Pilot study: digital subtraction radiography as a tool to assess alveolar bone changes in periodontitis patients under treatment with subantimicrobial doses of doxycycline

Background Subtle changes in marginal alveolar bone level can be demonstrated using digital subtraction of sequential radiographs. Objective We aimed to evaluate the practical application of geometrically corrected digital subtraction in a clinical study of alveolar bone response to a drug previously shown to inhibit alveolar bone loss. Study design Selected periapical radiographs were acquired with projective standardization of patients with clinical marginal alveolar bone loss. Subsequently, patients received a 6-month regimen of subantimicrobial doxycycline or placebo. Standardized radiographs of the same alveolar regions were acquired after 3 and 6 months, and baseline radiographs were subtracted from these images. Results Blinded digital subtraction analysis indicated various levels of marginal bone gain in 3 of the 6 patients in the experimental group, whereas in 3 of the 5 placebo patients the method showed bone loss. Conclusion These results suggest that geometrically corrected digital subtraction possibly agrees with clinical predictors of bone loss severity