Comparison between inverted and unprocessed digitized radiographic imaging in periodontal bone loss measurements

Abstract

The advances in digital imaging technology in dentistry have provided an alternative to film-based radiography and have given new options to detect periodontal bone loss. The purpose of this study was to compare inverted and unprocessed digitized radiographic imaging in periodontal bone loss measurements. Thirty-five film-based periapical radiographs of patients suffering from moderate to advanced untreated periodontal bone loss associated to lower premolar and molars was selected from the department files, with 40 bone loss areas. The film-based radiographs were digitized with a flatbed scanner with a transparency and radiograph adapter used for transilluminating the radiograph imaging. Digitization was performed at 600 dpi and in gray scale. The images were digitized using Image Tool software by applying image inversion, that is, transformation of radiopaque structures into radiolucent structures and vice-versa. The digital data were saved as JPEG files. The images were displayed on a 15-inch and 24-bit video monitor under reduced room lighting. One calibrated examiner performed all radiographic measurements, three times, from the cementoenamel junction to the most apical extension of the bone loss, in both types of image (inverted and unprocessed). Brightness and contrast were adjusted according to the examiner's individual demand. Intraclass correlation coefficient was used to compare the measurements from both types of images. The means of radiographic measurements, in mm, for inverted and unprocessed digitized imaging were 6.4485 and 6.3790, respectively. The intraclass correlation coefficient was significant (0.99) The inverted and unprocessed digitized radiographic images were reliable and there was no difference in the diagnostic accuracy between these images regarding periodontal bone loss measurements.

Diagnostic accuracy of cone beam computed tomography in identification and postoperative evaluation of furcation defects

“…[1] Periodontal disease leads to attachment loss, alveolar bone destruction, and subsequently loosening of teeth. The teeth more commonly involved are the molars.…”

Desempeño De Cuatro Métodos Estadísticos Para Evaluación De La Concordancia Prueba-Reprueba De Variables Continuas en Una Muestra

“…La mayoría de estos métodos incluyen pruebas de hipótesis (pruebas "t" de Student pareadas, análisis de varianzas-ANOVA) o coeficientes de correlación (Pearson y coeficiente de correlación intraclase) (18,22). Otros métodos incluyen análisis de regresión y el coeficiente de variación (23,24). Es de notar que entre los métodos menos considerados está la técnica propuesta por Bland & Altman (límites de acuerdo) y la descrita por Lin (coeficiente de correlación y concordancia de Lin)(25).…”

Assessment of using digital manipulation tools for diagnosing mandibular radiolucent lesions

“…Other studies have demonstrated that the inversion filter did not increase the efficacy in the measurement of bone loss. 7,8 In conclusion, expert and non-expert examiners had a low frequency of use of digital tools during radiographic interpretation. The most preferred tool was sharpness, but this did not improve the diagnostic accuracy.…”

“…2 In oral pathology, digital manipulation has some influence on radiographic diagnosis, such as contrast adjustments, 3,4 sharpness, smoothness and embossing for caries diagnosis, 5 use of noise filters for detection of vertical root fractures 6 and use of the inversion tool for bone loss measurements in periodontal disease. 7,8 However, digital image manipulation can increase the time taken to interpret the image and this processing may not contribute to an increase in the percentage of correct diagnoses. 2 The great challenge is to know which tools are useful and applicable to each diagnostic task in order to discard superfluous signs and stress useful signs in the images.…”