PERİODONTAL DEFEKTLERİN TOPOGRAFİK VE ANATOMİK ÖZELLİKLERİNİN KONİK IŞINLI BİLGİSAYARLI TOMOGRAFİDE VE PANORAMİK RADYOGRAFTA DEĞERLENDİRİLMESİ VE KARŞILAŞTIRILMASI
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BÜTEV, P., Evaluation and comparison of topographic and anatomical features of periodontal defects in cone beam computed tomography and panoramic radiograph. Hacettepe University Faculty of Dentistry, Periodontology Thesis, Ankara, 2022. Objective: To compare the panoramic and CBCT images of periodontal defects in terms of the anatomical and topographic structure of the defect, to evaluate the anatomical and topographic structures of the defects in CBCT images of periodontal defects by dentists (3rd year periodontology residency student, a professional periodontist and a professional oral and maxillofacial radiologist) with different expertise and experience, and to determine the interobserver and intraobserver agreement of three different observers. Materials and Methods: The tooth number, defect area, bone loss, depth, mesiodistal width, buccolingual width, presence/absence of furcation involvement in the first molar teeth were recorded of 300 intraosseous defects in CBCT. Defects were evaluated in terms of presence/absence of defect on panoramic radiograph, RBL%/age in the region with the most bone loss, presence/absence of furcation involvement in mandibular first molars. 90 defects determined by power analysis from 300 intraosseous defects on CBCT were measured to assess intra- and interobserver agreement. Measurements were repeated at two-week intervals to assess intra-observer agreement. The normality analysis of the data was determined by the Shapiro Wilk goodness-of-fit test. The relationship between the t-test for normally distributed data, Mann Whitney U test for non-normally distributed data, and the variables in CBCT and panoramic radiographs were determined. The sensitivity and selectivity analysis of the panoramic radiograph was determined by Youden index and ROC graphs were created. Intra-observer correlation coefficients were used to determine intra-observer and inter-observer agreement. Results: Intra-observer and inter-observer agreement was found to be high. According to the condition of the defect in panoramic radiographs, there is statistical significance compared to the Mann Whitney U test in terms of medians of age, bone loss, mesiodistal width of the defect, depth of the defect, buccolingual width of the defect, and bone loss/age variables. (p<0.05) According to Youden index, the cut-off point for bone loss was 5.73, the mesiodistal width of the defect was 3.21, the depth of the defect was 2.45, the buccolingual width of the defect was 3.62, bone loss/age was 1.15. Below these values, it was observed that the selectivity and sensitivity of panoramic radiographs decreased. Conclusion: Panoramic radiography is not sufficient for diagnosis, prognosis and treatment planning of intraosseous defects and furcation involvement. Clinical examination and 3D imaging techniques are of great importance in prognosis, diagnosis and treatment planning.