title: Use of digital panoramic radiology in presurgical implant treatment planning to accurately assess bone density.
abstract: BACKGROUND
  No cost-effective method of ascertaining bone density from 2-dimensional radiographic images is currently available for dental implants before surgery.
  
  
  OBJECTIVE
  The purpose of this in vivo study was to use digital panoramic radiology and dental computed tomography (CT) to evaluate the bone density of specific points in the jaw near the tooth-bearing areas. The objective was to determine whether digital panoramic radiology can be used in assessing bone density as an alternative to a more expensive and complex dental CT.
  
  
  METHODS
  This study involved determining bone densities at predetermined anatomic landmarks near tooth-bearing areas of the jaws of 20 participants, using digital panoramic radiology in gray-level scale with a lead step wedge. Subsequently, the bone densities of the same points were determined in Hounsfield units (Hu) with dental CT. The data collected after interpretation of the panoramic radiograph and CT were tabulated and analyzed statistically.
  
  
  RESULTS
  Bone density measured using CT correlated with the first 3 steps of (A, B, and C) the digital scale of gray. Further analysis conducted using the Mann-Whitney U test showed a significant association between step A to detect D4 bone, step B to detect D3 bone, and step C to detect D2 type bone.
  
  
  CONCLUSIONS
  The digital scale of gray obtained from a lead step wedge can be effectively used with digital orthopanoramic radiology to assess bone density before the placement of implants, but with certain restrictions.
authors.affiliation: Postgraduate student, Department of Prosthodontics, Gurunanak Institute of Dental Sciences and Research, Kolkata, India.
authors.forename: Niranjan Kumar
authors.initials: NK
authors.lastname: Chugh
authors.affiliation: Professor and Head, Department of Prosthodontics, Gurunanak Institute of Dental Sciences and Research, Kolkata, India. Electronic address: drjb68@gmail.com.
authors.forename: Jayanta
authors.initials: J
authors.lastname: Bhattacharyya
authors.affiliation: Professor, Department of Prosthodontics, Gurunanak Institute of Dental Sciences and Research, Kolkata, India.
authors.forename: Samiran
authors.initials: S
authors.lastname: Das
authors.affiliation: Reader, Department of Prosthodontics, Gurunanak Institute of Dental Sciences and Research, Kolkata, India.
authors.forename: Soumitra
authors.initials: S
authors.lastname: Ghosh
authors.affiliation: Lecturer, Department of Prosthodontics, Gurunanak Institute of Dental Sciences and Research, Kolkata, India.
authors.forename: Kaushik
authors.initials: K
authors.lastname: Dutta
authors.affiliation: Reader, Department of Prosthodontics, Gurunanak Institute of Dental Sciences and Research, Kolkata, India.
authors.forename: Preeti
authors.initials: P
authors.lastname: Goel
mesh_terms: D015519:Bone Density / Q000502:physiology*; D003758:Dental Implantation, Endosseous; D015921:Dental Implants; D006801:Humans; D008334:Mandible / Q000000981:diagnostic imaging* / Q000502:physiology; D008437:Maxilla / Q000000981:diagnostic imaging* / Q000502:physiology; D061330:Multidetector Computed Tomography; D011300:Preoperative Care; D019252:Radiography, Dental, Digital; D011862:Radiography, Panoramic
chemical_list: D015921:Dental Implants