Development of Semi-Automated Image-Based Analysis Tool for CBCT Evaluation of Alveolar Ridge Changes After Tooth Extraction

Following tooth extraction, the bone structure is prone to atrophic changes. Alveolar ridge resorption can compromise subsequent implant treatment not only at the extraction site itself but also by affecting the bone support of adjacent teeth. Various techniques, including the use of bone graft materials or autologous blood concentrates for ridge or socket preservation, aim to counteract this process. The efficacy of such methods can be evaluated non-invasively through radiological analysis of the treated region. However, existing radiological evaluation methods often focus only on isolated areas of the extraction socket, limiting their accuracy in assessing overall bone regeneration. This study introduces a novel, non-invasive, and semi-automated image-based analysis method that enables a more comprehensive evaluation of bone preservation using CBCT data. Developed with the open-source software "Fiji" (v2.15.0; based on ImageJ), the approach assesses bone changes at multiple horizontal and vertical positions, creating a near three-dimensional representation of the resorptive process. By analyzing the entire region around the extraction socket rather than selected regions, this method provides a more precise and reproducible assessment of alveolar ridge preservation. Although the approach requires some processing time and focuses exclusively on radiological evaluation, it offers greater accuracy than conventional methods. Its standardized and objective nature makes it a valuable tool for clinical research, facilitating more reliable comparisons of different socket preservation strategies.