Introduction. Making a dental implant means to put a hollow screw with a tooth on top in the dental alveolus that often is completely necrotic. Osteointegration and the quantity and quality of bone available in the site of implant is a crucial step for the stability of the protesis and the success of the rehabilitation. The aim of the study was to evaluate 24 biopsy from the dental alveolus of 20 patients who underwent “Guided Bone Regeneration” procedure with biocompatible material (heterologous bone powder or synthetic powder) 6 months following the treatment in order to determine the percentage of mature bone. All the specimens were first analyzed by an expert pathologist and then by an automatic procedure in order to determine an accurate cut off value which could predict the implant success. Material and methods. We used a digital microscope (Olympus “slide Digital virtual microscopy”) with a proper software (“dot slide” software) to scan all the specimens at 10X magnification to obtain VSI (Virtual Slide Image) files. On scanned images the percentage of integrated bone was determined by two different procedures: A) we captured all images from dot slide’s VSI files and measured the areas of each specimen by manual drawing using “dot slide” instrument from the menu bar. It took about one hour and half for each biopsy; B) we captured the images from VSI files in the same way but we converted VSI files in Jpg. These images were analyzed using another software called “Image-Pro Plus” by Media Cybernetics with a settings for automatic recognition and measurements of selected areas. With this approach we could evaluate the percentage of mature bone for each biopsy in 10 minutes, and no special expertise was required. Several stains such as Trichrome and Von Kossa were tested to give the best colour contrast between the different areas, but Hemathoxilin and eosin gave the best result. Results. The percentages of mature bone recognized using the different approaches were similar and almost overlapping with those reported by the expert pathologist, with a variability of 5-10%. Inflammation, granulation tissue and presence of osteoblasts/osteoclasts at the periphery of the mature bone could play an additional important role on the implant success and should be described. Conclusions. Determining an exact cut off level of regenerated vs. necrotic bone with rapid and automated procedure would be important not only for objectively predicting the implant success but also for testing different materials to be used in pre-implant therapy.
Automated evaluation of mature bone component in alveolar biopsies following pre-implant guided bone regeneration procedure
ASIOLI, SOFIA;
2007
Abstract
Introduction. Making a dental implant means to put a hollow screw with a tooth on top in the dental alveolus that often is completely necrotic. Osteointegration and the quantity and quality of bone available in the site of implant is a crucial step for the stability of the protesis and the success of the rehabilitation. The aim of the study was to evaluate 24 biopsy from the dental alveolus of 20 patients who underwent “Guided Bone Regeneration” procedure with biocompatible material (heterologous bone powder or synthetic powder) 6 months following the treatment in order to determine the percentage of mature bone. All the specimens were first analyzed by an expert pathologist and then by an automatic procedure in order to determine an accurate cut off value which could predict the implant success. Material and methods. We used a digital microscope (Olympus “slide Digital virtual microscopy”) with a proper software (“dot slide” software) to scan all the specimens at 10X magnification to obtain VSI (Virtual Slide Image) files. On scanned images the percentage of integrated bone was determined by two different procedures: A) we captured all images from dot slide’s VSI files and measured the areas of each specimen by manual drawing using “dot slide” instrument from the menu bar. It took about one hour and half for each biopsy; B) we captured the images from VSI files in the same way but we converted VSI files in Jpg. These images were analyzed using another software called “Image-Pro Plus” by Media Cybernetics with a settings for automatic recognition and measurements of selected areas. With this approach we could evaluate the percentage of mature bone for each biopsy in 10 minutes, and no special expertise was required. Several stains such as Trichrome and Von Kossa were tested to give the best colour contrast between the different areas, but Hemathoxilin and eosin gave the best result. Results. The percentages of mature bone recognized using the different approaches were similar and almost overlapping with those reported by the expert pathologist, with a variability of 5-10%. Inflammation, granulation tissue and presence of osteoblasts/osteoclasts at the periphery of the mature bone could play an additional important role on the implant success and should be described. Conclusions. Determining an exact cut off level of regenerated vs. necrotic bone with rapid and automated procedure would be important not only for objectively predicting the implant success but also for testing different materials to be used in pre-implant therapy.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
