Objectives: The purpose of this study was to compare the diagnostic quality of panoramic and intraoral radiographs in imaging the periodontal bone loss. Methods: Four experienced investigators examined the panoramic and full mouth radiographs of 100 patients for the capacity to interpret and measure the marginal bone level. Panoramic, periapical and bitewing radiographs are taken from each patient. The quality of the image at each anatomical site was classified as perfect ,acceptable and unacceptable. Results: In the maxillary arch, 66% of the sites yielded correlated scores ,31% divided by one and 3% divided by two score –points. In the posterior regions of both arches ,bitewing radiographs were superior to panoramic radiographs; more anatomic sites could be viewed using bitewing radiographs. The distal surfaces of the maxillary canines and the mesial surfaces of the first maxillary premolars usually cannot be seen in either panoramic or periapical radiographs due to overlapping in that region. But these sites usually are viewed clearly with the bitewing radiographs. A chi-square analysis of categorical bone level shoved significant differences between the panoramic and periapical images.(p‹001) Conclusions: In clinical practice when evaluating the alveolar bone loss and the periapical radiographs of a selected region should be evaluated together with its panoramic radiographs. In regions where the image quality is poor on panoramic radiographs or it there are structures of special interest.

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