Comparison of cone-beam computed tomography, clinical and surgical analysis for detection of maxillary molar furcation

Abstract

The aim of this study was to compare the performance of cone-beam computed tomography (CBCT), clinical and surgical probing in assessing maxillary molar furcation involvement (FI). Furcation defects (n= 120) were assessed through CBCT, clinical and intra-surgical evaluation (ISE). Furcation Involve-ment, vertical and horizontal bone loss were assessed through clinical probing, CBCT and probing during ISE. Three trained radiologists evaluated CBCT images and intra-and interob-server agreement were calculated by Kappa test and Intraclass Correlation Coefficient (ICC). McNemar and Wilcoxon tests were used to compare clinical probing, ISE and CBCT. Accu-racy, sensitivity, specificity, positive and negative predictive values were calculated to detect FI. Clinical findings showed 28 sites with Degree I, 25 sites with Degree II, and 8 sites with Degree III. Good intra-(k=1.00) and interobserver agreement (k=0.773) were observed. Intraobserver and interobserver agreement for horizontal bone loss were moderate, k=0.485 and k=0.549, respectively. Intra-surgical findings showed Degree I at 21 sites, and Degree II and Degree III FI at fifteen sites each. Clinical evaluation showed 75% agreement with ISE and 78% with CBCT. Accuracy for clinical detection of FI was 75%, while for CBCT evaluation ranged from 72.5% to 77.5%, considering the 3 observers. Significant differences were found at distal sites using CBCT (p<0.05). Clinical evaluation and CBCT showed similar results for the presence or absence of FI. Concerning horizontal and vertical bone loss, CBCT was not considered a precise examination method for incipient bone defects. Received: April 2021; Accepted: October 2021.