Digital subtraction of radiograph in evaluating alveolar bone changes after initial periodontal therapy

The purpose of this study was to determine the effect of initial periodontal therapy on crestal bone remineralization with the use of a digital subtraction method for quantitative analysis. Fifteen crestal sites randomly selected from five patients were examined at the initial visit, after completion of oral hygiene instruction, and 1, 3, and 6 months after scaling and root planing with standardized radiographs. The radiographs were digitized by means of a drum-scanning microdensitometer with a sampling aperture of 50 microns producing 256 gray levels and corrected for difference of contrast between image pairs. Results were as follows: (1) statistically significant changes were observed even 1 month after the therapy and (2) the extent of changes was quantitatively expressed and monotonically increased with time. These results indicate that subtraction radiography may be a reproducible and quantitative method for the evaluation of periodontal therapy.