Clinical System for Measurement of Oral Crest Height Change in Dental Radiographs

描述（申请人提供）：牙槽骨高度与随后的牙齿脱落密切相关。在研究环境中，人工测量的骨高度从数字化图像的射线已经显示精度约0.5毫米，可以进一步提高通过使用图像处理和配准技术。基于这些数据，我们相信可以通过牙科x光片可靠地测量骨骼高度的变化，如果这些测量结果被带到牙科诊所，牙科护理将会得到改善。但是，这些技术的翻译将需要一个“系统”，它非常适合牙科诊所的正常工作流程。本提案的目标是开发和实施一种可靠、敏感、易于使用、快速测量牙槽骨高度变化的系统，该系统将在全科医生办公室被接受和期望。简单地说，我们的目标是开发全科医生想要的系统，并将其视为患者护理能力的重要组成部分。为了实现这一目标，我们正在提出创新的方法来解决阻碍口腔x光片中牙冠高度测量转化为一般牙科实践的问题。(1)对于单张x线片，我们将使用手动指示牙骨质-牙釉质连接（CEJ）和牙冠连接，但我们将使用图像分析来改进和提高这些指示的准确性，从而也消除了仔细放置点的负担。(2)当比较两张或多张x线片以评估骨高度变化时，(a)我们将自动记录x线片上的CEJ和牙冠连接，以进一步提高测量变化的准确性；(b)我们将自动确定和纠正颌骨角度。(3)我们将把这些技术打包成一个简单、易用、快速的图形用户界面。我们的最终目标（在2期完成后）是基于1期开发的方法（针对单个部位）在每位患者不到一分钟的时间内完成自动全口（64个部位）分析。过去所有测量骨高的方法都不够简单、准确和快速，不能用于牙科诊所；我们建议的产品符合这些标准。这个完整的系统，在第一阶段进行原型设计，在第二阶段完成，将为全科医生提供一种简单快速的方法来评估每个患者，每个部位的骨高度变化。因此，破坏性牙周病的诊断将不会对正常的临床工作流程或患者舒适度产生负面影响。该系统将在诊断和治疗破坏性牙周病方面形成新的第一道防线，使全科医生能够在早期阶段发现和治疗疾病。因此，我们希望我们的系统能够很容易地应用到牙科实践中，并实现强大的市场渗透，这（加上准确、精确和可靠的数据）意味着为数百万患者提供更好的牙科护理。

DESCRIPTION (provided by applicant): Alveolar bone height correlates well with subsequent tooth loss. In research settings, manual measurements of bone height from digitized images of radiographs have shown a precision of about 0.5 mm which can be improved further by using image processing and registration techniques. Based on these data, we believe that bone height change can be measured reliably from dental radiographs and that dental care would improve if these measurements were brought into the dental office. But translation of these techniques will require a "system" which is well-suited to the normal work flow of the dental office. The goal of this proposal is the development and implementation of a reliable, sensitive, easy to use, rapid system for measurement of alveolar bone height change which will be accepted and desired in the general practitioner's office. Simply stated, our goal is to develop the system that general practitioners will want and that they will view as an essential part of their patient care capabilities. To achieve this goal, we are proposing innovative approaches to address issues which have obstructed translation of crest height measurements in oral radiographs into general dental practice. (1) For single radiographs, we will use manual indication of the cemento-enamel junction (CEJ) and crest-tooth junction, but we will use image analysis to refine and improve the accuracy of these indications, thereby also removing the onus of careful placement of points. (2) When two or more radiographs are compared for assessment of bone height change, (a) we will automatically register the CEJ and crest-tooth junctions in the radiographs to further improve the accuracy of the change measurements and (b) we will automatically determine and correct for jaw angulation. (3) We will package these techniques in a simple, easy to use, and quick graphical user interface. Our ultimate goal (after completion of Phase 2) is to perform automated full-mouth (64 sites) analysis based on the methodology developed in Phase 1 (for a single site) in less than one minute per patient. All past methods for measuring bone height are not simple, accurate, and rapid enough for use in the dental office; our proposed product meets these criteria. This complete system, prototyped in Phase 1 and completed in Phase 2, will provide the general practitioner with the means to assess bone height change for every patient, for each site, in an easy and rapid manner. As a result, diagnosis of destructive periodontal disease will be available without negative effects on normal clinical work flow or patient comfort. This system will result in a new first line of defense in the diagnosis and treatment of destructive periodontal disease, giving the general practitioner the ability to detect and treat the disease at an earlier stage. Thus, we expect our system to be adapted easily into dental practice and achieve strong market penetration, which (coupled with accurate, precise, and reliable data) means improved dental care for millions of patients. PUBLIC HEALTH RELEVANCE: Alveolar bone height correlates well with subsequent tooth loss. The goal of this proposal is the development and implementation of a reliable, sensitive, easy to use, rapid system for measurement of alveolar bone height change for the general practitioner's office. This system will consist of methods for measurement of crest height in single images, measurement of crest height change in two or more images, and a simple, easy to use, software interface. This complete system will provide the general practitioner with the means to assess bone height change for every patient, for each site, in a rapid manner. This system will result in a new first line of defense in the diagnosis of periodontal disease and its activity that has the ability to monitor all patients who visit the dental office, thus giving the general practitioner the ability to detect and treat the disease at an earlier stage.