In vivo comparison of Kodak E-speed film and direct digital imaging system for assessment of interproximal bone loss

Aims: To evaluate the diagnostic accuracy of direct digital radiography as compared to a conventional radiographic film for the assessment of interproximal bone loss with intrasurgical measurements as the gold standard. Materials and Methods: A total of 100 patients, with untreated moderate-to-advanced periodontal disease, were included in the study. The presurgical radiographs were made using a Kodak E-speed film and a Dexis digital sensor simultaneously, for sites with interproximal bone loss. At the time of surgery, the distance from the cementoenamel junction to the bone defect (CEJ-BD) was measured for 331 interproximal defects. The radiographs were randomized and then linear measurements were taken for the same sites in both conventional and digital radiographs. Stastistical Analysis: Comparison between the conventional, digital, and intrasurgical measurements was done statistically using the Student′s t-test. The agreement and correlation among the methods was assessed using the weighted Kappa measure of agreement and Pearson′s correlation, respectively. Results: The results showed that the conventional (5.15 ± 2.19 mm) and digital analyzing techniques (5.13 ± 2.19 mm) underestimated the interproximal bone loss, as compared to the intrasurgical measurements (6.07 ± 2.05 mm) (p < 0.001). The difference between conventional and digital radiographic methods was found to be statistically insignificant (p = 0.92). Conclusion: Under normal clinical use, the alveolar bone levels revealed on intraoral direct digital radiographs and Kodak E speed film were almost same. Therefore, the digital radiographic system can be routinely used in clinical practice as an alternative to conventional film