Investigation of the relationship between clinically detected loss of attachment and radiographic changes in early periodontal disease

A total of 383 students, ages 12-16, were examined clinically to determine periodontal attachment loss by a trained examiner, utilizing standard techniques. 70 of these were selected, for whom bitewing radiographs were available for assessment of early alveolar bone loss by 2 radiologists and a general dentist, utilizing 4 criteria. The results indicate poor agreement between clinical and radiographic diagnoses by the 3 examiners. Variations were also found in the diagnosis of pathologic sites utilizing radiographs. The data indicate that bitewing dental radiographs were a poor screening or diagnostic procedure for the assessment of early periodontal disease in adolescents.