Remodelling of interdental alveolar bone after periodontal flap procedures assessed by means of computer-assisted densitometric image analysis (CADIA).

The purposes of this study were to evaluate digitized images from standardized radiographs for quantitative changes in alveolar bone density following periodontal surgical procedures, and to correlate these changes to the changes in the clinical parameters P1I, GI, PD, AL. 14 crown-lengthening procedures for restorative purposes were performed in 13 patients and 15 modified Widman flaps were performed in 15 patients, providing 61 surgical interdental test sites and 61 matching controls. Standardized radiographs were obtained immediately post-operatively, and at 1 and 6 months postsurgically. Digitized images were obtained from the radiographs by means of a video camera linked to an image processor and a computer. Quantitative information regarding density changes within windows covering the interdental alveolar crest was obtained after superimposition and grey-level correction of images to be compared. The results indicated statistically significantly more density loss 4 to 6 weeks postsurgically at test sites treated by periodontal surgical procedures compared to corresponding controls. Significant differences in the remodelling activity between the patients exposed to crown lengthening procedures for restorative purposes and the periodontitis patients in the period 1 to 6 months postsurgically were evident. CADIA assessed differences in the tissue changes in the healing phase following periodontal surgical procedures, which were not detected by the clinical variables applied.