Digital subtraction radiography for the detection of periodontal bone changes

Abstract

This study was performed to evaluate the efficacy of digital subtraction radiography in detecting alveolar bone changes. In order to test the sensitivity of quantitative evaluation by subtraction radiography, a copper equivalent thickness obtained from digitized radiographs was compared with the actual mineral content of bone phantoms with 15 different minerals and 25 bone specimens. Results demonstrated that the copper equivalent thickness correlated well with the actual mineral content (bone phantoms: gamma s = 1.0, bone specimens: gamma s = 0.985). In order to test the ability of digitized subtraction radiography in assessing alveolar bone changes in vivo, subtraction images were compared with histological features. The experimental angular bony defects were treated with conservative periodontal therapy in 3 monkeys. The standardized radiographs were taken longitudinally after therapy, and subtraction images were made from the sequentially obtained radiographs. In addition, for fluorescent histomorphometrical evaluations of new bone formations, the animals were dosed with oxytetracycline, calsein solution and arizarin complex solution. Radiographic and histological evaluations were scheduled to provide healing periods of 2, 3, 4, 5, 6 and 9 weeks after periodontal therapy. Subtraction radiography offered an objective method to follow histological changes of alveolar bone, and the copper equivalent thickness obtained from subtraction radiographs correlated with the histometric bone volume (gamma s = 0.9023, p less than 0.01). The results of these studies indicated that subtraction radiography was useful in monitoring alveolar bone changes associated with periodontal disease and treatment and that the quanitative measurement of periodontal bone changes by subtraction radiography was feasible.