A method, Digitized Image Ratio (DIR), has been designed in order to evaluate and quantify bone mass, using standardized, superimposable, digitized dental radiographs (Jean A. et al. submitted). DIR has been used: to supplement clinical results in a clinical trial testing the efficiency of a bone graft substitute, Natural Coral Skeleton (NCS) and to evaluate the usefulness of such a radiographic method in periodontal clinical studies. Standardized radiographs were taken at day 0 and 12 months post-operatively. The protocole consisted in treating infrabony periodontal defects, with NCS as bone grafting substitute, or with debridement alone as control. A total of 12 defects were evaluated. Changes in bone mass were analyzed using ratio values between T0 and T12. The mean value for each defect allowed a quantification of bone gain or bone loss. Very subtle changes, such as loss of dentin mass after root planning, were detected. Also, with DIR it was possible to show a loss of density in the apical part of the treated defects, at 12 months, even with obvious bone gain. DIR prooved to be a valuable method to supplement clinical studies involving changes in alveolar bone.

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