J Korean Assoc Oral Maxillofac Surg.  2022 Feb;48(1):41-49. 10.5125/jkaoms.2022.48.1.41.

Comparison of cone-beam computed tomography and digital panoramic radiography for detecting peri-implant alveolar bone changes using trabecular micro-structure analysis

Affiliations
  • 1Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Necmettin Erbakan University, Konya, Turkey
  • 2Department of Periodontology, Faculty of Dentistry, Necmettin Erbakan University, Konya, Turkey
  • 3Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey

Abstract


Objectives
We compared changes in fractal dimension (FD) and grayscale value (GSV) of peri-implant alveolar bone on digital panoramic radiography (DPR) and cone-beam computed tomography (CBCT) immediately after implant surgery and 12 months postoperative.
Materials and Methods
In this retrospective study, 16 patients who received posterior mandibular area dental implants with CBCT scans taken about 2 weeks after implantation and one year after implantation were analyzed. A region of interest was selected for each patient. FDs and GSVs were evaluated immediately after implant surgery and at 12-month follow-up to examine the functional loading of the implants.
Results
There were no significant differences between DPR and CBCT measurements of FD values (P>0.05). No significant differences were observed between FD values and GSVs calculated after implant surgery and at the 12-month follow-up (P>0.05). GSVs were not correlated with FD values (P>0.05).
Conclusion
The DPR and reconstructed panoramic CBCT images exhibit similar image quality for the assessment of FD. There were no changes in FD values or GSVs of the peri-implant trabecular bone structure at the 12-month postoperative evaluation of the functional loading of the implant in comparison to values immediately after implantation. GSVs representing bone mass do not align with FD values that predict bone microstructural parameters. Therefore, GSVs and FDs should be considered different parameters for assessing bone quality.

Keyword

Fractals; Bone density; Panoramic radiography; Cone-beam computed tomography; Dental implants

Figure

  • Fig. 1 Region of interest selection at mesial (25×50 pixels), distal (25×50 pixels), and apical (50×25 pixels) areas on digital panoramic radiography and reformatted panoramic images of cone-beam computed tomography.

  • Fig. 2 A. Region of interest (ROI) on digital panoramic radiography and cone-beam volumetric tomography images were cropped and transferred to ImageJ. B, C. The cropped ROI was duplicated (B) and then blurred with a Gaussian filter (C). D, E. The blurred image was subtracted from the original image (D), and 128 was added to the result at each pixel location (E). F. The resultant image was converted to binary, to set the image into trabeculae and marrow spaces. G, H. The binary image was eroded then dilated to reduce the noise before skeletonization. I. The skeletonized image was used for fractal analysis.

  • Fig. 3 The selection of grayscale value (GSV) (4 mm2) at the implant apex on the cross sectional image of cone-beam computed tomography (CBCT). The mean GSV was measured automatically by the CBCT software program.


Reference

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