Digital Subtraction Radiography in the Evaluation of Early Alveolar Bone Density Changes Using Dried Mandible: An Original Radiological In Vitro Study

• Published in: Journal of Indian Academy of Oral Medicine and Radiology
• Main Authors: Dylan Dharmalaksana, Menik Priaminiarti, Bramma Kiswanjaya, Inka Saraswati, Hanna Bachtiar
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2025-07-01
• Subjects: alveolar bone loss; dental digital radiography; diagnostic imaging; periodontitis
• Online Access: https://journals.lww.com/10.4103/jiaomr.jiaomr_50_25
• ISSN: 0972-1363; 0975-1572

Background: Radiographic examination provides essential information for diagnosing periodontal disease and evaluating the results of periodontal treatment. The digital subtraction technique is a radiographic analysis method that can detect subtle changes in the hard tissue, including teeth and alveolar bones, thereby enabling a more precise diagnosis of periodontal disease and a more accurate evaluation of periodontal treatment outcomes. Objective: To determine the effectiveness of digital subtraction techniques using Regeemy (Image Processing Division, National Institute for Space Research (INPE), Brazil) and ImageJ (National Institutes of Health, USA) software in detecting changes in alveolar bone density. Methods: Decreases and increases in alveolar bone density were simulated in six dried mandibles, which were divided into two regions. The locations of the defects were determined randomly. Results: The subtraction technique using Regeemy and ImageJ software showed good effectiveness in detecting changes in alveolar bone density. The diagnostic values obtained based on the gold standard showed high sensitivity (0.91), specificity (0.94), and a receiver operator curve (0.905). Conclusion: This study shows that the digital subtraction technique using Regeemy and ImageJ software has good effectiveness in detecting subtle changes in alveolar bone density.