Análisis estructural cuantitativo del hueso alveolar trabecular de la mandíbula en tomografía computarizada multidetector: diferencias por tipo y estado dentario / Quantitative structural analysis of trabecular alveolar bone in the mandible by multidetector computed tomography: differences according to tooth presence and type

Antecedentes y objetivo: Existe una carencia de métricas cuantitativas de la calidad del hueso trabecular alveolar, factor determinante en implantología. El objetivo de este estudio es desarrollar una metodología con tomografía computarizada multidetector para objetivar la calidad del hueso trabecular y establecer diferencias entre los distintos tipos y el estado de las piezas dentarias mediante procesado de imágenes y análisis estructural. Materiales y métodos: Se analizan 20 pacientes con exploración de tomografía computarizada multidetector dental para la valoración del hueso mandibular y posiciones dentales. El análisis de las imágenes incluyó la segmentación automática de la mandíbula, obtención de secciones perpendiculares a la arcada dentaria y análisis estructural del hueso trabecular de cada sección. Se obtuvieron la ratio entre volumen de hueso y volumen total de la sección, el grosor, la separación y el número trabecular, y la atenuación promedio en unidades Hounsfield. Se analizaron diferencias entre tipos de diente (incisivos, caninos, premolares y molares) y entre estados de las piezas dentarias (ausente o presente). Resultados: Se obtuvieron diferencias estadísticamente significativas entre los tipos y estados de las piezas. Por tipo, los incisivos mostraron mayor ratio de hueso trabecular, con disminución progresiva para caninos, premolares y molares. Por estado, las secciones pertenecientes a dientes ausentes presentaron mayor ratio de hueso que con el diente presente. Conclusiones: La metodología desarrollada permite cuantificar las propiedades estructurales del hueso alveolar a partir de imágenes de tomografía computarizada multidetector. Los resultados obtenidos objetivan el estado del sustrato óseo de cara a la planificación y seguimiento de la colocación de implantes dentales

Background and objective: There is a lack of quantitative measures of the quality of alveolar trabecular bone, an important factor in implantology. This study aimed to develop a method of objectively assessing the quality of trabecular bone by means of image processing and structural analysis of multidetector computed tomography images and to establish differences between tooth types and tooth presence/absence. Materials and methods: We analyzed 20 patients who underwent multidetector computed tomography to evaluate mandibular bone and tooth positioning. Image analysis included automatic segmentation of the mandible, obtainment of sections perpendicular to the dental arch, and structural analysis of the trabecular bone in each section. We calculated the ratio between the volume of bone and the total volume of the section, the thickness, the trabecular number, and the mean attenuation in Hounsfield units. We analyzed the differences among different tooth types (incisors, canines, premolars, and molars) and between present and absent teeth. Results: We found statistically significant differences between different tooth types and between sections in which teeth were present or absent. Incisors had a greater ratio of trabecular bone; the ratio of trabecular bone progressively decreased from the incisors to the canines, premolars, and molars. The ratio of trabecular bone was greater in sections in which teeth were absent than in those in which teeth were present. Conclusions: The method allows to quantify the structural properties of alveolar bone from multidetector computed tomography images. Our results provide an objective picture of the bone substrate that can be useful for planning and following up dental implant procedures

Quantitative structural analysis of trabecular alveolar bone in the mandible by multidetector computed tomography: differences according to tooth presence and type. / Análisis estructural cuantitativo del hueso alveolar trabecular de la mandíbula en tomografía computarizada multidetector: diferencias por tipo y estado dentario.

BACKGROUND AND OBJECTIVE: There is a lack of quantitative measures of the quality of alveolar trabecular bone, an important factor in implantology. This study aimed to develop a method of objectively assessing the quality of trabecular bone by means of image processing and structural analysis of multidetector computed tomography images and to establish differences between tooth types and tooth presence/absence. MATERIALS AND METHODS: We analyzed 20 patients who underwent multidetector computed tomography to evaluate mandibular bone and tooth positioning. Image analysis included automatic segmentation of the mandible, obtainment of sections perpendicular to the dental arch, and structural analysis of the trabecular bone in each section. We calculated the ratio between the volume of bone and the total volume of the section, the thickness, the trabecular number, and the mean attenuation in Hounsfield units. We analyzed the differences among different tooth types (incisors, canines, premolars, and molars) and between present and absent teeth. RESULTS: We found statistically significant differences between different tooth types and between sections in which teeth were present or absent. Incisors had a greater ratio of trabecular bone; the ratio of trabecular bone progressively decreased from the incisors to the canines, premolars, and molars. The ratio of trabecular bone was greater in sections in which teeth were absent than in those in which teeth were present. CONCLUSIONS: The method allows to quantify the structural properties of alveolar bone from multidetector computed tomography images. Our results provide an objective picture of the bone substrate that can be useful for planning and following up dental implant procedures.

Reproducibilidad y exactitud en la cuantificación morfométrica y mecánica del hueso trabecular a partir de imágenes de resonancia magnética de Tesla / Reproducibility and accuracy in the morphometric and mechanical quantification of trabecular bone from 3 Tesla magnetic resonance images

Objetivo. En este trabajo se analizan en un modelo animal la reproducibilidad y la exactitud de ciertos biomarcadores de imagen de calidad ósea utilizando como patrón de referencia la microtomografía computarizada (mTC). Material y métodos. Se estudiaron con RM y mTC 5 metáfisis tibiales de oveja. Las imágenes de RM (3 Tesla) se adquirieron con una secuencia eco de gradiente potenciada en T1 y una resolución espacial isotrópica de 180 mm. Las imágenes de mTC se adquirieron en un escáner con una resolución espacial de 7,5 mm en vóxeles isotrópicos. En la preparación de las imágenes se aplicaron algoritmos de ecualización, interpolación y umbralización. En el análisis cuantitativo se calculó el porcentaje de volumen de hueso (BV/TV), el grosor trabecular (Tb.Th), la separación trabecular (Tb.Sp), el índice trabecular (Tb.N), la dimensión fractal en 2 D (D2D) y 3 D (D3D) y el módulo elástico en las 3 direcciones del espacio (Ex, Ey y Ez). Resultados. La cuantificación morfométrica y mecánica del hueso esponjoso con la RM fue muy reproducible, con porcentajes de variación por debajo del 9% para todos los parámetros. Su exactitud con respecto a la mTC fue alta, con errores inferiores al 15% para BV/TV, D2D, D3D y Eappx, Eappy y Eappz. Conclusiones. Los resultados experimentales en animales confirman que los parámetros de BV/TV, D2D, D3D y Eappx, Eappy y Eappz obtenidos a partir de RM tienen una excelente reproducibilidad y precisión, y pueden emplearse como biomarcadores de imagen de la calidad del hueso trabecular (AU)

Objective: We used an animal model to analyze the reproducibility and accuracy of certain biomarkers of bone image quality in comparison to a gold standard of computed microtomography (mCT). Material and methods: We used magnetic resonance (MR) imaging and mCT to study the metaphyses of 5 sheep tibiae. The MR images (3 Teslas) were acquired with a T1-weighted gradient echo sequence and an isotropic spatial resolution of 180 mm. The mCT images were acquired using a scanner with a spatial resolution of 7.5 mm isotropic voxels. In the preparation of the images, we applied equalization, interpolation, and thresholding algorithms. In the quantitative analysis, we calculated the percentage of bone volume (BV/TV), the trabecular thickness (Tb.Th), the trabecular separation (Tb.Sp), the trabecular index (Tb.N), the 2 D fractal dimension (D2D), the 3 D fractal dimension (D3D), and the elastic module in the three spatial directions (Ex, Ey and Ez). Results: The morphometric and mechanical quantification of trabecular bone by MR was very reproducible, with percentages of variation below 9% for all the parameters. Its accuracy compared to the gold standard (mCT) was high, with errors less than 15% for BV/TV, D2D, D3D, and Eappx, Eappy and Eappz. Conclusions: Our experimental results in animals confirm that the parameters of BV/TV, D2D, D3D, and Eappx, Eappy and Eappz obtained by MR have excellent reproducibility and accuracy and can be used as imaging biomarkers for the quality of trabecular bone (AU)

[Reproducibility and accuracy in the morphometric and mechanical quantification of trabecular bone from 3 Tesla magnetic resonance images]. / Reproducibilidad y exactitud en la cuantificación morfométrica y mecánica del hueso trabecular a partir de imágenes de resonancia magnética de Tesla.

OBJECTIVE: We used an animal model to analyze the reproducibility and accuracy of certain biomarkers of bone image quality in comparison to a gold standard of computed microtomography (µCT). MATERIAL AND METHODS: We used magnetic resonance (MR) imaging and µCT to study the metaphyses of 5 sheep tibiae. The MR images (3 Teslas) were acquired with a T1-weighted gradient echo sequence and an isotropic spatial resolution of 180µm. The µCT images were acquired using a scanner with a spatial resolution of 7.5µm isotropic voxels. In the preparation of the images, we applied equalization, interpolation, and thresholding algorithms. In the quantitative analysis, we calculated the percentage of bone volume (BV/TV), the trabecular thickness (Tb.Th), the trabecular separation (Tb.Sp), the trabecular index (Tb.N), the 2D fractal dimension (D(2D)), the 3D fractal dimension (D(3D)), and the elastic module in the three spatial directions (Ex, Ey and Ez). RESULTS: The morphometric and mechanical quantification of trabecular bone by MR was very reproducible, with percentages of variation below 9% for all the parameters. Its accuracy compared to the gold standard (µCT) was high, with errors less than 15% for BV/TV, D(2D), D(3D), and E(app)x, E(app)y and E(app)z. CONCLUSIONS: Our experimental results in animals confirm that the parameters of BV/TV, D(2D), D(3D), and E(app)x, E(app)y and E(app)z obtained by MR have excellent reproducibility and accuracy and can be used as imaging biomarkers for the quality of trabecular bone.