Examination of periodontal status of patients with cone beam computed tomography according to current periodontal classification

Radiographic assessment provides important complementary information on periodontal bone support, while cone-beam computed tomography (CBCT) enables three-dimensional visualization of alveolar bone and furcation morphology. However, the distribution of radiographic alveolar bone loss and furcation involvement in previously acquired CBCT examinations remains insufficiently characterized, particularly according to age and sex. Therefore, this study aimed to characterize radiographic alveolar bone loss and furcation involvement in CBCT examinations and to evaluate their distribution according to age and sex. The recorded tomographic images were examined and listed according to exclusion and inclusion criteria. This retrospective study included 501 CBCT records of adults aged ≥ 18 years obtained between January 2021 and May 2025. The CBCT images were evaluated for radiographic alveolar bone loss and furcation involvement. Radiographic alveolar bone loss was categorized as no radiographic bone loss, < 15%, 15–33%, or > 33%. Furcation involvement was assessed according to horizontal and vertical classifications. The radiographic findings were subsequently evaluated according to age and sex. The chi-square test was used to compare categorical variables according to sex and age groups. Pairwise comparisons were performed using the post hoc Z test with Bonferroni correction. 41.9% of these individuals showed no bone loss and were included in the no-bone-loss group. In contrast, 58.1% showed bone loss and were categorized into three different groups based on the percentage of bone loss. Absence of bone loss was more common in women, while bone loss exceeding 33% was more common in men. Overall, furcation defects, classified as vertical and horizontal, were detected in 20.4% of participants. This retrospective CBCT-based study showed significant differences in radiographic bone loss and furcation involvement according to age and sex. Images obtained from CBCT allowed for detailed evaluation of alveolar bone loss and furcation morphology in the evaluated records, especially in cases of advanced periodontal destruction. However, radiographic findings alone cannot establish a clinical diagnosis of periodontitis or gingivitis. The absence of radiographic bone loss should not be interpreted as evidence of periodontal health or gingivitis, and similarly, the presence of bone loss without clinical measurements does not necessarily imply periodontitis.