Impacts of X-ray beam angulation and image receptor positioning on the quantification of alveolar bone mineral density using intraoral radiographic technique.

Objectives: The purpose of this study was to evaluate the impact of X-ray beam angulation and image receptor positioning on the quantification of alveolar bone mineral density (BMD) using intraoral radiographic technique.

Methods: Intraoral radiographs were acquired from four dry mandibular bone specimens, specifically in the region between the first premolar and first molar. An imaging phosphor plate system and a DentalSCOPE alignment device were used. Standard orthoradial projections were compared with images taken at 7° mesial and distal angulations, as well as 5° upward and downward angulations. In addition, radiographs were obtained with the receptor shifted anteriorly from the standard position by 2 mm, 4 mm, 6 mm, and 8 mm. BMD was measured in the alveolar septum between the mandibular second premolar and first molar using a DentalSCOPE image processing program. Statistical analyses were conducted to assess the impacts of projection angle and receptor positioning.

Results: BMD values obtained from mesiodistal and vertical oblique projections were significantly higher than those from the orthoradial view. However, no statistically significant differences were found between mesial and distal or between upward and downward projections. Variations in receptor positioning up to 8 mm anteriorly did not result in significant changes in BMD values.

Conclusions: Oblique radiographic projections tend to overestimate alveolar bone BMD compared to orthoradial projections. Orthoradial imaging provides reliable and reproducible quantitative BMD assessments when using computer-assisted analysis, highlighting its suitability for clinical and research applications.