A new digital tool for radiographic bone level measurements in longitudinal studies

Abstract

BackgroundThe reproducibility of measurements on radiographs is influenced by the techniques by which the images as well as the measurements are obtained. Thus, bias resulting from errors in the image and/or image examinations at two points in time may result in wrongful registrations of true biological or pathological changes. The aim of the present study was to propose and evaluate an indirect radiological examination technique, by which bias, when measuring radiographic bone level, could be substantially reduced as compared to the technique using direct mm measurements.MethodsA plugin to ImageJ was designed to reduce bias when measuring bone loss on radiographic images. In human dry mandibles, radiographic images of 20 teeth were obtained parallel with the tooth axis (alpha = 0) and at an angle of 30° deviation. The direct technique of measuring radiographic bone level (RBL) and the indirect, length-adjusted RBL were registered by four researchers in a double blinded fashion.ResultsWhen mean RBL measured at 0° angle was 7.0 mm, the corresponding mean RBL measured at 30° angle was 7.8 mm, signifying an 11.4 % increase (p = 0.032), whereas the mean length-adjusted RBL increased by 0.6 % (p = 0.9).ConclusionsThis study showed that the use of the original, direct technique (ImageJ) resulted in markedly biased radiographic bone level at 30° angle, while the proposed indirect length-adjusted technique (ImageJ plugin) did not.

Radiographic alveolar bone level and levels of serum 25-OH-Vitamin D3 in ethnic Norwegian and Tamil periodontitis patients and their periodontally healthy controls

“…A deviance in angle between the beam direction in BW and full tooth radiograph is obvious, especially in the upper canine region. This problem has been addressed by Preus et al 2015 [31] and it was shown that a change in beam angle (α) of 30 o resulted in an 11% increase of RBL readings of an actual bone level of 7 mm. The increased reading will be reduced as the actual bone level is reduced, and at 2–3 mm an α of 30 o will not increase RBL significantly.…”

“…The latest version of the ImageJ image processing and analysis software program [30] was used for the experiment. An application (plugin) to this program had been developed [31] with the intent to semi-automatically register the ratio between the bone level and the corresponding length of tooth in longitudinal studies. The plugin allowed for just pointing and clicking on the Cemento-Enamel Junction (CEJ), alternatively the Restoration Margin (RM) and Alveolar Crest (AC) to digitally register these points.…”

“…The plugin allowed for just pointing and clicking on the Cemento-Enamel Junction (CEJ), alternatively the Restoration Margin (RM) and Alveolar Crest (AC) to digitally register these points. This technique has proven more accurate, versatile and easy to use [31] than the original ImageJ technique [30] even for direct measurements like in the present study.…”

“…In short, the computer application automatically stores the marked coordinates (relative to the upper left corner of the image) and projects them onto an imaginary vertical axis parallel to the vertical dimension of the receptor [31]. The coordinates, unit of length, time and date of measurement were automatically stored in a text file, which was imported into an EXCEL spreadsheet to automatically calculate the distance from the RBL.…”

Comparative Study between a Novel In Vivo Method and CBCT for Assessment of Ridge Alterations after Socket Preservation—Pilot Study

“…Although these are well-established, they have several drawbacks. Patients are subjected to additional X-ray exposure, and clinical methods are more time-consuming and are prone to more measurement errors [16,17]. The use of various radiographic methods, including CBCT for the assessment of post-extraction resorption of the alveolar bone, is used by many authors [18,19,20].…”