Purpose: This study was performed to introduce, evaluate, and compare various novel assessment protocols designed for straightforward, reliable, and reproducible measurement of alveolar bone levels. These protocols are intended for standardized periodontal assessment and follow-up, utilizing cone-beam computed tomography (CBCT) images and manipulation of Digital Imaging and Communications in Medicine (DICOM) viewer software. Materials and Methods: Two experienced oral and maxillofacial radiologists developed 5 distinct radiographic measurement protocols. These techniques were established to assess the alveolar bone level of a periodontally affected upper central incisor using a method that is consistently repeatable across observers. Two additional assessors, blindedto the details of the study, independently applied the protocols to retrieved DICOM files that met the eligibility criteria.A scoring system with 3 subscores was created and used to compare the protocols. Results: Statistically excellent inter-observer reliability was observed for all protocols, other than protocol 1, which demonstrated moderate reliability. The average discrepancy between measurements taken by the 2 observers was 1.2 mm for protocol 1, 0.81 mm for protocol 2, and less than 0.5 mm for the remaining 3 protocols. All approaches except protocol 4 were straightforward to apply. Conclusion This study introduces multiple reliable protocols for the evaluation of periodontal bone levels that ensureconsistency across observers. Based on the findings, the double axial lines and incisocrestal distance protocols are recommended. These new assessment approaches, along with any future modifications, may be useful in periodontal assessment, dental implant follow-up, orthodontic evaluation, research, and artificial intelligence model generation.

Purpose: This study was performed to introduce, evaluate, and compare various novel assessment protocols designed for straightforward, reliable, and reproducible measurement of alveolar bone levels. These protocols are intended for standardized periodontal assessment and follow-up, utilizing cone-beam computed tomography (CBCT) images and manipulation of Digital Imaging and Communications in Medicine (DICOM) viewer software. Materials and Methods: Two experienced oral and maxillofacial radiologists developed 5 distinct radiographic measurement protocols. These techniques were established to assess the alveolar bone level of a periodontally affected upper central incisor using a method that is consistently repeatable across observers. Two additional assessors, blindedto the details of the study, independently applied the protocols to retrieved DICOM files that met the eligibility criteria.A scoring system with 3 subscores was created and used to compare the protocols. Results: Statistically excellent inter-observer reliability was observed for all protocols, other than protocol 1, which demonstrated moderate reliability. The average discrepancy between measurements taken by the 2 observers was 1.2 mm for protocol 1, 0.81 mm for protocol 2, and less than 0.5 mm for the remaining 3 protocols. All approaches except protocol 4 were straightforward to apply. Conclusion This study introduces multiple reliable protocols for the evaluation of periodontal bone levels that ensureconsistency across observers. Based on the findings, the double axial lines and incisocrestal distance protocols are recommended. These new assessment approaches, along with any future modifications, may be useful in periodontal assessment, dental implant follow-up, orthodontic evaluation, research, and artificial intelligence model generation.

Purpose: This study was performed to introduce, evaluate, and compare various novel assessment protocols designed for straightforward, reliable, and reproducible measurement of alveolar bone levels. These protocols are intended for standardized periodontal assessment and follow-up, utilizing cone-beam computed tomography (CBCT) images and manipulation of Digital Imaging and Communications in Medicine (DICOM) viewer software. Materials and Methods: Two experienced oral and maxillofacial radiologists developed 5 distinct radiographic measurement protocols. These techniques were established to assess the alveolar bone level of a periodontally affected upper central incisor using a method that is consistently repeatable across observers. Two additional assessors, blindedto the details of the study, independently applied the protocols to retrieved DICOM files that met the eligibility criteria.A scoring system with 3 subscores was created and used to compare the protocols. Results: Statistically excellent inter-observer reliability was observed for all protocols, other than protocol 1, which demonstrated moderate reliability. The average discrepancy between measurements taken by the 2 observers was 1.2 mm for protocol 1, 0.81 mm for protocol 2, and less than 0.5 mm for the remaining 3 protocols. All approaches except protocol 4 were straightforward to apply. Conclusion This study introduces multiple reliable protocols for the evaluation of periodontal bone levels that ensureconsistency across observers. Based on the findings, the double axial lines and incisocrestal distance protocols are recommended. These new assessment approaches, along with any future modifications, may be useful in periodontal assessment, dental implant follow-up, orthodontic evaluation, research, and artificial intelligence model generation.

Purpose: This study aimed to evaluate the anatomic circle around the impacted lower third molar to show, document,and correlate essential findings that should be included in the routine radiographic assessment protocol as clinically meaningful factors in overall case evaluation and treatment planning. Materials and Methods: Cone-beam computed tomographic images of impacted lower third molars were selected according to specific inclusion criteria. Impacted teeth were classified according to their position before assessment. The adjacent second molars were assessed for distal caries, distal bone loss, and root resorption. The fourth finding was the presence of a retromolar canal distal to the impaction. Communication with the dentist responsible for each case was done to determine whether these findings were detected or undetected by them before communication. Results: Statistically significant correlations were found between impaction position, distal bone loss, and detected distal caries associated with the adjacent second molar. The greatest percentage of undetected findings was found in the evaluation of distal bone status, followed by missed detection of the retromolar canal. Conclusion The radiographic assessment protocol for impacted third molars should consider a step-by-step evaluation for second molars, and clinicians should be aware of the high prevalence of second molar affection in horizontal and mesioangular impactions. They also should search for the retromolar canal due to its associated clinical considerations.(Imaging Sci Dent 2023; 53: 137-44)