Validation of a dental image analyzer tool to measure alveolar bone loss in periodontitis patients

J Periodontal Res. 2009 Feb;44(1):94-102. doi: 10.1111/j.1600-0765.2008.01111.x. Epub 2008 Oct 7.


Background and objective: Radiographs are an essential adjunct to the clinical examination for periodontal diagnoses. Over the past few years, digital radiographs have become available for use in clinical practice. Therefore, the present study investigated whether measuring alveolar bone loss, using digital radiographs with a newly constructed dental image analyzer tool was comparable to the conventional method, using intra-oral radiographs on film, a light box and a Schei ruler.

Material and methods: Alveolar bone loss of the mesial and distal sites of 60 randomly selected teeth from 12 patients with periodontitis was measured using the conventional method, and then using the dental image analyzer tool, by five dentists. The conventional method scored bone loss in categories of 10% increments relative to the total root length, whereas the software dental image analyzer tool calculated bone loss in 0.1% increments relative to the total root length after crucial landmarks were identified.

Results: Both methods showed a high interobserver reliability for bone loss measurements in nonmolar and molar sites (intraclass correlation coefficient > or = 0.88). Also, a high reliability between both methods was demonstrated (intraclass correlation coefficient nonmolar sites, 0.98; intraclass correlation coefficient molar sites, 0.95). In addition, the new dental image analyzer tool showed a high sensitivity (1.00) and a high specificity (0.91) in selecting teeth with > or = 50% or < 50% alveolar bone loss in comparison with the conventional method.

Conclusion: This study provides evidence that, if digital radiographs are available, the dental image analyzer tool can reliably replace the conventional method for measuring alveolar bone loss in periodontitis patients.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Alveolar Bone Loss / diagnostic imaging*
  • Alveolar Process / diagnostic imaging
  • Bicuspid / diagnostic imaging
  • Cuspid / diagnostic imaging
  • Humans
  • Image Processing, Computer-Assisted / methods*
  • Image Processing, Computer-Assisted / statistics & numerical data
  • Incisor / diagnostic imaging
  • Molar / diagnostic imaging
  • Periodontitis / diagnostic imaging*
  • Radiography, Bitewing / methods
  • Radiography, Dental, Digital / methods*
  • Sensitivity and Specificity
  • Software
  • Tooth Apex / diagnostic imaging
  • Tooth Cervix / diagnostic imaging
  • Tooth Root / diagnostic imaging
  • X-Ray Film