Image-based quantification of alveolar bone

Diminished alveolar bone support is the principal cause of tooth loss. This bone loss is most commonly attributed to periodontal disease. The causes of periodontal disease are not fully understood although bacteria in dental plaque are known to be major contributors. Moreover, it is thought that the incidence and prevalence of alveolar bone loss vary among human populations, hence identification of high-risk groups is essential to epidemiological studies aimed at establishing hypotheses about the etiology of alveolar bone loss. Data drawn from population surveys can then be used to test these hypotheses. Both epidemiological studies and laboratory and clinical testing have been hampered because of the lack of accurate methods for alveolar bone quantification. Recently, several non-invasive, image-based techniques, with accuracy sufficient for testing hypotheses concerning alveolar bone, have become available. The most commonly used of these methods are x-rays and dental radiographic films. We review the current methods for quantitative dental radiography, concentrating on digital techniques used in alveolar bone assessment. Although there is considerable potential to improve the imaging and quantifying of alveolar bone, current digital radiographic methods are practical for use by physical anthropologists and can provide information on bone mass variations among populations. Such information can be used to suggest and evaluate potential etiologic agents of alveolar bone loss. Moreover, these methods can be adapted to the quantitative measurement of image features (other than alveolar bone) that are of interest in anthropologic studies. © 1994 Wiley-Liss, Inc.