Computer‐Assisted Densitometric Image Analysis of Digital Subtraction Images: In Vivo Error of the Method and Effect of Thresholding

The aim of the present study was to assess the in vivo error of the method as well as the effect of thresholding when obtaining and evaluating standardized periapical radiographs for computer-assisted densitometric image analysis (CADIA). Twenty healthy volunteers participated in an experimental gingivitis study in which neither mechanical nor chemical plaque control was performed for 21 days. Two pairs of standardized periapical radiographs were taken at days 0 (baseline) and 21 (follow-up), one from a maxillary area (15 volunteers) and one from a mandibular molar/premolar area (17 volunteers). Each baseline radiograph was digitized and its image displayed on a monitor. The follow-up radiograph was then superimposed and digitized as well. After gray level correction, subtraction radiographic images were produced. The difference in gray level between the baseline and the follow-up image was calculated within each region of interest (ROI) at each picture point (pixel). In bone ROI, changes in density refle...