Western Society of Periodontics

Clinical Studies

Volume Number 4, 1995

Efficacy of the FDA selection criteria for radiographic assessment of the periodontium

This study evaluated the effectiveness of the recently promulgated guidelines of the U.S. FDA for ordering radiographs for new adult dental patients as related to assessment of the periodontal condition. The 490 subjects seeking care at UCLA dental clinic were examined, and it was determined if periapicals were needed to supplement the posterior bitewings based on clinical findings. The reduction in the number of radiographs ordered, as well as the extent of missed alveolar and furcation bone loss resulting from the use of a selected set of radiographs when compared with a full-mouth series, were measured. At least one clinical sign of periodontitis was detected in 433 subjects, and 264 demonstrated radiographic evidence of bone loss. Of the 460 subjects on whom periodontal probing was conducted, two-thirds demonstrated periodontal probing depths in excess of 3 mm; almost half showed evidence of bleeding. Individuals with clinical signs of periodontitis had, on average, 10 periapicals ordered-more than twice the number of those with no sign of periodontitis. Of the 2,415 teeth with radiographic findings of proximal or furcal bone loss, 152 sites of bone loss (6%) were missed when the selected set of films plus the posterior bitewings were used. [J.Y.K.]