Reliability of Using Texture Analysis of Periapical Radiographs Obtained Using Radiovisiography for Assessing Bone Quality in Dental Implant Planning: A Cross-Sectional Study

Background Pre-prosthetic implant radiographic imaging helps in the quantitative and qualitative analysis of the bone structure and also enables the evaluation of the relationship between critical structures and potential implant sites. Purpose The aim of the study was to define the reliability of utilizing the analysis of textures from the periapical radiographic images obtained through Radiovisiography (RVG) in order to better plan for dental implantations. Methods A cross-sectional study was conducted using 50 intraoral periapical radiographs which were obtained through RVG performed prior to the placement of implants. The radiographs were segregated based on anatomical locations i.e. 12 for the anterior maxilla, nine for the posterior maxilla, seven for the anterior mandible, and 22 for the posterior mandible. Each of the radiographs was visually assessed by four experienced examiners, namely a Prosthodontist E1, Periodontist E2, Oral surgeon E3, and Oral radiologist E4, which was then compared to an experienced operator's tactile perception during a pilot drill for implant placement. As a reference, the Lekholm and Zarb classification was provided to all the examiners for them to qualitatively assess the bone structure in the radiographs. Results The examiners’ results were correlated with the assessment provided by the experienced operator. E1 and E4 successfully assessed 42% of the radiographs while E2 had the least success with only 26%. Of the 12 anterior maxillary radiographs, only eight were accurately assessed by E1. With respect to the posterior maxilla, all examiners correctly assessed four radiographs each. Of the seven anterior mandibular radiographs, except for E2, the rest correctly assessed three radiographs each. Of the 22 posterior mandibular radiographs, only nine were accurately assessed by E4. Conclusion Intraoral periapical radiographs obtained through RVG did not meet the desired parameters for assessing the bone quality during the planning stage for implants.