Computer-assisted measurement of radiographical alveolar bone density using intraoral radiographs: Preliminary study on comparison between men and women in young adults

Makoto Oohashi; Fumi Mizuhashi; Yoshihiro Sugawara; Hisato Saegusa; Akitoshi Katsumata; Ichiro Ogura

doi:10.4103/jomr.jomr_2_20

ORIGINAL ARTICLE

Year : 2020 | Volume : 8 | Issue : 1 | Page : 1-4

Computer-assisted measurement of radiographical alveolar bone density using intraoral radiographs: Preliminary study on comparison between men and women in young adults

Makoto Oohashi¹, Fumi Mizuhashi², Yoshihiro Sugawara³, Hisato Saegusa³, Akitoshi Katsumata⁴, Ichiro Ogura⁵
¹ Dental Anesthesia and General Health Management, The Nippon Dental University Niigata Hospital, Niigata, Japan
² Department of Removable Prosthodontics, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan
³ Comprehensive Dental Care, The Nippon Dental University Niigata Hospital, Niigata, Japan
⁴ Department of Oral Radiology, Asahi University School of Dentistry, Mizuho, Japan
⁵ Department of Oral and Maxillofacial Radiology, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan

Date of Submission	10-Jan-2020
Date of Decision	24-Feb-2020
Date of Acceptance	02-Mar-2020
Date of Web Publication	2-Jul-2020

Correspondence Address:
Ichiro Ogura
Department of Oral and Maxillofacial Radiology, The Nippon Dental University School of Life Dentistry at Niigata, 1-8 Hamaura-Cho, Chuo-Ku, Niigata 951-8580
Japan

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/jomr.jomr_2_20

Abstract

Background: As bone mineral is one of the major determinants of bone strength, its exact measurement should be useful for the diagnosis of osteoporosis, as well as for the prediction of fracture risk and monitoring of therapeutically response. Aims: The aim of this study was to investigate computer-assisted measurement of radiographical alveolar bone density using intraoral radiographs, especially comparison between men and women in young adults. Materials and Methods: Forty-two patients in young adults (20 men and 22 women; age 22–25 years; and mean age 23.2 years) of the mandibular premolar region who underwent intraoral radiographs with imaging plate (IP) detector and computer analysis system “DentalSCOPE” were included in this study. The DentalSCOPE had a special X-ray beam indicator in which a special calcium carbonate reference object was embedded. IP-based digital X-ray images were input into the DentalSCOPE system. The DentalSCOPE software measured the image density of the reference object automatically and calculated the mineral density value of an arbitrary region of interest (ROI). The mineral density of a rectangular ROI in the periapical region of mandibular premolars was evaluated. The age and alveolar bone density were compared between men and women using the Mann–Whitney U-test. P <0.05 was considered statistically significant. Results: There was no difference in age between men (23.1 ± 0.9 years) and women (23.2 ± 0.9 years) in this study. The alveolar bone density of the mandibular premolar region in men (0.98 ± 0.08 g/cm²) was significantly higher than that in women (0.88 ± 0.14 g/cm², P = 0.006). Conclusions: This study suggested that DentalSCOPE may be useful for evaluating the mineral density of alveolar bone.

Keywords: Alveolar bone density, computer-assisted detection, computer-assisted diagnosis, intraoral radiography, mineral density

How to cite this article:
Oohashi M, Mizuhashi F, Sugawara Y, Saegusa H, Katsumata A, Ogura I. Computer-assisted measurement of radiographical alveolar bone density using intraoral radiographs: Preliminary study on comparison between men and women in young adults. J Oral Maxillofac Radiol 2020;8:1-4

How to cite this URL:
Oohashi M, Mizuhashi F, Sugawara Y, Saegusa H, Katsumata A, Ogura I. Computer-assisted measurement of radiographical alveolar bone density using intraoral radiographs: Preliminary study on comparison between men and women in young adults. J Oral Maxillofac Radiol [serial online] 2020 [cited 2023 Mar 24];8:1-4. Available from: https://www.joomr.org/text.asp?2020/8/1/1/288831

Introduction

As bone mineral is one of the major determinants of bone strength, its exact measurement should be useful for the diagnosis of osteoporosis, as well as for the prediction of fracture risk and monitoring of therapeutically response. Various methods for evaluating bone mineral in appendicular, and axial bone or in the whole skeleton have recently become available.^[1] Dual-energy X-ray absorptiometry systems provide accurate methods for assessing bone mineral content and density.^[2],[3],[4] Furthermore, computer-controlled radiographic absorptiometry is precise and accurate; it is also fast, inexpensive, and easy to use in a wide variety of clinical settings.^[5]

It is important in the field of dentistry to establish a simple method for evaluating the mineral density of alveolar bone. Micro-densitometric analysis of interdental bone structure is used to measure bone mineral density (BMD).^[6],[7] In recent years, a computer program “DentalSCOPE” based on conventional microdensitometry techniques was developed. The computer program is a computer-aided detection (CAD) system for intraoral radiography and useful for preliminary screening of osteoporosis in dental practice. However, to the best of our knowledge, the computer program “DentalSCOPE” for the alveolar bone density based on image density of intraoral radiographs has not been reported in the literature. The aim of this study was to investigate computer-assisted measurement of radiographical alveolar bone density using intraoral radiographs, especially comparison between men and women in young adults with the computer program “DentalSCOPE.”

Materials and Methods

Patient population

This study was approved by the ethics committee of our institution (ECNG-R-318). After providing written informed consent, 42 patients in young adults (20 men and 22 women; age 22–25 years; and mean age 23.2 years) of the mandibular premolar region who underwent intraoral radiographs with imaging plate (IP) detector and computer analysis system (DentalSCOPE; Media Co, Tokyo, Japan) at our university hospital from April 2019 to September 2019 were included in this study.

Image acquisition and analysis

Intraoral radiographs were acquired with an intraoral machine (Heliodent Plus; Sirona Dental Systems, Tokyo, Japan) using the dental protocol at our hospital: tube voltage, 70 kV; tube current, 7 mA. Computed radiography was performed with a scanner (VistaScan; YOSHIDA, Tokyo, Japan).

The DentalSCOPE, based on conventional microdensitometry techniques, has a special X-ray beam indicator in which a special calcium carbonate reference object (mineral density; 20% (500 mg/cm³), 60% (1000 mg/cm³), and 100% (1500 mg/cm³)) is embedded [Figure 1]. IP-based digital X-ray images were input into the DentalSCOPE system. The DentalSCOPE software measures the image density of the reference object automatically [Figure 2] and calculates the mineral density value of an arbitrary region of interest (ROI). The mineral density of a rectangular ROI in the periapical region of the mandibular premolars was evaluated [Figure 3].

Figure 1: The DentalSCOPE, based on conventional microdensitometry techniques, has a special X-ray beam indicator (a) in which a special calcium carbonate reference object (mineral density; 20% [500 mg/cm³], 60% [1000 mg/cm³], and 100% [1500 mg/cm³]) is embedded (b)

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Figure 2: The DentalSCOPE software measures the image density of the reference object automatically

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Figure 3: The DentalSCOPE software calculates the mineral density value of an arbitrary region of interest

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Statistical analysis

The age and alveolar bone density were compared between men and women using the Mann–Whitney U-test. The analyzes were performed using SPSS version 26 (IBM Japan, Tokyo, Japan) with a 5% significance level.

Results

[Table 1] shows computer-assisted measurement of radiographical alveolar bone density using intraoral radiographs. There is no difference in age between men (23.1 ± 0.9 years) and women (23.2 ± 0.9 years) in this study.

Table 1: Computer-assisted measurement of the radiographical alveolar bone density using intraoral radiographs

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The alveolar bone density of the mandibular premolar region in men (0.98 ± 0.08 g/cm²) was significantly higher than that in women (0.88 ± 0.14 g/cm², P = 0.006). Furthermore, of all young adults (age 22–25 years, mean age 23.2 ± 0.9 years), the alveolar bone density of the mandibular premolar region was 0.93 ± 0.13 g/cm².

Discussion

It is important in the field of dentistry to establish a simple method for evaluating the mineral density of alveolar bone using intraoral radiographs. This study indicated that the computer program “DentalSCOPE” may be useful for evaluating the mineral density of alveolar bone using intraoral radiographs.

Intraoral radiography has been widely accepted as a valuable diagnostic tool in dental diseases. We consider that this technique would be useful for the follow-up of medication-related osteonecrosis of the jaw (MRONJ), the dental implant preoperative examination, and the screening of osteoporosis in dental practice. However, preliminary study for young and older adults as patients is necessary for the evaluation using the technique. Therefore, first, we investigated the patients, especially the comparison between men and women in young adults with the computer program.

Bone densitometry is currently the most useful method of diagnosing osteoporosis and assessing fracture risk.^[5] Bisphosphonates are inhibitors of osteoclastic bone resorption^[8] and useful for the treatment of osteoporosis and bone metastases of cancer.^[9],[10] However, they are also implicated in the onset of MRONJ.^[11],[12] Intraoral and panoramic projections are useful screening tools for assessing the presence of dental disease and the severity and extent of osteonecrotic changes, as well as for the follow-up of patients with osteonecrosis of the jaw.^[13] Therefore, we consider that DentalSCOPE should be useful for the follow-up of patients with MRONJ. However, if the diagnostic information is an ambiguous or more detailed investigation of the dental and osseous health is required, more advanced imaging is necessary as computed tomography, magnetic resonance imaging, and nuclear imaging with scintigraphy.^{[13],[14],[15],[16],[17]}

Nakamoto et al.^[18] developed a computer-assisted detection/diagnosis (CAD) system based on mathematical morphology for identifying postmenopausal women with low skeletal BMD or osteoporosis, based on the World Health Organization criteria, by identifying whether the endosteal margin of mandibular cortical bone was eroded. Their results suggested that a CAD system applied to dental panoramic radiographs may be useful for identifying postmenopausal women with low skeletal BMD or osteoporosis. Kavitha et al.^[19] developed a CAD system to continuously measure mandibular inferior cortical width on dental panoramic radiographs and evaluate the system’s efficacy in identifying postmenopausal women with low skeletal BMD. They concluded that their new CAD system was a useful procedure in triage screening for osteoporosis. We consider that the DentalSCOPE system using intraoral radiographs may be useful for the screen of osteoporosis.

In this study, the alveolar bone density of the mandibular premolar region in men (0.98 ± 0.08 g/cm²) was significantly higher than that in women (0.88 ± 0.14 g/cm², P = 0.006). Sudo et al.^[5] measured BMD of the second metacarpal bone using microdensitometry and showed that BMD in men was higher than that in women. We consider that BMD correlates with sex differences in this study.

The limitations of this study were as follows: the number of patients with DentalSCOPE was small and alone young adults, and logistic multivariate regression analysis was not used to determine the relationship between alveolar bone density and useful for the diagnosis of osteoporosis, as well as for the prediction of fracture risk. We consider that the authors had to compare between the normal and osteoporosis patient for this study to prove the usefulness of DentalSCOPE. However, preliminary study for young and older adults as patients is necessary for the evaluation using the technique. Therefore, first, we showed the current samples, especially comparison between men and women in young adults with the computer program.

Conclusions

The aim of this study was to investigate the computer-assisted measurement of radiographical alveolar bone density using intraoral radiographs, especially comparison between men and women in young adults. The alveolar bone density of the mandibular premolar region in men was significantly higher than that in women. This study suggested that DentalSCOPE may be useful for evaluating the mineral density of the alveolar bone.

Financial support and sponsorship

This work was supported by JSPS KAKENHI Grant Number JP 18K09754.

Conflicts of interest

There are no conflicts of interest.

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