Radiographic detectability of periodontal diseases. A comparison of perapical radiography with detailed zonography.

Objective: To compare the diagnostic accuracy of conventional periapical radiography with detailed zonography using the Scanora system for the detection of periodontal disease.

Methods: We selected for comparison 311 periodontal sites in 165 patients. Five observers independently assessed the periapical radiographs and detailed zonograms for marginal widening of periodontal ligament space, crestal erosion, vertical bone loss, furcation involvement and calculus.

Results: ROC analysis revealed no significant differences between the two imaging techniques for either overall or lesion-specific interpretation of periodontal pathology. The sensitivity of periapical radiography was 79%, and of detailed zonography 91% (multiview) and 89% (stereoscopic). Specificities were 82%, 77% and 83%, respectively.

Conclusions: Detailed zonography performs as well as periapical radiography in the detection of periodontal disease.