Comparison of the reproducibility of storage phosphor and film bitewings for assessment of alveolar bone loss

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Objective. To compare bitewing storage phosphor images and a digital measuring method with bitewing films and an analog measuring method with regard to the reproducibility of measurements of alveolar bone loss. Material and methods. Nine participants randomly selected from an epidemiological study were radiographically examined using two modalities: bitewing SP images and bitewing films. A digital measuring method was used on the bitewing SP images and an analog measuring method on the bitewing films. Alveolar bone loss was measured at 12 index sites in the premolar/molar region per participant and modality. One hundred measured sites on each modality were assessed twice by three observers. Paired t-test values and intra-class correlation coefficient (ICC) were computed. Results. Comparison of the mean absolute difference of alveolar bone loss between the digital and analog measuring methods demonstrated comparable results (p=0.53). The absolute difference in millimetres between 1st and 2nd measurements was comparable for two observers and statistically different for one. Intra-observer performance between 1st and 2nd measurements was comparable for the digital (ICC=0.85) and analog (ICC=0.83) measuring methods. Inter-observer agreement for the digital measurements was higher (ICC=0.79) than for the analog measurements (ICC=0.64). Conclusions. The study demonstrates that digital and analog measuring methods are comparable with regard to absolute alveolar bone measurements and intra-observer agreement. Inter-observer comparison demonstrated significantly higher agreement for the digital measurements. Based on the overall results, the modalities with the measuring methods utilized are comparable when measuring minor alveolar bone loss.