Introduction: The height of the alveolar bone, is normally maintained by equilibrium between bone formation and bone resorption, but in periodontal disease more destruction or lack of bone formation will reduce the alveolar bone height. However the radiography is important in diagnosis, treatment plan and detection of quality and quantity of the alveolar bone although the type of radiography is more important. The purpose of this study is the comparison between panaromic, P.A (Parallel), Bite Wing radiographs in diagnosis of periodontitis. Methods: This study was descriptive cross-Sectional study Periapical (PA), Bitewing (B.W) & Panoramic radiographic images in 32 pationent 13 male and 19 female with moderate to advanced periodontitis (mean age 38 year) were taken before surgical treatment. Actual hight of defect were measured by a William's probe during surgery, the distance between cemento enamel junction (CEJ) and alveolar crest were measured on radiographs using a digital vernie scale as will as. Actual measurements were compared with values taken from panoramic PA, B.W radiographs. For Data analysis Paired t test was used. Results: A total of 314 linear distances from the panoramic PA , B.W, and CEJ/BL were measured. The mean difference between panoramic and actual Measurements (0.115 and 0.28) P=(0.24-0.07), were not satistically significant (P> 0.05). The mean difference between P.A and actual measurements (0.279-0.498) P=(0.0001-0.004) showed a satistically significant difference (P< 0.05). The mean deference between BW and actual Measurements (0.576-0.613) P=(0.24-0.07) were satistically significant (P<0.05). Conclusion: Although, all forms of radiographic images showed agreement in detection of periodontal bone loss, the accuracy of panoramic radiographs was more than PA & BW radiographs'. Specially when the magnification was adjusted in panoramic radiography.

Keywords: panoramic Radiography, periapical Radiography (parallel) film holder, Bitewing Radiography(B.W), Alveolar Bone loss(BL), Cemento Enamel junction (CEJ)

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