NCT04341636

A Comparison of the Accurate Diagnosis of the Horizontal & Vertical Bitewing Images

Completed NA Results posted Last updated 12 August 2025

What this trial tests

NA trial testing Bitewing X ray in Periodontal Diseases in 20 participants. Completed in 30 July 2023.

Timeline

15 May 2023

Primary endpoint
29 June 2023

30 July 2023

Quick facts

Lead sponsor	King Abdulaziz University
Phase	NA
Status	Completed
Study type	INTERVENTIONAL
Allocation	randomized
Design	crossover
Masking	single
Primary purpose	diagnostic
Enrollment	20
Start date	15 May 2023
Primary completion	29 June 2023
Estimated completion	30 July 2023
Sites	1 location across Saudi Arabia

Drugs / interventions tested

• Bitewing X ray

Conditions studied

• Periodontal Diseases — all drugs for Periodontal Diseases →
• Dental Caries — all drugs for Dental Caries →

Sponsor

King Abdulaziz University

Who can join

Adults 18 to 80, any sex, with Periodontal Diseases or Dental Caries. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Caries Detection Primary · baseline and 15 minutes

Count number of teeth with caries

Group	Value	95% CI
Vertical Bitewing	7.22	6.00 – 8.44
Horizontal Bitewing	6.48	5.24 – 7.72

Level of Bone Loss Primary · baseline and at 15 minutes

All of the bitewing radiographs will be evaluated for bone loss measurements. The steel wire will be used to determine the magnification factor . The steel wire and cemento enamel junction (CEJ) - if not obscure by caries - will be used as reference points for bone loss measurements. Each tooth will be measured from the CEJ to the bone crest.

Group	Value	95% CI
Vertical Bitewing	1.15	± 0.69
Horizontal Bitewing	1.12	± 0.63

Sponsor's own description

The aims of this research are to determine if vertical bitewings will be more effective and more comprehensive for the diagnosis of caries and the level of alveolar bone loss than the horizontal bitewing technique for the patients at King Abdulaziz University over the age of 18. This is a cross sectional study. All the images in this study will be conducted at School of Dentistry, King Abdulaziz University. Each patients will be exposed to 4 horizontal bitewing for posterior teeth ( standard of care ) and 4 vertical bitewing for the same area ( experimental ). The radiographs will be processed digitally. All the x ray will be taken using the standard protection protocol.

Publications & conference data

1 peer-reviewed publication reference this trial (live from Europe PMC):

1. A comparison of the horizontal and vertical bitewing images in detecting approximal caries and interdental bone loss in posterior teeth: A diagnostic accuracy randomized cross over clinical trial.
   Natto ZS, Olwi A, Abduljawad F. · · 2023 · cited 7× · PMID 37021254 · DOI 10.1016/j.jds.2022.08.006