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Dentomaxillofacial Radiology (2003) 32, 379-384
© 2003 British Institute of Radiology
doi: 10.1259/dmfr/23241049

RESEARCH

Image processing and analysis program for measurement of bone density changes in reference and follow-up standardized extraoral oblique lateral cephalometric radiographs of the mandible

JM Ruijter1,2, JW Verhoeven*,3, JAM van der Linden1,4, MS Cune3 and M Terlou1

1 Department of Image Processing and Design, Faculty of Biology, Utrecht University, The Netherlands; 2 Department of Anatomy and Embryology, Academic Medical Center, Amsterdam, The Netherlands; 3 Department of Oral and Maxillofacial Surgery, Prosthodontics and Special Dental Care, University Medical Center, Utrecht, The Netherlands; 4 Department of Pulmonary Diseases, University Medical Center, Utrecht, The Netherlands

*Correspondence to: JW Verhoeven, Department of Oral and Maxillofacial Surgery, Prosthodontics and Special Dental Care, University Medical Center, Location Stratenum, PO Box 85.060, 3508 AB Utrecht, The Netherlands; Email: j.w.verhoeven{at}med.uu.nl

Received 11 November 2002; revised 22 June 2003; accepted 10 December 2003

Objectives: The aim of this study was to develop an image processing and analysis program for peri-implant bone density measurements of the mandible using extraoral radiographs, which includes a correction for the variable projection of the soft tissues of the face.

Methods: The measurement procedure is based on pairs of reference and follow-up extraoral oblique lateral cephalometric radiographs (OLCRs) of patients with endosseous implants in the anterior part of the atrophic edentulous mandible. The procedure consists of image acquisition, correction for radiographic variation using an aluminium wedge (i.e. film exposure and development) and transformation of the grey values into aluminium-equivalent values. After correction for variation in the projection of the soft tissues of the face using internal calibration fields, the actual peri-implant bone density measurements are performed.

Results: The soft tissue projection correction significantly reduces the variation between radiographs owing to the position of the soft tissues.

Conclusions: It is concluded that the described image processing and analysis program, in combination with extraorally made OLCRs, is a valuable technique for measurement of peri-implant bone density changes of the mandible. With minor adaptations, the program can be used for other semi-edentulous patients.

Keywords: image processing; radiology; extraoral radiographs; endosseous implants; mandible






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