Abstract
<jats:p>The study presents the results of determining the radiological index in patients of different sex diagnosed with generalized periodontitis. Densitometric parameters of the mineral density of the alveolar bone are considered important indicators reflecting the course and severity of periodontitis. The development of an index-based assessment of radiological examination results may serve as a potential biomarker of generalized periodontitis progression and may improve the diagnostic accuracy of this pathology. A total of 32 individuals (16 men and 16 women) aged 35–70 years were enrolled in the study. Based on clinical and radiological examination, the degree of periodontitis progression was graded according to the AAP/EFP World Workshop (2017) classification of periodontal and peri-implant diseases and conditions. The inclusion criteria comprised a confirmed diagnosis of generalized periodontitis, the presence of indications for cone-beam computed tomography (CBCT) for implant or endodontic treatment planning, and the absence of acute dental or systemic inflammatory conditions. Patients with metallic foreign bodies in the oral cavity (such as dental prostheses or implants) that could cause CBCT artifacts, those taking medications affecting bone metabolism, as well as individuals diagnosed with osteoporosis or other musculoskeletal disorders, were excluded from the study. Additionally, the control group included 12 participants (6 men and 6 women) without clinical signs of periodontal lesions. All participants underwent CBCT, and the radiological index (RI) was determined. The index was calculated as the ratio between the mineral density of the alveolar bone in the interincisal region of the mandible and the mineral density of the cancellous bone of the second cervical vertebra. Densitometric characteristics were measured during CBCT analysis in Hounsfield units (HU). According to the results, 7 patients (21,9 %) had grade A periodontitis, 14 individuals (43,7 %) had grade B, and 11 patients (34,4 %) had grade C. Men more frequently demonstrated a more severe course of the disease, whereas women predominantly exhibited slow or moderate progression. The mean of RI was the highest in patients with grade A periodontitis – 1,32±0,19, and the lowest in those with grade C – 0,32±0,12, showing statistically significant differences (p<0,05) compared with the mean index value in the control group – 1,79±0,19. The mean index in men with periodontitis was 0,76±0,47, while in women it was significantly (p<0,05) higher – 1,03±0,49. In the control group, the mean values were 1,71±0,07 and 1,62±0,09 for men and women, respectively, showing no significant difference (p>0,05). Thus, the radiological index in patients with generalized periodontitis is significantly associated with both the degree of disease progression and the patient’s sex. The minimum RI values were recorded in men with grade C periodontitis (mean 0,22±0,04), while the maximum values were found in women with grade A periodontitis (1,45±0,17), showing statistically significant differences compared with healthy subjects. The application of an index-based assessment of bone mineral density may serve as an additional diagnostic tool for the early detection of periodontal tissue pathology and enable prediction of the clinical course of the disease.</jats:p>