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

描述（由申请人提供）：26%的20岁及以上人口患有破坏性牙周病（骨高度损失> 4 mm）。牙槽骨高度与随后的牙齿脱落密切相关。此外，已经发现牙周病与其他疾病相关，例如，动脉粥样硬化和糖尿病。正确的诊断、治疗、维护和患者教育可以减少牙周病的影响，最终提高患者的生活质量。然而，对于绝大多数人来说， 美国和世界人口，牙周状况的临床评估是主观的并且通过定性手段进行，即，目视检查和使用牙周探针，很少关注 耐心教育。在第1阶段，Imagination Software Corporation（ISC）开发了一种可靠、灵敏、易于使用和快速的系统，用于测量牙槽骨高度及其变化，包括：（a）用户友好的界面，用于手动指示牙齿的牙骨质-釉质连接（CEJ）和牙顶-牙齿连接，（B）图像分析技术，以提高指示的准确性，消除仔细指示的责任，并计算沿着牙齿的远中边缘的骨高度，以及（c）确定骨高度变化的方法。在第二阶段，将开发一个原型系统，该系统将在每个患者不到一分钟的时间内进行全自动全口（64个部位）牙嵴高度分析。该系统使用作为标准牙科护理的一部分采集的数字/数字化X光片，即不需要对患者施加额外的辐射剂量，基于第1阶段开发的技术（针对单个部位），并需要在图像输入后进行用户交互。这将通过将第1阶段技术与牙齿及其编号的自动识别相结合来实现。该系统将在实验和临床环境中进行评估，利用牙医的反馈进行改进，提高软件的易用性和临床实用性。在开发过程中与产品的最终用户合作，将确保其在不影响临床工作流程的情况下增强临床实践，最终成为其实践的重要组成部分。最终产品将允许使用放射影像对所有牙齿的牙周骨状态进行简单、快速、精确和准确的评估，从而在牙周病中形成新的第一道防线。 诊断破坏性牙周病。该系统将使所有牙医能够在早期阶段检测和治疗疾病，并使他们能够更好地监测接受疾病治疗的维持性患者。当整合到牙医使用和已经熟悉的现有图像查看软件中时，ISC的系统将很容易适应实践并实现强大的市场渗透，这（加上准确，精确和可靠的数据）意味着改善数百万患者的牙科护理。 公共卫生相关性：牙槽骨高度与随后的牙齿脱落密切相关。该提案的目标是开发和实施一种自动化、可靠、灵敏、易于使用和快速的产品，用于测量每位患者每颗牙齿的牙槽骨高度及其变化。当在牙科实践中常规使用时，该系统将导致在诊断破坏性牙周病中的新的第一道防线，从而使牙医能够在早期阶段检测和治疗疾病，并提高他们监测接受治疗的患者的维护的能力。

DESCRIPTION (provided by applicant): Twenty-six percent of the population twenty years and over have destructive periodontal disease (> 4 mm loss of bone height). Alveolar bone height correlates well with subsequent tooth loss. Moreover, it has been found that periodontal disease correlates with other diseases, e.g., atherosclerosis and diabetes. Proper diagnosis, treatment, maintenance, and patient education result in the reduced effects of periodontal disease and ultimately improve the quality of life of the patient. Yet for the vast majority of the U.S. and world population, clinical assessment of periodontal status is subjective and performed by qualitative means, i.e., visual inspection and by using periodontal probes, with little focus on patient education. In Phase 1, Imagination Software Corporation (ISC) developed a reliable, sensitive, easy to use, and rapid system for measuring alveolar bone height and its change consisting of (a) a user-friendly interface for manual indication of the cemento-enamel junctions (CEJ) and crest-tooth junctions of a tooth, (b) image analysis techniques to improve the accuracy of the indications, removing the onus of careful indication, and calculate the bone height along the distal and mesial edges of a tooth, and (c) methods to determine bone height change. In Phase 2, a prototype system will be developed that will perform a fully automated full-mouth (64 sites) crest height analysis in less than one minute per patient. The system uses digital/digitized radiographs acquired as part of standard dental care are required, i.e. no additional radiation dose to the patient, is based on the technology developed in Phase 1 (for a single site), and requires user interaction after image input. This will be achieved by coupling th Phase 1 technology with automated identification of the teeth and their numbers. This system will be evaluated in experimental and clinical settings, using feedback from dentists to make enhancements and improve the ease of use and clinical utility of the software. Working with the end users of the product in its development will ensure that it will enhance the clinical practice without affecting clinical workflow, eventually becoming an essential part of their practice. The final product will allow a simple, rapid, precise, and accurate assessment of the periodontal bone status of all teeth using radiographic images, resulting in a new first line of defense in the diagnosis of destructive periodontal disease. The system will give all dentists the ability to detet and treat the disease at an earlier stage and allow them to better monitor maintenance patients receiving treatment for the disease. When incorporated into existing image viewing software that dentists use and are already familiar with, ISC's system will be adapted easily into practice and achieve a 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 an automated, reliable, sensitive, easy to use, and rapid product for the measurement of alveolar bone height and its change for every tooth in every patient. When used routinely in dental practice, this system will result in a new first line of defense in the diagnosis of destructive periodontal disease, thus giving the dentist the ability to detect and treat the disease at an earlier stage and improve thei ability to monitor maintenance in patients receiving treatment.