The contribution of image processing in the evaluation of guided bone regeneration

Abstract

One of the most ambitious goals of modern bone surgery is to predict the shape of the bone defect, monitor the progress of bone regeneration, and assess the quantity and quality of newly formed bone. Calcium phosphate biomaterials such as hydroxyapatite and tricalcium phosphate are commonly used as bone substitutes in maxillofacial and dental surgery. The objective of this work is to use cone-beam computed tomography (CBCT) and image processing to assess the spatial (architectural) layout, rate of bone generation and osseointegration of implanted commercial granules (PAH 40%, β-TCP 60%, size 0.5 to 1 mm) in the bone defect generated after tooth extraction. CBCT measurements were performed at 48 hours and 12 months. The analysis of 3D images and the application of appropriate morphological mathematical operations allowed us to evaluate the volume of the cavity to be filled, the volume occupied by the granules and the volume of porosity generated by the random stacking of the granules. The result shows that the bone generation rate reaches a value of 89% after one year of implantation. This study shows that by using 3D image processing techniques CBCT, the same results as classical anatomical and histological studies can be obtained.