Comparative Analysis of Data Efficiency Between Conventional Periapical Radiography and Digital Subtraction Radiography in Chronic Periodontitis Patients

Purpose: Advancements in technology have driven a shift towards digital techniques alongside conventional screening methods in dental radiology and across medical disciplines. This study aims to compare the efficacy of two radiographic techniques, periapical radiography and digital subtraction radiography, in assessing bone recovery processes. Materials and Methods: Sixty mandibular premolar and molar regions in eighteen chronic periodontitis patients undergoing flap surgery were examined pre- and post-operatively using both periapical radiographs and digital subtraction radiography. Periodontal surgery outcomes were monitored by recording periodontal index, pocket depth, and gingival recession preoperatively (baseline) and at the 3rd and 6th months postoperatively. Standardized parallel periapical radiographs and via digital subtraction radiography images were analyzed by different observers to evaluate changes in alveolar bones and assess surgical outcomes. Results: Results showed significant reductions in index values and pocket depths, along with an increase in gingival recession. Intraobserver consistency was found to be good and fair, while interobserver consistency was poor across the 0-3, 3-6, and 0-6 month periods. Radiographic evaluation demonstrated a statistically significant increase in digital subtraction radiography data compared to conventional radiography in defect recovery throughout the follow-up period. Conclusions: This study demonstrated that the digital subtraction radiography technique is more efficient in detecting minimal changes in mineralised tissues that cannot be clearly traced by conventional radiographic techniques. Keywords: Chronic Periodontitis, Dental, Digital Subtraction