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Assessment of Peri-Implant Bone Density Using Intraoral Periapical Radiographs: A Retrospective Observational
Saturnino Marco Lupi1, Edoardo Giannini1, Viviana Maria Petrantoni1
1Department of Clinical Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy.
Healthcare (Basel, Switzerland)
|February 27, 2026
Summary
Peri-implant radiographic bone density (PIBD) can reliably monitor osseointegration after dental implant placement. PIBD changes reflect distinct healing phases, aiding clinical decisions.
Area of Science:
- Dentistry
- Biomaterials Science
- Radiology
Background:
- Osseointegration is critical for dental implant success.
- Radiographic assessment can evaluate peri-implant bone healing.
- Peri-implant radiographic bone density (PIBD) is explored as an osseointegration indicator.
Purpose of the Study:
- To evaluate PIBD as a potential indicator of osseointegration.
- To assess temporal changes in PIBD following implant-prosthetic rehabilitation.
- To correlate PIBD with Marginal Bone Level (MBL) changes.
Main Methods:
- Retrospective study of 88 implants in 64 patients with standardized periapical radiographs.
- Digital radiograph analysis using ImageJ® to calculate normalized bone density in Areas of Interest (AOIs).
- Assessment of Marginal Bone Level (MBL) changes and statistical analysis.
Main Results:
- Normalized bone density showed significant temporal changes, particularly between 3 and 12 months.
- PIBD decreased ~8% from placement to 3 months, then significantly increased by one year.
- No significant correlation was found between MBL and normalized bone density.
Conclusions:
- PIBD assessment is a reliable, non-invasive tool for monitoring osseointegration.
- PIBD monitoring supports clinical decision-making in postoperative dental implant care.
- Observed PIBD patterns indicate three distinct radiographic healing phases: remodeling, osseointegration, and stabilization.
