Accurate diagnosis of periodontal and peri-implant diseases relies significantly on radiographic examination, especially for assessing alveolar bone levels, bone defect morphology, and bone quality. This narrative review aimed to comprehensively outline the current state-of-the-art in radiographic diagnosis of alveolar bone diseases, covering both two-dimensional (2D) and three-dimensional (3D) modalities. Additionally, this review explores recent technological advances in periodontal imaging diagnosis, focusing on their potential integration into clinical practice. Clinical probing and intraoral radiography, while crucial, encounter limitations in effectively assessing complex periodontal bone defects. Recognizing these challenges, 3D imaging modalities, such as cone beam computed tomography (CBCT), have been explored for a more comprehensive understanding of periodontal structures. The significance of the radiographic assessment approach is evidenced by its ability to offer an objective and standardized means of evaluating hard tissues, reducing variability associated with manual clinical measurements and contributing to a more precise diagnosis of periodontal health. However, clinicians should be aware of challenges related to CBCT imaging assessment, including beam-hardening artifacts generated by the high-density materials present in the field of view, which might affect image quality. Integration of digital technologies, such as artificial intelligence-based tools in intraoral radiography software, the enhances the diagnostic process. The overarching recommendation is a judicious combination of CBCT and digital intraoral radiography for enhanced periodontal bone assessment. Therefore, it is crucial for clinicians to weigh the benefits against the risks associated with higher radiation exposure on a case-by-case basis, prioritizing patient safety and treatment outcomes.

中文翻译：

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牙周病的放射诊断——当前证据与创新。


牙周和种植体周围疾病的准确诊断很大程度上依赖于放射学检查，尤其是评估牙槽骨水平、骨缺损形态和骨质量。这篇叙述性综述旨在全面概述牙槽骨疾病放射学诊断的最新技术，涵盖二维 (2D) 和三维 (3D) 模式。此外，本综述探讨了牙周影像诊断的最新技术进展，重点关注其融入临床实践的潜力。临床探诊和口内放射线照相虽然至关重要，但在有效评估复杂的牙周骨缺损方面遇到了限制。认识到这些挑战后，人们开始探索锥形束计算机断层扫描 (CBCT) 等 3D 成像方式，以更全面地了解牙周结构。射线照相评估方法的重要性体现在它能够提供客观和标准化的硬组织评估方法，减少与手动临床测量相关的变异性，并有助于更精确地诊断牙周健康。然而，临床医生应该意识到与 CBCT 成像评估相关的挑战，包括视场中存在的高密度材料产生的光束硬化伪影，这可能会影响图像质量。数字技术的集成，例如口腔内放射成像软件中基于人工智能的工具，可以增强诊断过程。最重要的建议是明智地将 CBCT 和数字口内放射线摄影相结合，以增强牙周骨评估。 因此，临床医生必须根据具体情况权衡与较高辐射暴露相关的益处和风险，并优先考虑患者安全和治疗结果。