Comparison of the sensitivity of detecting risk factors for periodontitis using conventional radiography

Introduction. Periodontitis is a condition of tooth supporting structures, which are responsible for normal dental morphology and function. Bacterial biofilm formation in the presence of local risk factors plays a fundamental role in the development of periodontitis. Early and accurate detection of risk factors which promote dental plaque accumulation is the basis of treatment and prophylaxis. Aim. The aim of the study was to assess overhanging dental restorations and their impact on the maxillary alveolar process margin and the alveolar mandible based on panoramic radiography. Furthermore, the correlation between the type of restoration and the magnitude of bone loss was analysed. Material and methods. A retrospective analysis of 200 panoramic radiographs showing restorations in permanent dentition was performed using the Planmeca Romexis Viewer software. Further analysis included 113 radiographs with the presence of a homologous tooth on the opposite side of the dental arch. In the study, we analysed the following variables: age, gender, the bone level, occlusal contact points between the opposite teeth and the condition of the tooth adjacent to overhanging dental restoration. We also assessed the type of incorrect dental restoration according to G.V. Black classification. The obtained data was analysed statistically, with p < 0.005 considered statistically significant. The study was approved by the Bioethics Committee of the Medical University of Warsaw (approval no. KB/115/A/2012). Results. We obtained data on the prevalence and magnitude of overhanging dental restorations, the type of restoration and the coexisting bone lesion. The largest size of the overhanging dental restoration was associated with Class II (according to G. V. Black) mesio-occlusal-distal cavities (1.15 mm; p < 0.03), whereas the smallest ones were observed for occlusal-distal cavities (0.91 mm; p < 0.001). The Spearman’s rank correlation coefficient between mesio-occlusal-distal cavities and radiographically measured size of bone lesions was positive (R = 0.51; p = 0.03). Conclusions. The conducted study revealed a significant positive correlation between the mean size of overhangs and radiographically measured size of bone loss. Adjunctive radiology is an important aid in the detection of risk factors for periodontitis.