Analysis of Bone Density and Bone Morphometry by Periapical Radiographs in Dental Implant Osseointegration Process

Abstract

Objective. This research aimed to analyze the differences in bone density and bone morphometry by periapical implant radiography in the dental implant osseointegration stages. Methods. This experimental research uses 12 periapical radiographs of tibial bones from a New Zealand white rabbit (Oryctolagus cuniculus). The analysis was performed on day 3, 14, and 28 of the osseointegration stages with density, trabecular thickness (Tb.Th.), trabecular separation (Tb.Sp.), and trabecular number (Tb.N.) as parameters. The implant used is a titanium alloy and coated by SA (sunblasted with alumina acid) of 4 mm in diameter and 7 mm in length. The radiographic assessment of the osseointegration process is obtained with the region of interest (ROI) segmentation results. Additionally, each ROI was analyzed for bone density and morphometry using the open-source ImageJ software with the BoneJ plugin. The significant difference was evaluated by analysis of variance (F-test) with p < 0.05 and nonparametric Kruskal–Wallis test with p < 0.05 . Results. Analysis of the osseointegration images of dental implants at day 3, 14, and 28 with the periapical X-ray modality shows significant differences ( p < 0.05 ) in the parameters measuring density and trabecular thickness (Tb.Th.). In the variables of trabecular separation (Tb.Sp.) and number (Tb.N.) ( p > 0.05 ), there is no significant difference. Conclusion. Based on the results, density and trabecular thickness (Tb.Th.) showed a significant difference between healing times. However, trabecular separation (Tb.Sp.) and trabecular number (Tb.N.) showed no difference in healing time.

Experimental Study for the Evaluation of Titanium Disc Decontamination and Osseointegration in the Rabbit Tibia Model

“…FD has been used for the assessment of osteoporosis, bone healing, periodontitis, and the stability of implants on radiographs [25,[34][35][36]. It is a well-known method for investigating bone mineral density (BMD), where higher box-counting values imply complex trabecular and medullar bone.…”

“…Bone density quantifies the size of the marrow space relative to the bone volume and serves as a valuable metric for assessing the quality of osseointegration in decontaminated implants [25]. The fractal dimension (FD) is a quantitative value for evaluating the trabecular bone pattern [26].…”

“…This method involves statistical analysis of the structural patterns in the fractal dimension and is independent of projection geometry and radiodensity; thus, it is widely employed in the dental field, including the evaluation of implant stability [27,28]. As inflammation in the bone progresses, the trabecular bone is destroyed, and lower FD values are obtained [25]. Also, the mean grayscale value (GV) serves as the metric for quantifying bone density measurements [25,29].…”

“…As inflammation in the bone progresses, the trabecular bone is destroyed, and lower FD values are obtained [25]. Also, the mean grayscale value (GV) serves as the metric for quantifying bone density measurements [25,29]. The mean GV demonstrates the intensity of attenuated X-rays using a numerical scale.…”

An Artificial Intelligence model for implant segmentation on periapical radiographs

“…3 During placement of dental implants into the jawbone, a periapical (PA) radiograph is exposed which confirms the position of implant fixture as well as forming a baseline for future evaluations. 4 With the advent of digitized radiography in dentistry, extensive radiographic data is now available. And with more technological advancements this data is being used for automation of dental radiographic diagnoses using Artificial Intelligence (AI).…”