Objectives: To update the findings of a systematic review from the year 2016 on the evidence for the accuracy and potential benefits of cone beam computed tomography (CBCT) in periodontal diagnostics.
Material and methods: A systematic literature search was performed and the criteria for PICO, PRISMA and risk of bias assessment were applied. Only clinical trials (> 10 patients) conducted in humans on periodontal bone loss, i.e. vertical and/or horizontal or furcation involvement, in CBCT compared with clinical and/or conventional radiographic measures were included.
Results: From 1152 articles identified, 11 case series on furcations and eight on vertical and/or horizontal bone loss were included. The studies showed moderate risk of bias and heterogeneous study designs. The agreement between non-surgical clinical or two-dimensional radiographic assessments of horizontal, vertical or interfurcal bone loss and CBCT measurements was analysed in 11 studies and was low in six studies with comparable study designs. A high accuracy (80-84%) of CBCT measurements compared with intra-surgical findings of furcation involvement was observed in four studies. Comparing CBCT with intra-surgical measurements of vertical or horizontal bone loss, an accuracy between 58 and 93% was found in four out of six studies. Three studies were analysed and indicated benefits of CBCT in decision making and/or a reduction of treatment costs and time in teeth of interest.
Conclusions: The findings provide additional evidence for the accuracy of CBCT in assessing periodontal bone loss.
Clinical relevance: CBCT is an accurate diagnostic tool in periodontology, which needs to be carefully considered in certain situations.
Keywords: Cone beam computed tomography; Decision making; Diagnosis; Furcation involvement; Three-dimensional imaging; Vertical bone defects.