LAUSR

Objectives The aim of this study is to propose a method that automatically select the trabecular bone area in digital periapical radiographic images using a sequence of morphological operations. Methods The study involved 50 digital periapical radiographic images of women aged from 36 to 58 years old. The proposed method consists of three stages: teeth detection, trabecular identification, and validation. A series of morphological operations—top-hat and bottom-hat filtering, automatic thresholding, closing, labeling, global thresholding, and image subtraction—are performed to automatically obtain the trabecular bone area in images. For validation, the results of the proposed method were compared with those of two dentists pixel by pixel. Three parameters were used in the validation: trabecular area, percentage of agreed area, and percentage of disagreed area. Results The proposed method obtains the trabecular bone area in a polygon. The obtained trabecular bone area is usually larger than that of previous studies, but is usually smaller than the dentists'. On average over all images, the trabecular area produced by the proposed method is 5.83% smaller than that identified by dentists. Furthermore, the average percentage of agreed area and the average percentage of disagreed area of the proposed method against the dentists' results were 75.22% and 8.75%, respectively. Conclusions The shape of the trabecular bone area produced by the proposed method is similar and closer to that identified by dentists. The method, which consists of only simple morphological operations on digital periapical radiographic images, can be considered for selecting the trabecular bone area automatically.