HD-CBCT protocols. Real measurements obtained with periodontal probes and digital calipers served as the gold standard. Furcation defect were recorded and compared across the both doses (LD-CBCT & HD- CBCT). Inter- and intra-observer reliability were assessed. The results indicated that the mean furcation measurements were highest in the gold standard group (8.61 ± 1.90 mm), followed by HD-CBCT (7.22 ± 2.27 mm) and LD-CBCT (6.99 ± 2.15 mm). Differences between HD-CBCT and gold standard were not statistically significant (p = 0.062), whereas LD-CBCT showed a significant difference from the gold standard (p = 0.008). However, diagnostic agreement between HD and LD protocols was high, with acceptable variability. In conclusion it was found that LD-CBCT demonstrates acceptable diagnostic accuracy for measuring furcation defect, suggesting that reduced-dose protocols may be viable in clinical settings to limit radiation exposure without compromising diagnostic outcomes.

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