UTILITY OF RADIOGRAPHIC CRESTAL LAMINA DURA FOR PREDICTING PERIODONTITIS DISEASE-ACTIVITY

The relationship between radiographic crestal lamina dura and periodon titis disease-activity was studied longitudinally in 51 treated adult patients on a systematic 3-month maintenance program. The presence or absence of crestal lamina dura at 1809 interproximal sites was scored from periapical and bitewing radiographs taken at baseline of a 36-mon th maintenance care period. Semi-annual clinical evaluations by 2 inde pendent examiners were carried out on each patient, with disease recur rence defined as sites revealing a greater than or equal to 3 mm incre ase in probing depth from baseline, or a greater than or equal to 2 mm increase in probing depth together with a greater than or equal to 2 mm loss of relative attachment level from an occlusal reference stent. Over the 36-month study period, 23 (45%) patients exhibited disease r ecurrence at 55 (3%) interproximal tooth sites scored for baseline cre stal lamina dura. Absence of detectable baseline crestal lamina dura y ielded high sensitivity (87-100%), but low specificity (17%) and low p ositive predictive values (0.8-3.2%), for localized periodontitis recu rrence. In contrast, no sites exhibiting an intact baseline crestal la mina dura demonstrated periodontitis recurrence up to 24 months from b aseline (100% positive predictive values). Presence of radiographic cr estal lamina dura was positively associated with clinical periodontal stability (summary odds ratio for sites = 2.6, P = 0.0004), and negati vely associated with periodontitis recurrence (summary odds ratio for sites = 0.4, P = 0.0004), for the 36-month study period. Evaluation of radiographic crestal lamina dura status appears valuable for assessin g the risk of periodontitis disease-activity at interproximal tooth si tes in patients on maintenance care programs.