Applicability of 3D-dental reconstruction in cervical odontometrics.

OBJECTIVES: The objective of this study was to assess the accuracy, reliability, and reproducibility of computed tomography (CT) images in measuring cervical mesiodistal and buccolingual tooth sizes, by comparing the values obtained by 3D virtual models from CT images with those obtained using digital calipers. MATERIALS AND METHODS: In total, 530 maxillary and mandibular teeth of 51 individuals from two Iron Age sites were scanned using a Siemens Somatom sensation 64-slice computed tomography machine, and the images were reconstructed and measured. Values obtained by direct measurement served as the primary reference for cervical measurements. Intra- and inter-observer reliability was assessed by calculating technical error of measurements (TEM), relative technical error of measurements (rTEM), and the coefficient of reliability (R). RESULTS: Results showed that virtual cervical measurements were not significantly different from the actual measurements, and the correlation of the two measurement methods shows that the methods are comparable. Inter- and intra-observer error analysis also indicated high replicability of measurements with both measuring methods (R > 0.99). The rTEM values for all the measurements were below the 5% standards for anthropometric studies. DISCUSSION: CT is a non-invasive technique that allows for an accurate and detailed visualization of morphological features without causing any damage to teeth. Our findings indicate that virtual odontometric analysis is a reliable method, similar to traditional physical odontometric analysis. Currently, the virtual system is likely to be more suitable for fragile specimens, such as archaeological samples.

Dental nonmetric trait intraobserver precision: three observations of a large sample.

ABSTRACT: The utility of nonmetric dental traits in population phenetic studies is well documented. However, consistency in scoring trait expression is a concern due to the subjectivity in scoring quasicontinuous variables with graded scales. The aims of this study are to 1) analyze intraobserver results from an independent scorer and 2) interpret the least precise results. Six hundred individuals (300 of each sex) were scored for 48 dental nonmetric traits using ASUDAS, in one preliminary (100 individuals) and two full observations. Intraobserver precision between scoring sessions yielded adequate results (85% to 100%), with two notable exceptions (UI2 tuberculum dentale and LC distal accessory ridge) and three somewhat problematic cases (UM2 hypocone, UM1 Carabelli's trait, and LM1 anterior fovea). Kendall's τ-b rank correlation coefficients are usually moderate to strong (> 0.3). The results are similar to previously published studies of observer error. Error rates are likely caused by inexperience in observable surface selection and trait/grade definition. ASUDAS requires restraint from scoring teeth that are too worn or modified by caries or chipping. A careful study of trait and grade definitions is strongly encouraged. The key element in achieving high precision rates is experience. Intraobserver (and, if needed, interobserver) error should always be calculated. Overall, ASUDAS is a reliable and useful method, especially if the author's recommendations are followed.

Vertical dimension of occlusion (VDO): cephalometric norms for a Moroccan population.

OBJECTIVES: The purpose of this work was to develop cephalometric standards of the vertical dimension of occlusion (VDO) in Moroccan adults. METHODS: Our data consisted of standardized lateral cephalometric radiographs of 98 students at the Casablanca Faculty of Dentistry. These included 74 women and 24 men aged 18-34 years, who were selected on the basis of a well-proportioned face, acceptable profile, Class I occlusion, minor or no crowding, and no history of orthodontic treatment. Mean values of seven (six angle and one linear) dentoskeletal parameters were determined from lateral cephalometric radiographs. RESULTS: These Moroccans tended to exhibit an opening in the VDO in comparison with the standards of Steiner and Wylie and those of other populations: GoGn/SN: 35.4° ± 5.3°, FMA: 25.6° ± 5.1°, Occ/SN: 19.3° ± 4.7°, Occ/Fr: 9.1° ± 4°, SGn/Fr: 59.2° ± 3.4°, ENA-Xi-Pm: 46.2° ± 4.4°, ENA-Me: 69.7 ± 5.9 mm. CONCLUSION: Moroccans have distinct cephalometric characteristics, which should be used as the reference in future orthodontic and prosthetic treatments.

Ex vivo accuracy of Root ZX II, Root ZX Mini and RomiApex A-15 apex locators in extracted vital pulp teeth.

The objective of this study was to compare, ex vivo, the accuracy of three electronic apex locators (EALs), Root ZX II, Root ZX Mini and RomiApex A-15, in detecting the apical foramen (AF). Forty extracted single-Rooted human teeth with vital pulp were used in this study. After access preparation, the Root canal length of each tooth was measured by placing a #10 file until the tip was visible at the AF under a stereomicroscope. The teeth were subsequently embedded in an alginate model. In each Root canal, all three EALs were used to determine the working length, which was defined as the zero reading or equivalent. The distance between the file tip and AF was measured to an accuracy of 0.01 mm. Results were analyzed using analysis of variance and the Chi-squared test. Root ZX II, Root ZX Mini and RomiApex A-15 were accurate within 0.5 mm, 62.5, 56.2, 50% of the time. No significant differences were found between the three EALs (p > 0.05). Considering all EALs, the mean distance from the file tip to AF was 4.49 mm. The accuracy of the three EALs evaluated in this study was not statistically significantly different. The 'Apex' or '0.0' marks of the EALs do not indicate the AF itself, but just a position coronal 0.49 mm to the AF. Using a tolerance of ± 0.5 mm from the actual lengths, the ZX II yielded the most acceptable measurements.

A standardized novel method to measure radiographic root changes after endodontic therapy in immature teeth.

INTRODUCTION: Outcome studies of endodontic treatment of necrotic immature permanent teeth rely on radiographic measures as surrogates of whether the treatment achieved regeneration/revascularization/revitalization. An increase in radiographic root length and/or width is thought to result in a better long-term prognosis for the tooth. In this study, a method to measure radiographic outcomes of endodontic therapies on immature teeth was developed and validated. METHODS: A standardized protocol was developed for measuring the entire area of the root of immature teeth. The radiographic root area (RRA) measurement accounts for the entire surface area of the root as observed on a periapical radiograph. Reviewers were given instructions on how to measure RRA, and they completed measurements on a set of standardized radiographs. RESULTS: The intraclass correlation between the 4 reviewers was 0.9945, suggesting a high concordance among reviewers. There was no effect of the reviewer on the measured RRA values. High concordance was also observed when 1 rater repeated the measurements, with an intraclass correlation value of 0.9995. There was no significant difference in RRA values measured at the 2 sessions by the same rater. Furthermore, significant differences in RRA were detectable between clinical cases that showed obvious continued root development and cases that did not demonstrate discernible root development. CONCLUSIONS: These results suggest that RRA is a valid measure to assess radiographic outcomes in endodontically treated immature teeth, and RRA should be useful in future clinical studies of regenerative endodontic outcomes.

Not all electronic foramen locators are accurate in teeth with enlarged apical foramina: an in vitro comparison of 5 brands.

INTRODUCTION: Electronic working length measurement during root canal treatment in teeth with enlarged apical foramina is a challenge. The aims of this in vitro study were (1) to assess the influence of foramen widening on the accuracy of 5 different electronic foramen locators (EFLs) and (2) to compare the accuracy of EFLs in different foramen sizes. METHODS: The following EFLs were used: MiniApex, Root ZXII, iPex, Propex II, and Elements Apex Locator. Each EFL was used in 3 groups (n = 20) of extracted teeth, with foramen diameters of 0.27 mm (G27), 0.47 mm (G47), and 0.72 mm (G72). Working length was measured according to manufacturer's instructions and compared with visual measurements (control method). Results were classified as accurate (equal or differences ≤ 0.05 mm) or inaccurate (differences > 0.5 mm). RESULTS: In G27, all EFLs yielded accurate findings (intragroup reliability; Fisher exact test, P < .05), compared with only MiniApex, Root ZXII, and Elements Apex Locator in G47 and G72. MiniApex, Root ZXII, and Elements Apex Locator were similarly accurate regardless of foramen size. iPex and Propex II were the least accurate among the devices tested, and foramen diameter influenced their accuracy, with greater diameters yielding poorer EFL performance. CONCLUSIONS: Foramen diameter did not influence the accuracy of MiniApex, Root ZXII, and Elements Apex Locator EFLs. iPex and Propex II showed decreased accuracy as foramen size increased.

Evaluation of alginate as a substitute for root-surrounding tissues in electronic root canal measurements.

Alginate as a substitute for root-surrounding tissue was investigated. The electronic working lengths of root canals under clinical conditions were compared with an in vitro simulation of the same teeth extracted and embedded in alginate. The working lengths in 26 teeth were determined on two occasions using an electronic apex locator, before extraction and after extraction with the same teeth embedded in an alginate mass. The apical 4 mm of the root canals were exposed following the measurements, and the distances between the apical constrictions and the tips of files repositioned in the canals were measured and recorded. The mean distance between the file tip and the constriction was +0.33 mm (±0.38) in vivo and +0.32 mm (±0.30) in vitro. The Wilcoxon signed-rank test indicated that these means were not significantly different. The apical constriction was assessed to be within the limits of 0.5 mm in 80.7% of in vivo cases and in 76.9% of extracted teeth. Statistical analysis demonstrated that there was no significant difference between the results recorded in vivo and in vitro regarding apical constriction localisation. Based on the results of this study, the alginate mass is a useful tool in evaluating the performance of electronic apex locators.

Facial approximation: evaluation of dental and facial proportions with height.

BACKGROUND: Fabrication of complete dentures requires the use of certain guidelines which are placed on the bite blocks to assist the clinician to have the maxillary anterior teeth restored to optimal dento-labial relations, in harmony with the overall facial appearance. OBJECTIVE: To explore if any relationship exists between dental and facial proportions as well as the height of the individuals. METHODS: Two hundred and four dental students of the Obafemi Awolowo University volunteered to participated in the study. The lower facial height, inter incisal, inter canine, and intercommisure distances, as well as the height of the participants were measured. The data were imputed, analyzed, and reported as simple frequency, means and standard deviations using the SPSS vs 11. Statistical significance was inferred at p<0.05. RESULT: The mean values of all the parameters measured were significantly higher in males than females. None of the mean values measured were coincident. However, a significant correlation exists between intercanine and interincisal distances(r=0.8) while a weak but significant negative correlation exists between the intercanine distance and the difference of the intercommisural and intercanine distances (r=-0.4) CONCLUSION: The study showed no relationship between intercanine distance, interincisal distance, lower facial height, and the height of the participants with the intercommissural distance. Hence, intercommissural distance may not be used in marking canine line during bite registration procedure. At best, 1.75-2.45 cm should be subtracted from the intercommissural distance to determine the intercanine distance.

A new method to measure mesiodistal angulation and faciolingual inclination of each whole tooth with volumetric cone-beam computed tomography images.

INTRODUCTION: The purpose of this study was to develop a methodology to measure the mesiodistal angulation and the faciolingual inclination of each whole tooth (including the root) by using 3-dimensional volumetric images generated from cone-beam computed tomography scans. METHODS: A plastic typodont with 28 teeth in ideal occlusion was fixed in position in a dry human skull. Stainless steel balls were fixed to the occlusal centers of the crowns and to the apices or bifurcation or trifurcation centers of the roots. Cone-beam computed tomography images were taken and rendered in Dolphin 3D (Dolphin, Chatsworth, Calif). The University of Southern California root vector analysis program was developed and customized to digitize the crown and root centers that define the long axis of each whole tooth. Special algorithms were used to automatically calculate the mesiodistal angulation and the faciolingual inclination of each whole tooth. Angulation measurements repeated 5 times by using this new method were compared with the true values from the coordinate measuring machine measurements. Next, the root points of 8 selected typodont teeth were modified to generate known angulation and inclination values, and 5-time repeated measurements of these teeth were compared with the known values. RESULTS: Intraclass correlation coefficients for the repeated mesiodistal angulation and faciolingual inclination measurements were close to 1. Comparisons between our 5-time repeated angulation measurements and the coordinate measuring machine's true angulation values showed 5 teeth with statistically significant differences. However, only the maxillary right lateral incisor showed a mean difference that might exceed 2.5° for clinical significance. Comparisons between the 5-repeated measurements of 8 teeth with known mesiodistal angulation and faciolingual inclination values showed no statistically significant differences between the measured and the known values, and no measurement had a 95% confidence interval beyond 1°. CONCLUSIONS: We have developed the novel University of Southern California root vector analysis program to accurately measure each whole tooth mesiodistal angulation and faciolingual inclination, in a clinically significant level, directly from the cone-beam computed tomography volumetric images.

Mesiodistal angulation and faciolingual inclination of each whole tooth in 3-dimensional space in patients with near-normal occlusion.

INTRODUCTION: An important objective of orthodontic treatment is to obtain the correct mesiodistal angulation and faciolingual inclination for all teeth. Current techniques are based on crown angulation and inclination standards, and not enough attention has been given to the roots. In this study, we report the mesiodistal angulation and faciolingual inclination of each whole tooth including the root in patients with near-normal occlusion. METHODS: We screened 1840 patients who had cone-beam computed tomography scans taken before treatment to obtain a sample of 76 patients with near-normal occlusion. Using our custom University of Sourthern California root vector analysis software program, we digitized the crown and root centers to determine the "true" long axis of each tooth from where the mesiodistal angulation and the faciolingual inclination were measured. RESULTS: The means and standard deviations for the mesiodistal angulation and the faciolingual inclination of each whole tooth were calculated. The maxillary angulations of the teeth started from approximately 6° for the central incisors, slightly increased for the lateral incisors, and peaked at 11° for the canines; then it gradually decreased to just above 0° for the first molars and eventually reached -6° for the second molars. The mandibular angulations started from about 0° for the incisors and increased to 17.5° for the second molars. The maxillary inclination was the highest at 33.5° for the central incisors, decreased to about 0° at the second premolars, and then increased for the 2 molars. The mandibular inclination also was the highest at 26.5° for the central incisors, decreased also to about 0° at the second premolars, and continued to decrease for the 2 molars. For the opposing tooth pairs, the interdental mesiodistal angulations always remained within 10° from one another, whereas the interdental faciolingual inclination increased from about 120° for the incisors to about 180° for the second premolars and the 2 molars. CONCLUSIONS: We obtained the average mesiodistal angulation and faciolingual inclination for each whole tooth measured from its long axis digitized on the cone-beam computed tomography volumetric images of 76 patients with near-normal occlusion. We found distinctive angulation and inclination relationships between the neighboring and opposing teeth. This information can be used in addition to the crown standards for positioning each whole tooth properly in the arches.

[Validity and reliability of digital diagnostic measurements on digital three-dimensional dental models]. / Validiteit en betrouwbaarheid van digitale diagnostische metingen op digitale driedimensionale gebitsmodellen.

Digital three-dimensional dental models are widely used for orthodontic diagnosis. The aim of this clinical study was to assess the validity and reliability of digital diagnostic measurements on digital three-dimensional dental models. Two types of digital three-dimensional dental models and a plaster dental model were made of 10 volunteers. Digital measurements of the tooth width were compared with the physical measurements of the plaster models. None of the digital diagnostic measurements appeared to differ significantly from the physical measurements.

In vivo accuracy of three electronic root canal length measurement devices: Dentaport ZX, Raypex 5 and ProPex II.

AIM: To compare in vivo three different electronic root canal length measurement devices: Dentaport ZX, Raypex 5 and ProPex II. METHODOLOGY: Thirty single-rooted permanent teeth scheduled for extraction because of periodontal disease were selected from 10 adult patients (ranging from 45 to 67 years) and divided into three groups of 10 teeth. Before the extraction, an access cavity was prepared and the crown was adjusted to establish a stable reference point for all measurements. The working length in Group 1 was determined using the Dentaport ZX apex locator. A K-file with the largest diameter that could reach the last green bar on the screen was stabilized in the canal using a dual-curable flow resin composite. The same procedure was used for the Raypex 5 (the file reached the last yellow bar) and Propex II (0.0 orange bar) apex locators. The teeth were then extracted and cleared. The distance between the tip of the file and the major foramen was then calculated for each tooth using digital photography according to Axiovision AC software (Carl Zeiss). Positive values were assigned when the file tip passed beyond the major foramen, negative values when the tip was short of the foramen and zero value when the file tip and the foramen coincided. Statistical analysis was performed using the chi-squared test or Fisher's exact test (P ≤ 0.05). RESULTS: Dentaport ZX, Raypex 5 and ProPex ΙΙ produced, respectively, 6, 2 and 4 out of 10 correct measurements, 0, 6 and 5 long measurements and 4, 2, and 1 short measurements. The differences between the three electronic root canal length measurement devices were not significant (P = 0.507). CONCLUSIONS: Under the in vivo conditions of this study, the three electronic root canal length measurement devices were not significantly different in terms of locating the major foramen.

Comparison of in vivo and in vitro readings when testing the accuracy of the Root ZX apex locator.

INTRODUCTION: The purpose of the study was to compare the accuracy of the Root ZX electronic apex locator (J Morita Corp, Tokyo, Japan) between an in vivo and an in vitro model. METHODS: The working length (WL) was determined electronically for 46 root canals of human teeth with a 15 K-file using both in vitro (n = 23) and in vivo (n = 23) models. The files were fixed at the WL. The apical 4 mm of each canal was trimmed to expose the file tip. The samples were observed under a scanning electron microscope, and the distance from the file tip to the point 0.5 mm coronal to the major foramen (the final WL) was measured. The data were analyzed using the Student t test, and significance was set at P ≤ .05. RESULTS: The statistical analysis revealed no significant differences between the in vivo group and in vitro group with respect to the accuracy of the Root ZX device in determining the final WL. The mean distance from the final WL to the file tip was 0.23 ± 0.39 mm for the in vivo group and 0.29 ± 0.32 mm for the in vitro group. In determining the final WL, the Root ZX was accurate 78.3% of the time to ±0.5 mm and 100% of the time to ±1 mm in the in vivo group, whereas it was accurate 74% of the time to ±0.5 mm and 100% of the time to ±1 mm in the in vitro group. CONCLUSIONS: No statistically significant differences were observed between the in vivo group and the in vitro group.

The validity and reliability of mixed-dentition analysis methods: a systematic review.

BACKGROUND: The authors conducted a literature review to determine the validity and reliability of mixed-dentition analysis (MDA) methods used to predict permanent tooth size in the mixed dentition and to evaluate the effect of relevant variables. TYPES OF STUDIES REVIEWED: The authors searched eight online databases for studies of MDA. They selected 39 articles. Inclusion criteria included assessment of mesiodistal tooth width predictions of canines and premolars, use of study-model measurements with or without radiographs, reliability and validity of MDA values and a minimum sample size of 10. RESULTS: All MDA methods had positively correlated validity and high intrarater reliability. Mean differences were less than 2 millimeters with correlation coefficients that tended to be above 0.6. Correlation coefficients were less variable with multiple linear regression equations (MLREs) than with simple linear regression equations (SLREs) with the study-model method, but the opposite was true with the radiographic method. Polymorphisms based on ethnicity, sex, jaw or side of mouth did not meaningfully influence the validity of SLRE predictions, but some differences were apparent with the use of MLRE predictions. CLINICAL IMPLICATIONS: The results of this review call into question the clinical implications of the multiple variations of MDA that have been described in the literature.

Accuracy of volumetric measurement of teeth in vivo based on cone beam computer tomography.

OBJECTIVES: to evaluate the accuracy of cone beam computed tomography (CBCT) for volumetric measurement of teeth, using micro-computed tomography (Micro-CT) as the reference standard. SETTING AND SAMPLE POPULATION: The Department of Orthodontics at Sichuan University. The sample consisted of 27 maxillary and mandibular premolars of 15 patients, planned to be extracted for orthodontic treatment. MATERIAL AND METHODS: The 27 teeth were subjected to standardized CBCT scanning before extraction and Micro-CT scanning after extraction. From CBCT data, teeth were tissue segmented and then three-dimensionally (3D) reconstructed, while from Micro-CT data, teeth were 3D reconstructed directly. Tooth volumes were then calculated. The intra-observer repeatability and reproducibility of two observers and the overall between-instrument agreement of the measurements were evaluated using intra-class correlation coefficients (ICCs) and concordance correlation coefficient (CCC), respectively. RESULTS: The intra-observer repeatability was high for both observers. ICCs were 0.999 and 0.998, respectively. The reproducibility of the two observers was also high (ICC, 0.740). The overall between-instrument agreement of the measurements was good, and CCC was 0.993 and its lower 95% confidence interval was 0.989. CONCLUSIONS: The accuracy of the CBCT method for volumetric measurement of teeth in vivo is comparable to the Micro-CT method in vitro. The CBCT method has the potential possibility to be applied in studies on root resorption associated with orthodontic force. Further study is needed to prove the sensitivity of the method.

In vivo comparison of the accuracy of two electronic apex locators.

The aim of this study was to analyse in vivo the accuracy of two apex locators, Root ZX and Novapex, to determine the position of the apical constriction. Twenty-three human single-rooted teeth to be extracted for periodontal reasons constituted the experiment. Endodontic access was obtained and the apical constriction was determined by one of the apex locators after initial crown-down preparation. When the electronic marker indicated that the tip of the endodontic file was at the apical constriction, the teeth were filled with composite and then surgically removed. The presence of the endodontic file tip at the apical constriction was evaluated stereomicroscopically (30×) and confirming radiographs were exposed. The accuracy of Root ZX and Novapex was 91.7% and 81.8% respectively. Within the limits of this study, the evaluated apex locators have a similar clinical performance for the apical constriction location.

A clinical photogrammetric method to measure dental arch dimensions and mesio-distal tooth size.

The aim of this research was to evaluate the reliability and validity of measurements obtained from clinical standardized occlusal photographs compared with dental cast measurements. This study comprised a consecutive sample of 16 patients (eight males and eight females, aged 15-24 years) in the permanent dentition without agenesis and/or tooth loss. A paired t-test and intraclass correlation coefficient (ICC) were used to examine validity and reliability. Both statistics were applied for intra- and inter-methods error analysis, at P < 0.05. Random error for the photogrammetric method (less than 0.48 mm) was similar to that for the dental cast measurements (less than 0.43 mm). ICC revealed excellent reliability for both methods (P < 0.01) and no significant difference for any variables, with the exception of upper inter-canine width obtained on the dental casts (P = 0.0038) and photogrammetry (P = 0.01). However, differences were less than 1 per cent of the mean inter-canine width. Inter-method analysis showed a significant correlation for all variables (P < 0.001), with good to excellent reliability (r = 0.66-0.93). A significant mean inter-method difference was consistently observed for the upper first molars (0.33 mm, P < 0.01). For the remaining teeth (left to right second premolars), the largest mean difference was approximately equal to the resolution of the human eye (0.2 mm or less). Minor differences (around 2 per cent of the mean) and an excellent ICC (0.75-0.93, P < 0.01) were observed for arch dimensions. Except for the mesio-distal width of the upper first molars, the recently developed photogrammetric method showed accuracy, validity, and reliability acceptable for clinical and scientific purposes.

Maxillary and mandibular mesiodistal tooth sizes among different malocclusions in a sample of the Turkish population.

The purpose of this study was to establish normative data for mesiodistal tooth crown dimensions with respect to malocclusions and gender differences in Turkish sample. The subjects were randomly selected and assigned to three malocclusion groups according to Angle's classification. Each group consisted of 100 individuals between the ages of 13 and 18 years with the following distribution: Class I, 42 males and 58 females; Class II, 52 males and 48 females; and Class III, 51 males and 49 females. An electronic digital calliper was used to measure the mesiodistal tooth width from the right second permanent molar to the left second permanent molar on both upper and lower study casts. For statistical evaluation, one- and two-way analyses of variance and post hoc Tukey's honestly significant difference (HSD) tests were performed. There were statistically significant differences for the maxillary canine (P < 0.001), first premolar (P < 0.05), second molar (P < 0.05), and mandibular canine (P < 0.01) for males, and for all maxillary teeth and the mandibular central (P < 0.05), canine (P < 0.001), and first premolar (P < 0.05) teeth in females among the malocclusion groups. When Angle's classification was evaluated, significant differences were determined, except for the first and second mandibular molars. All mesiodistal widths were also found to be statistically different according to gender dimorphism. A significant relationship was found between mesiodistal tooth size, Angle's classification, and gender. Therefore, tooth dimensions may play a crucial role in treatment planning and in achieving satisfactory interdigitation of the upper and lower dentition following the completion of orthodontic treatment.

Comparison of different methods involved in the planning of clinical crown lengthening surgery.

There is little material in the literature that compares biological width measurements in periapical and bite-wings radiographs with clinical measurements. The purpose of this study was to compare measurements of biological width taken by three different methods which are frequently used for planning periodontal surgery - periapical radiograph, bite-wing radiograph and transperiodontal probing - with the trans-surgical measurements. Thirty-four sites from twenty-one subjects were analyzed. The intra-class correlation coefficients between measurements obtained trans-surgically (gold standard) and those obtained by transperiodontal probing, periapical radiography and bite-wing radiography were determined. Average measurements were compared using the Wilcoxon test at a significance level of 0.05. Also, the frequency distribution of differences between test measurements and the gold standard was calculated. The results showed that transperiodontal probing (mean 2.05 mm) was the most accurate measurement, as compared to the gold standard (mean 1.97 mm), with no statistically significant difference observed. On the other hand, periapical and bite-wing radiographic mean values (1.56 mm and 1.72 mm, respectively) were smaller than the gold standard, with statistically significant differences (p < 0.05). It was concluded that transperiodontal probing was the most accurate measurement, as compared to the gold standard, followed by that obtained with the bite-wing radiograph. The clinical relevance of these results could be that planning for crown lengthening surgery should, preferably, include transperiodontal probing.