Diagnosis of infra-alveolar bony lesions in the dentate alveolar process with high-resolution computed tomography. Experimental results

RATIONALE AND OBJECTIVES: Conventional intraoral radiography was compared with axial computed tomography (CT) scans for identification and classification of bony pockets in dentate jaw segments. METHODS: Fifty-five artificial bone defects were produced in six dentate jaw segments. The jaws were examined radiographically using a dental x-ray unit and by contiguous axial CT scans. Identification, classification, and vertical depth of the bony defects were compared among the specimens, radiographs, and CT scans. RESULTS: On the intraoral radiographs, 38 (69%) bony lesions were identified, and the vertical depth was underestimated by a mean of 2.2 mm, compared with the objective measurements on the jaws. In contrast, all artificial bony lesions (100%) were identified and classified on the axial CT scans and the vertical depth was underestimated by a mean of 0.5 mm. CONCLUSIONS: High-resolution CT improves the identification and metric assessment of the vertical dimension of infra-alveolar bony lesions compared with conventional intraoral x-ray films and allows these defects to be classified according to the number of existing walls into one-walled, two-walled, and three-walled bony pockets. In patients with apically extended metallic restorations, the image quality could be limited by artifacts.