• 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.

• Imaging Science in Dentistry
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• v.32 no.2
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• pp.107-111
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• 2002

Purpose : To compare the accuracy of digital subtraction images acquired by two different methods different in positioning four reference points for geometrical standardization. Materials and Methods : A total of 36 digital radiographic images of 6 volunteers were taken at the areas of the incisor, premolar, and molar of both the maxilla and mandible using the Digora system. Each image was moved 4 mm vertically and horizontally. Four oral and maxillofacial radiologists performed digital subtraction radiography between the paired images before and after movement using Emago (Oral Diagnostic Systems, Amsterdam, The Netherlands) and Sunny (Biomedisys Co., Seoul, Korea). The standard deviation of the internal gray value in Region of Interest (ROI) was statistically analyzed between the two programs using the paired t-test. Results : The standard deviation of pixel gray values from the digital subtraction images using the Sunny program were lower than that of the Emago program (p<0.05). All observers showed significant differences between each other when the Sunny program was used (p<0.05), but one observer showed a significantly higher score than other observers when they used Emago (p<0.05). The standard deviations of premolar area from both Sunny and Emago programs were significantly higher than those of anterior and molar regions (p<0.05). Conclusion: The subtracted images using the Sunny program were more accurate and sensitive than those taken using the Emago program.

• Imaging Science in Dentistry
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• v.32 no.3
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• pp.147-151
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• 2002

Purpose: To compare the standard deviation of gray levels on digital subtracted images obtained by different dental subtraction programs. Materials and Methods: Paired periapical films were taken at the lower premolar and molar areas of the phantoms involving human mandible. The bite registration group used Rinn XCP equipment and bite registration material, based on polyvinyl siloxane, for standardization. The no bite registration group used only Rinn XCP equipment. The periapical film images were digitized at 1200 dpi resolution and 256 gray levels by a flat bed scanner with transparency unit. Dental digital subtraction programs used for this study were Subtractor (Biomedisys Co., Korea) and Emago (Oral Diagnostic Systems, The Netherlands). To measure the similarities between the subtracted images, the standard deviations of the gray levels were obtained using a histogram of subtracted images, which were then analyzed statistically. Results: Subtracted images obtained by using the Emago program without manual selection of corresponding points showed the lowest standard deviation of gray levels (p<0.01). And the standard deviation of gray levels was lower in subtracted images in the group of a bite registration than in the group of no use of bite registration (p < 0.01). Conclusion: Digital radiographic subtraction without manual selection of reference points was found to be a convenient and superior method.

• Journal of Dental Rehabilitation and Applied Science
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• v.31 no.1
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• pp.33-44
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• 2015

Purpose: This study is to evaluate the clinical significance of the platform switching concept by comparing the marginal bone loss around platform-matched and platform-switched implants. Materials and Methods: Date of implant placement, diameter, length, implant-abutment connection type and absence of splinting prosthesis were investigated on patients who performed treatment with implant placement at Wonkwang University Dental Hospital Implant Center. To measure the marginal bone loss around implants, periapical radiographs of patient were used when implant was placed and when visited the center most recently by using the program, Emago advanced v5.6. Results: As a result of observing on 150 implants of 82 patients for 6 - 63 months, platform-matched implants showed $1.16{\pm}0.54mm$, platform-switched implants showed $0.68{\pm}0.27mm$ of marginal bone loss. Conclusion: It was considered that there is the positive effect to reduce marginal bone loss around platform-switched implants.

• 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.

• Korean Journal of Cleft Lip And Palate
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• v.4 no.2
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• pp.69-78
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• 2001

Alveolar cleft exists in 75% of cleft patients, In alveolar cleft patients, alar base is widening, palatal fistular formation, maxillary growth disturbance & tooth loss of adjacent area is raised, Alveolar bone grafting, especially iliac bone grafting, is a general treatment method. As operation timing, bone grafting is classified with primary, early secondary, secondary, & late secondary, Here we report cleft width, marginal bone height, bone resorption rate, grafted shape & bone densities after secondary iliac bone grafting was done in the Dept. of oral and maxillofacial surgery of chonbuk national university hospital. We compared cleft width to bone resorption rate and grafted shape. Also, alveolar bone densities of grafted and contralateral site was compared with Emago 3 package? (Oral Diagonostic System, The Netherlands), The data obtained were analyzed using Spearman's rho coefficients and sign test with SPSS for window, The results were obtained as follows. 1. As alveolar cleft width is increase, bone resorption rate is, too. This relation showed significant difference(P<.01). 2, In proximal & distal area, alvolar cleft width and bone graft contour after bone grafting had a reverse proportional difference. It was not significant difference(P>.05). 3. After 3 month, in bone density results by using Emago 3 package? with periapical standard view, occlusal view & panoramic view, differences between grafted bone and alveolar bone of contralateral site didn't show a significant difference(P>.05). Thus, differences of bone densities in the alveolar bones didn't exist.

• Imaging Science in Dentistry
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• v.31 no.1
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• pp.23-34
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• 2001

Purpose : To develop a new subtraction program for registering digital periapical images based on the correspondence of anatomic structures. Materials and Methods: The digital periapical images were obtained by Digora system with Rinn XCP equipment after translation of 1-16 mm, and rotation of 2-20° at the premolar and molar areas of the human dried mandible. The new subtraction program, NIH Image program and Emago/Advanced program were compared by the peak-signal-to noise ratio (PSNR). Results : The new subtraction program was superior to NIH Images program and Emagol Advanced program up to 16 mm translation and horizontal angulation up to 4°. Conclusion: The new subtraction program can be used for subtracting digital periapical images.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.2
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• pp.103-109
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• 2016

Purpose: This study is to evaluate the clinical significance of implantation with simultaneous bone graft by comparing the marginal bone loss around maxillary anterior implants with or without bone graft. Materials and methods: Patients treated with implant-retained restorations on maxillary anterior region at Implant Center, Dental Hospital, Wonkwang University between June 2011 and May 2014 were included in this study. Date of implant placement, implant diameter, implant length, implant-abutment connection type and whether the bone graft was done were investigated. The patient's periapical radiographs taken immediately after implantation and at the most recent visit were compared. Marginal bone loss was measured using Emago advanced v5.6 program (Oral diagnostic systems, Amsterdam, Netherlands). Statistical analysis was done in independent t-test by using SPSS 22.0 program. Results: As a result of observing on 83 implants (without bone graft: 44, with bone graft: 39) of 52 patients for 6 - 45 months (average: 18.4 months), implants without bone graft showed $1.42{\pm}0.42mm$, implants with bone graft showed $1.28{\pm}0.45mm$ of marginal bone loss. Conclusion: In limitations of this study, implants with simultaneous bone graft had significantly less marginal bone loss than implants without bone graft.

• Journal of Dental Rehabilitation and Applied Science
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• v.28 no.1
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• pp.1-13
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• 2012

Short implants are used in parts which have anatomical structures like maxillary sinus, inferior alveolar nerve and limited alveolar height due to severe alveolar bone resorption. In these case, there are no need of additional bone augmentation so there are advantages like reduced entire treatment time, reduced patient's discomfort and protection of important anatomical structures. The aim of this study is, in implants whose length is less than 10mm, to analyze the impact of implant length, diameter, location of implant placement, presence of bone graft, presence of prosthesis splinting on survival rates and marginal bone resorption. The samples used in this study were 227 implants, less than 10mm, placed in 137 patients in Wonkwang university dental hospital implant center. From dental charts the information about implant length, diameter, location of implant placement, presence of bone graft, presence of prosthesis splinting were obtained. Emago advanced v5.6(Oral diagnostic systems, Amsterdam, The Netherlands)program was used to measure the amount of marginal bone resorption. Out of total 227 implants, resulting in 96.5 % of survival rate. There was a tendency toward higher failure rates for the maxilla and bone graft site. No significant difference in marginal bone resorption was found associated with length of implants(p>0.05) and neither with the diameter of implants. Among the risk factors examined, more failure rates of short implants can be attributed to poor bone quality in the maxilla and presence of bone graft. At implants under 10mm, length, diameter, location of implant placement, bone graft and splinting of prosthesis didn't affect marginal bone loss.

• Imaging Science in Dentistry
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• v.47 no.2
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• pp.99-107
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• 2017

Purpose: Erosions and osteophytes are radiographic characteristics that are found in different stages of temporomandibular joint (TMJ) osteoarthritis. This study assessed the effectiveness of digital subtraction radiography (DSR) in diagnosing simulated osteophytes and erosions in the TMJ. Materials and Methods: Five intact, dry human skulls were used to assess the effectiveness of DSR in detecting osteophytes. Four cortical bone chips of varying thicknesses (0.5 mm, 1.0 mm, 1.5 mm, and 2.0 mm) were placed at the medial, central, and lateral aspects of the condyle anterior surface. Two defects of varying depth (1.0 mm and 1.5 mm) were created on the lateral, central, and medial poles of the condyles of 2 skulls to simulate erosions. Panoramic images of the condyles were acquired before and after artificially creating the changes. Digital subtraction was performed with Emago dental image archiving software. Five observers familiar with the interpretation of TMJ radiographs evaluated the images. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic accuracy of the imaging methods. Results: The area under the ROC curve (Az) value for the overall diagnostic accuracy of DSR in detecting osteophytic changes was 0.931. The Az value for the overall diagnostic accuracy of panoramic imaging was 0.695. The accuracy of DSR in detecting erosive changes was 0.854 and 0.696 for panoramic imaging. DSR was remarkably more accurate than panoramic imaging in detecting simulated osteophytic and erosive changes. Conclusion: The accuracy of panoramic imaging in detecting degenerative changes was significantly lower than the accuracy of DSR (P<.05). DSR improved the accuracy of detection using panoramic images.