APPROBATION OF CLINICALLY ORIENTED APPROACH TO ASSESS PERIODONTAL PROBING DEPTH BASED ON DIGITAL DATA

Abstract

Introduction. Despite the reported precision and adaptability of intraoral scanning technology to the needs of diagnostic procedures related with analysis of changes localized on the outer surface of the teeth and gingiva, possibilities of IOS for objectifying intra- and subgingival changes observed in patients with periodontitis are still being studied. Objective of the research. To test the possibility of implementing the approach targeted at digital periodontal probing based on the combination of intraoral scanning data and cone-beam computed tomography. Materials and methods. Studied sample of patients was conditionally divided into those who were characterized with the absence of clinical signs of generalized and/or localized periodontitis (8 patients), and those in whom signs of generalized periodontitis or localized periodontitis were verified within the projection of the studied teeth (9 patients). Final sample of studied teeth included 127 objects, of which 48 were represented by teeth without signs of periodontal tissue pathology, and 79 were pepresented with signs of periodontitis. Periodontal probing was performed using UNC-15 design of periodontal probe. Digital periodontal probing was held as procedure for measuring the vertical level of the gingiva from its marginal level registered on intraoral scan and to the registered position of the bone crest level according to cone beam computed tomography. Results and discussions. Average differences in the depth parameters measured by digital periodontal probing and clinical probing within a sample of 48 teeth without signs of periodontal tissue pathology were 2,08 ± 1,69 mm, while in a sample of teeth with signs of periodontal disease it was 1,14 ± 1,85 mm, and the difference between such was statistically confirmed (p < 0,05). Correlation coefficients between the depth value of digital periodontal probing and that determined clinically intraoral using a specialized probe were r = 0,68 (p < 0,05) for the entire sample of 127 analyzed teeth, however, the correlation coefficient for the above parameters among the subsample of analyzed teeth without signs of periodontal pathology reached r=0.56 (p<0.05), and for the sample of teeth with signs of surrounding periodontal tissue pathology – r = 0,71 (p < 0,05). Conclusions. Statistically significant positive correlation was established between the depth values determined by the digital method and the results of clinical probing, which indicates the potential diagnostic value of the approbated approach. At the same time, it was found that the accuracy of digital probing is higher in areas with signs of periodontitis than in the projection of teeth with clinically healthy periodontal tissues. At the same time, the results of digital probing are significantly influenced by technical factors, in particular the quality of intraoral scanning, CBCT parameters (including voxel size), as well as the accuracy of algorithms for combining data from different modalities, which should be standardized in further studies.