• Journal of Periodontal and Implant Science
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• v.25 no.1
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• pp.67-75
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• 1995

The progress of periodontal disease and the wound healing process after treatment result in alveolar bone bone change. So, detection of it is very important in the diagnosis and the radiograph of periodontal disease. Various effects have been made to assess the subtle alveolar bone change and digital subtraction radiography (DSR) has been reported to be the best method in evaluating it qualitatively and quantitatively. The present study was performed to estimate the detectable alveolar bone change qualitatively with digital subtraction radiography. For the in vitro study, 10 intraoral standard radiographs were taken from porcine dry mandible which a rectangular cortical bone chip of 0.1mm to 1.0mm thickness with 0.1mm increment was attached on the buccal surface. The radiographs without and with bone plates were reviewed at the same time by 10 observers and requested to detect the presence of cortical bone plates. Digital Subtraction radiograph was reviewed subsequently by using the DSR system(digital converter-256 grey-levels,DT 2851,Data Translation Co., U.S.A;IBM 386 ; CCD camera, FOTOVIX, Tamrom Co., Japan). The detectable thickness of cortical bone plate was O.4mm on the intraoral radiograph and 0.2mm on the subtaction images. For the human study, radiographs were taken from patients by using intraoral film holding device and aluminum reference wedge before and 3 month after bone graft and 1 week after osteoplasty. The grey level change was estimated in the subtraction images and calculated to aluminum equivalent thickness. The grey level of the grafted site was higher that that of healthy controls. Average grey levels of change on healthy controls were O.48mm aluminum equivalent. However, the amount of changes in grafted sites were 1.87mm aluminum thickness equivalent and in the site of osteoplasty were -1.49mm aluminum thickness equivalent. In conclusion, digital subtraction radiography was more effective in detecting as subtle change of alveolar bone than intraoral standard radiography. With the aid of quantitative analysis of digital subtraction radiography, alveolar bone resorption of apposition can be estimated during diagnosis and treatment of periodontally diseased patients.

• Imaging Science in Dentistry
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• v.32 no.3
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• pp.123-127
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• 2002

Purpose : To determine whether subtraction images utilizing contrast media can improve the diagnostic performance of proximal caries diagnosis compared to conventional periapical radiographic images. Materials and Methods: Thirty-six teeth with 57 proximal surfaces were radiographied using a size #2 RVG-ui sensor (Trophy Radiology, Marne-la-Vallee, France). The teeth immersed in water-soluble contrast media and subtraction images were taken. Each tooth was then sectioned for histologic examination. The digital radiographic images and subtraction images were examined and interpreted by three dentists for proximal caries. The results of the proximal caries diagnosis were then verified with the results of the histologic examination. Results: The proximal caries sensitivity using digital subtraction radiography was significantly higher than simply examining a single digital radiograph. The sensitivity of the proximal dentinal carious lesion when analyzed with the subtraction radiograph and the radiograph together was higher than with the subtraction radiograph or the radiograph alone. Conclusion: The use of subtraction radiography with contrast media may be useful for detecting proximal dentinal carious lesions.

• Imaging Science in Dentistry
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• v.31 no.1
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• pp.51-55
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• 2001

Purpose : This study was performed to compare the diagnostic ability of conventional intraoral radiographs with that of digital subtraction image and to assess the quantifying ability of digital subtraction image for simulated apical root resorption Materials and Methods : Conventional intraoral radiographs and digital images of ten sound maxillary central incisors and those with simulated apical root resorption were taken with varying horizontal and vertical angulations of the x-ray beam. The diagnostic accuracy to detect the lesion was evaluated on conventional intraoral radiographs and digital subtraction images by ROC analysis. The amount of simulated apical root resorption was also estimated on the reconstruction images by Emago/sup (R)/ and compared with actual amount of tooth loss using paired t-test. Results: The diagnostic accuracy of conventional intraoral radiographs to detect the apical root resorption was low (ROC area = 0.6446), and the sensitivity and the specificity of digital subtraction images were 100%, respectively. The calculated amounts of apical root resorption showed no statistically significant difference with the actual amounts of the lesion (p>0.05). Conclusion: Digital subtraction radiography is powerful tool to detect the small apical root resorption, and quantitative analysis of small amounts of the lesion can be evaluated by digital subtraction radiography.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.29 no.2
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• pp.417-422
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• 1999

Purpose : The aim of this study was to assess the validity of standard deviation of gray scale histogram in digital subtraction radiography as a test parameter for superimposition error. Materials and Methods : Twenty periapical radiographs were used as baseline images and they were copied to exclude the influence of exposure geomety and contrast differences. These subsequent images were linearly displaced by 0.1-0.5 mm in the x-. y- and xy-directions, rotated by 0.5-3° and distorted by angular contraction of 1-5° in x- and y-axis before subtraction. The standard deviations of gray levels in the subtraction images were obtained and paired t-tests were performed. Pearson correlation coefficients(r) were calculated between the standard deviations and the superimposition errors. Results : Linear displacement showed high correlation coefficients of 0.997, 0.997 and 0.995 in x-. y- and xy-axis respectively. Statistically significant different standard deviation existed among all linearly displaced groups(p<0.05). Distortion showed relatively low correlation coefficients of 0.982 and 0.959 in x- and y-axis. The standard deviations between the two distortion groups were statistically significant different(p<0.05). Conclusion : Standard deviation of gray level distribution in digital subtraction images is satisfactory but not perfect similarity measure to assess the superimposition errors.

• Journal of Periodontal and Implant Science
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• v.28 no.4
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• pp.797-809
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• 1998

The purposes of this study were to develop the computer program for the contrast and geometric correction in digital subtration radiography with the IDL (Interactive Data Language) and compare the results with this program for the correction of the non-standardized radiographs to those of standardized radiographs and those with "Emago" software, the commercial program for the correction. The procedures were written for the contrast correction and subtraction with the geometric correction, using IDL. 32 pairs of periapical radiographs of premolar and molar portion of two dry human mandibles were taken at two different occasions with XCP film holder(nonstandardized films) and another 32 pairs with customized XCP film holder(standardized films). Subtraction of standardized film pairs was performed. Subtraction after the contrast and geometric correction of non-standardized films was performed using the newly developed program and Emago software. Standard deviations of grey levels of the subtracted images by the newly developed program were compared with those of the standardized group and Emago-corrected group. Standard deviations of grey levels of new program-corrected group were much smaller than those of the Emago-corrected group (p<0.001) and slightly larger than those of standardized group (p<0.05). However, the difference was very minute. This study indicates that the newly developed program written with IDL may substitute the mechanical standardization for digital subtraction radiography.

• Journal of Periodontal and Implant Science
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• v.23 no.3
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• pp.595-604
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• 1993

Since $Gr{\"{o}}nadhl$ et al introduced a digital subtraction radiography into periodontal dignosis in 1983, many reports using this system has aimed to assess the peroiodontal disease activity and the alveolar bone changes after periodontal treatment. The present study was performed to evaluate the usefulness of digital subtraction radiography for asessing an alveolar bone changes in 3 months after periodontal flap surgery. Serial intraral raiographs were taken from 5 normal subjects and 6 periodontally diseased patients using customized bite blocks attached to film holder in fxation device and digitized by image processing system(consisting of IBM 386, digital frame grabber, CCD camera, Image-pro II software). And the reference parameters were measured by pixel unit and compared with respective radiographs. The serial radiographs showed a little and statistically insignificant difference in reference paramenters. The conventional intraoral radiographs, the subtraction images and the clor enhanced subtraction images were reviewed by 4 examiners and the examiner's agreement rates were compared. The subtraction images and its color enhanced images showed higher examiner's agreement rate than the conventional radiographs. And the propotions of sites diagnosed with bone loss or gain after periodontal surgery were highter in the subtraction images and its color enhanced images than in the conventional radiographs. Especially, in color enhanced images, the unber of bone agin sites tended to increase according to post-surgery periods. These results indicate that projection geometry could be standardized with the divice used in this study, and the subtraction radiography may be useful to assess an alveolar bone changes after periodntal flap surgery.

• The KIPS Transactions:PartB
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• v.11B no.3
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• pp.275-280
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• 2004

In this paper, we propose automatic subtraction radiography algorithms to overcome conventional subtraction radiography's defects by applying image processing technique. In order to reach these goals, this paper suggests the image alignment method that is necessary for getting subtraction image and ROI(Region Of Interest) focused on a selection method using the structure characteristics in target images. Therefore, we use these methods because they give accurary, consistency and objective information or data to results. According to the results, easily and visually we can identify fine difference int the affected parts wether they have problems or not.

• Imaging Science in Dentistry
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• v.33 no.1
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• pp.27-33
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• 2003

Purpose : The purpose of this experiment was to evaluate the diagnostic ability of a CCD-based digital system (CDX-2000HQ) in the detection of incipient dental caries. Materials and Methods : 93 extracted human teeth with sound proximal surfaces and interproximal artificial cavities were radiographed using 4 imaging methods. Automatically processed No.2 Insight film (Eastman Kodak Co., U.S.A.) was used for conventional radiography, scanned images of conventional radiograms for indirect digital radiography were used. For the direct digital radiography, the CDX-2000HQ CCD system (Biomedisys Co. Korea) was used. The subtraction images were made from two direct digital images by Sunny program in the CDX-2000HQ system. Two radiologists and three endodontists examined the presence of lesions using a five-point confidence scale and compared the diagnostic ability by ROC (Receiver Operating Characteristic) analysis and one way ANOV A test. Results: The mean ROC areas of conventional radiography, indirect digital radiography, direct digital radiography, and digital subtraction radiography were 0.9093, 0.9102, 0.9184, and 0.9056, respectively. The diagnostic ability of direct digital radiography was better than the other imaging modalities, but there were no statistical differences among these imaging modalities (p > 0.05). Coclusion : These results indicate that new CCD-based digital systems (CDX-2000HQ) have the potential to serve as an alternative to conventional radiography in the detection of incipient dental caries.

• The Journal of Korean Academy of Prosthodontics
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• v.39 no.3
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• pp.273-281
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• 2001

Digital subtraction radiography may be one of the most precise and noninvasive methods for assessing subtle density changes in peri-implant bone, providing additional diagnostic information on implant tissue integration in overall maintenance. The aims of this study were to evaluate density changes after first, second surgery of dental implant and to measure the amount of marginal bone loss 9 months after second surgery using digital subtraction radiography. Bone change around 30 screw-shaped implants in 16 patients were assessed on radiographs. 17 Branemark implants of 3.75mm in diameter(Nobel Biocare, Goteborg, Sweden), 2 Branemark implants of 5.0mm in diameter, 11 $Replace^{TM}$ implants of 4.3mm in diameter(Nobel Biocare, Goteborg, Sweden) were used. To standardize the projection geometry of serial radiographs of implants, customized bite block was fabricated using XCP film holder(Rinn Corporation, Elgin, IL.) with polyether impression material of Impregum(ESPE, Germany) and direct digital image was obtained. Qualitative and quantitative changes on radiographs were measured with Emago software(The Oral Diagnostic System, Amsterdam, Netherlands). The results were as follows: 1. The peri-implant bone density of 69.2% implants did not change and the peri-implant bone density of 30.8% implants decreased after 3 months following first surgery. 2. The crestal bone density of 53.9% implants decreased first 3 months after second surgery. The crestal bone density of 58.8% implants increased 9 months after second surgery. No density change was observed around the midportion of the implants after second surgery, 3. The amount of marginal bone loss between different kinds of implants showed no statistically significant differences (p>0.05). 4. More than 90% of total marginal bone loss recorded in a 9-month period occurred during the first 3 months.

• Imaging Science in Dentistry
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• v.39 no.1
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• pp.35-39
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• 2009

Purpose: The purpose of the experiment was to evaluating the diagnostic ability of dental caries detection using digital subtraction in the artificial caries activity model. Materials and Methods: Digital radiographies of five teeth with 8 proximal surfaces were obtained by CCD sensor (Kodak RVG 6100 using a size #2). The digital radiographic images and subtraction images from artificial proximal caries were examined and interpreted. In this study, we proposed novel caries detection method which could diagnose the dental proximal caries from single digital radiographic image. Results: In artificial caries activity model, the range of lesional depth was $572-1,374{\mu}m$ and the range of lesional area was $36.95-138.52mm^2$. The lesional depth and the area were significantly increased with demineralization time (p<0.001). Furthermore, the proximal caries detection using digital subtraction radiography showed high detection rate compared to the proximal caries examination using simple digital radiograph. Conclusion: The results demonstrated that the digital subtraction radiography from single radiographic image of artificial caries was highly efficient in the detection of dental caries compared to the data from simple digital radiograph.