A revision of the adult intraoral radiograph protocol for ABO clinical examinations.

f As the American Board of Orthodontics (ABO) strives to increase objectivity in certification and recertification examinations, it has developed new testing instruments and established a standard protocol of examiner calibration. Although the board has historically required the highest quality of diagnostic records, its intent to effectively evaluate the pretreatment and posttreatment periodontal status of adults (21 years or older) has necessitated revision of the intraoral radiographic requirements for case displays. It was documented that at least 1 region of 2 mm or more of attachment loss is noted in 50% of untreated 18and 19-year-old subjects. This frequency increases to 87% in patients between the ages of 45 and 49 years. At least 3 independent studies showed rad graphic bone losses in 79.95%, 64.0%, and 68.77% of adult subjects. It is therefore incumbent on orthodontist to provide accurate assessment of the adult patient’s pretreatment periodontal susceptibility and possible attachment loss during active therapy. Although clinical indicators such as mobility and bleeding indexes can be used to assess periodontal susceptibility, radiographic evaluation is an integral component of pretreatment status as well as changes in crestal bone levels coincident with treatment.