Radiographic Assessment of Normal Periapical Bone Density: A Descriptive Analysis Based on Digital Imaging
TL;DR
Findings support baseline assessment and suggest further validation with 3D imaging in periapical bone density, which was higher in males, older adults, and the mandible compared to the maxilla.
Abstract
Introduction Accurate evaluation of alveolar bone density is essential for dental diagnosis and treatment planning. Panoramic radiographs offer relative estimates of bone density. Due to limited data in Iranian populations, this study assessed the radiographic density of normal periapical bone using panoramic imaging. Materials and Methods This descriptive cross‐sectional study analyzed digital panoramic radiographs at three anatomical regions—anterior, premolar, and molar—in both jaws. A standardized 1.5 mm × 1.5 mm region of interest (ROI) was positioned within 2 mm of the apical third of each tooth. Bone density was quantified as gray values (arbitrary units [AU]) using Digora software. Demographic data were collected, and statistical comparisons between groups were performed using independent t‐tests and one‐way ANOVA at a significance level of α = 0.05. Results In 458 panoramic radiographs (212 males, 246 females; ages 20–50), bone density was significantly higher in males, older individuals (35–50), and the mandible compared to the maxilla. Density decreased from anterior to molar regions. The anterior mandible showed the highest values, with notable differences from the anterior maxilla, while premolar and molar regions showed no significant interjaw differences. Conclusion Panoramic radiographs revealed consistent patterns in periapical bone density. Density was higher in males, older adults, and the mandible compared to the maxilla. The anterior mandible showed the highest values overall. In the maxilla, bone density increased from anterior to posterior regions. These findings support baseline assessment and suggest further validation with 3D imaging.