Comparison of Measurements of Alveolar Bone Levels by Clinical, Bitewing and Panoramic Radiography

Gingival and periodontal diseases in their various forms have affected human since the dawn of history. The earliest historical records dealing with medical topics revealed an awareness of periodontal diseases and need for treatment.1 The diagnosis of periodontal diseases which involve the soft and hard tissue destruction should be made systematically and should include both clinical and radiographic examination.2 Dental radiographs (bitewing, panoramic) are important in the detection and assessment of periodontal diseases, a valuable adjunct in the treatment planning and determination of prognosis.3 Bitewing radiographs are used both in clinical practice and epidemiological studies as they are characterized by their simplicity, reduced exposure time, have an advantage of coverage of posterior teeth and require less number of films than that of periapical radiographs.4 Bitewing radiograph is made to show the proximal surfaces of the teeth and the crest of alveolar bone of both maxilla and mandible on the same film.5 They provide a good perspective of alveolar bone crest and thereby useful for evaluating periodontal conditions.6 Panoramic radiography is a radiographic procedure that produces single image of facial structures including maxillary, mandibular arches and their supporting structures, utilizes intensifying screens, requires less radiation and saves time thereby making it potential substitute for intraoral radiography in assessing periodontal conditions.7 The efficacy of panoramic radiography compared to bitewing radiography remains an unsolved problem when imaging periodontal bone diseases or marginal bone levels.8 Therefore, a study was planned to compare the bitewing and panoramic radiography and pocket probing for the measurement of alveolar bone level.