title: A digital subtraction radiography investigation of upper first molar proximal bone density changes in adolescents.
abstract: The aim of this in vivo study was to investigate the ability of digital subtraction radiography to monitor changes in proximal bone density, adjacent to the upper first molars, in a group of adolescents using the Digora direct digital radiographic system to acquire images. For 57 adolescents, assessments of changes in probing attachment level at the mesio- and disto-buccal surfaces of both upper first molars and proximal crestal bone density using digital subtraction radiography were made. At the conclusion of this 21-month study attachment loss was identified in 34 (17%) of the 204 sites analysed. For sites with attachment loss a mean decrease in bone density equivalent to 5.51 mm3 aluminium (Al) was found compared to 2.96 mm3 Al for those without (p < 0.001). For the 17 subjects with attachment loss a mean equivalent to 4.66 mm3 Al was lost from the crestal bone compared with 2.56 mm3 Al for the 40 subjects without attachment loss (p < 0.01). The correlation between attachment loss and bone density changes was poor for both sites (r = 0.13), p = 0.067) and mean scores for subjects (r = 0.24, p = 0.069). A visual qualitative assessment of bone density change found that 70.6% of sites with attachment loss compared to 62.4% of those without had a decrease in crestal bone density. This study suggests that it is possible to monitor bone density changes in adolescents, with a developing dentition, using digital subtraction radiography. Further, it is suggested that conventional probing assessments of attachment level may underestimate the level of destructive periodontal disease in this age group.
authors.affiliation: Dental Health Unit, University of Manchester, UK.
authors.forename: R
authors.initials: R
authors.lastname: Ellwood
authors.forename: K
authors.initials: K
authors.lastname: Horner
authors.forename: S
authors.initials: S
authors.lastname: Alexander
authors.forename: R
authors.initials: R
authors.lastname: Davies
mesh_terms: D000293:Adolescent; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging*; D015519:Bone Density; D006801:Humans; D008437:Maxilla / Q000000981:diagnostic imaging; D008963:Molar; D017622:Periodontal Attachment Loss / Q000000981:diagnostic imaging; D010514:Periodontal Pocket / Q000175:diagnosis; D019252:Radiography, Dental, Digital; D015203:Reproducibility of Results; D013382:Subtraction Technique