{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T14:07:10Z","timestamp":1767967630408,"version":"3.49.0"},"reference-count":52,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T00:00:00Z","timestamp":1753920000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objectives<\/jats:title>\n<jats:p>Periodontal probing and intraoral radiography are conventional methods for periodontal assessment. Evaluating periodontium using CBCT-reconstructed multiplanar or cross-sectional views is labor-intensive and time-consuming. The objective of this study is to evaluate the accuracy of CBCT-simulated panoramic projections for periodontal assessment and determine whether a more efficient evaluation method can be developed.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>CBCTs taken at East Carolina University School of Dental Medicine from 2014\u20132023 were screened. The inclusion criteria were: (1) diagnostic-quality CBCT scans covering maxilla and\/or mandible; (2) full-mouth surveys (FMXs) taken within 6 months of the CBCT scans; and (3) clinical attachment loss (CAL) noted in periodontal charting. The cementoenamel junction (CEJ) to alveolar crest distance on mesial and distal surfaces of maxillary and mandibular central incisors, canines, first premolars, and first molars were measured on bitewings\/periapical radiographs (BW\/PA) and CBCT-simulated panoramic images. CALs were extracted from periodontal chartings. One-way ANOVA followed by Tukey\u2019s HSD post hoc test, Pearson correlation, and Bland Altman analysis were used to analyze the data.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>CBCT, BW\/PA, and CAL demonstrated strong correlations, with BW\/PA and CBCT producing comparable results in periodontal assessments for most sites. For mandibular central incisors and canines, CBCT and PA showed significantly more bone loss compared to CAL values. For the mandibular molars, CBCT revealed significantly more bone loss compared to BW.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>CBCT-reconstructed panoramic imaging has proven to be a reliable tool for periodontal assessment. Some discrepancies among the evaluation methods are likely due to periodontal configurations or conditions, operator errors, and the projection geometry of intraoral radiographs.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0329604","type":"journal-article","created":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T17:41:13Z","timestamp":1753983673000},"page":"e0329604","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Determine the accuracy of CBCT reconstructed panoramic images in periodontal assessment"],"prefix":"10.1371","volume":"20","author":[{"given":"Megan","family":"Blackstock","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus","family":"Mosley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erika","family":"Stevens","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerard","family":"Camargo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoxi","family":"Cui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5169-5250","authenticated-orcid":true,"given":"Wenjian","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,7,31]]},"reference":[{"issue":"1","key":"pone.0329604.ref001","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1111\/jre.12087","article-title":"Tooth loss in individuals under periodontal maintenance therapy: 5-year prospective study","volume":"49","author":"FO Costa","year":"2014","journal-title":"J Periodontal Res"},{"key":"pone.0329604.ref002","doi-asserted-by":"crossref","first-page":"2146160","DOI":"10.1155\/2020\/2146160","article-title":"Global prevalence of periodontal disease and lack of its surveillance","volume":"2020","author":"M Nazir","year":"2020","journal-title":"ScientificWorldJournal"},{"key":"pone.0329604.ref003","article-title":"Dental caries and periodontal diseases in the ageing population: call to action to protect and enhance oral health and well-being as an essential component of healthy ageing - consensus report of group 4 of the joint EFP\/ORCA workshop on the boundaries between caries and periodontal diseases","author":"MS Tonetti","year":"2017","journal-title":"J Clin Periodontol"},{"issue":"1","key":"pone.0329604.ref004","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1038\/sj.ebd.6400634","article-title":"Periodontal disease is a risk marker for coronary heart disease?","volume":"10","author":"A Cronin","year":"2009","journal-title":"Evid Based Dent"},{"key":"pone.0329604.ref005","article-title":"Epidemiology of association between maternal periodontal disease and adverse pregnancy outcomes--systematic review","volume":"84","author":"M Ide","year":"2013","journal-title":"J Periodontol"},{"issue":"2","key":"pone.0329604.ref006","first-page":"72","article-title":"Prevalence of periodontal disease, its association with systemic diseases and prevention","volume":"11","author":"MA Nazir","year":"2017","journal-title":"Int J Health Sci (Qassim)"},{"issue":"2","key":"pone.0329604.ref007","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1111\/jcpe.12837","article-title":"A systematic review and meta-analysis of epidemiologic observational evidence on the effect of periodontitis on diabetes An update of the EFP-AAP review","volume":"45","author":"F Graziani","year":"2018","journal-title":"J Clin Periodontol"},{"key":"pone.0329604.ref008","first-page":"74","article-title":"Group E. 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