Retrospective longitudinal study of the rate of alveolar bone loss in humans using bite-wing radiographs

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Abstract
The possible use of unstandardized bite-wing radiographs to determine the rate of alveolar bone loss over long periods of time is investigated. A total of 100 pairs of bite-wing radiographs obtained from patients of 2 general dental practitioners were read. For the purpose of measurement, 2 reference points were selected on the teeth; the highest point on the occlusal surface of the crown, the mesial and distal points of the cemento-enamel junction [CEJ]. Vertical and horizontal bone loss were measured. Initially, bone levels on 20 full mouth bite-wing radiographs on all posterior teeth were measured, then in the next 80 cases, an abbreviated index was used. The bone heights were first examined at the beginning and then at the end of a 10-yr time span. The percentages of measurable distances were 28% and 57%. From the occlusal measurement point and the CEJ measurement points, reasons for unreadability were also recorded. The annual rate of horizontal bone loss was 0.06 mm and 0.04 mm from the occlusal reference point and the CEJ reference point. The rates for the vertical bone loss were 0.05 and 0.03 mm. In order to study whether there was a constant loss over a period of time, bone levels were measured for 10 successive years. The bone loss rate per year apparently fluctuated. The bite-wing radiographs apparently can be used in longitudinal studies of periodontal diseases and can provide important information on the natural history of the disease.