Avaliação da condição periodontal de pacientes através da mensuração de perda óssea alveolar interproximal em radiografias panorâmicas

Abstract

Periodontitis is a chronic, multifactorial inflammatory disease associated with dysbiotic biofilm. It presents progressive destruction of the tooth supporting tissues, which can be manifested clinically by clinical attachment loss and radiographically by alveolar bone loss. The purpose of this study was to evaluate the periodontal condition of patients by measuring alveolar bone loss (ABL) in the interproximal tooth region obtained from panoramic radiograph images. The sample consisted of 44 patients (mean age 38.8 ± 10.4 years), 65.9% women, mean 22.5 teeth (± 4.42) with their respective panoramic radiograph images. Radiographic alveolar bone loss (ABL) data were measured by two examiners previously calibrated intra- and inter-examiner (CCIC > 0.80). The distance from the CEJ (cement-enamel junction) to the AB (alveolar bone crest) and RL (root length) measured from the CEJ to the root apex were measured using the Image J software. ABL was calculated from the CEJ-AB measurement divided by the RL and the result transformed into a percentage. All patients had data from the simplified periodontal examination (PSR) and revealed the presence of sextants with codes 2, 3 and 4. Data from 174 sextants were collected. Thirty-three patients had data on periodontal clinical parameters in their medical records. Among them, seven were classified as Stage 2 periodontitis, 23 as Stage 3 periodontitis and three as Stage 4 periodontitis. Sextants that displayed PSR 4 code values had higher ABL values when compared to sextants that displayed PSR 2 codes, 22.4 (15.5/29.7) x 15.1 (11.1/17.3) and PSR codes 3, 22.4 (15.5/29.7) x 16.9 (12.8/21 .9), with the same condition observed regarding PO values for PSR 2 codes (median, interquartile range), 2.9 (2.3/3.9) x 1.5 (1.0/2, 4) and PSR codes 3, 2.9 (2.3/3.9) x 2.0 (1.3/3.8) (p<0.01) (data expressed as median, interquartile range). Significant differences were found in the POA and PO values in sextants that had a PSR score of 4, being considered the highest score that can be found clinically, and which is correlated with periodontitis.