Ultrasonography for chairside evaluation of periodontal structures: A pilot study

Mustafa Tattan; Khaled Sinjab; Eunjee Lee; Michelle Arnett; Tae-Ju Oh; Hom-Lay Wang; Hsun-Liang Chan; Oliver D Kripfgans

doi:10.1002/JPER.19-0342

Ultrasonography for chairside evaluation of periodontal structures: A pilot study

J Periodontol. 2020 Jul;91(7):890-899. doi: 10.1002/JPER.19-0342. Epub 2020 Jan 8.

Authors

Mustafa Tattan¹, Khaled Sinjab², Eunjee Lee³, Michelle Arnett⁴, Tae-Ju Oh², Hom-Lay Wang², Hsun-Liang Chan², Oliver D Kripfgans^{5

6}

Affiliations

¹ Department of Periodontics and Iowa Institute for Oral Health Research, University of Iowa College of Dentistry, Iowa City, IA, USA.
² Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.
³ Department of Information and Statistics, Chungnam National University, Daejoen, South Korea.
⁴ Department of Primary Dental Care, Division of Dental Hygiene, University of Minnesota, Minneapolis, MN, USA.
⁵ Department of Radiology, University of Michigan Medical School, Ann Arbor, MI, USA.
⁶ Department of Biomedical Engineering, College of Engineering, Ann Arbor, MI, USA.

PMID: 31837020
DOI: 10.1002/JPER.19-0342

Abstract

Background: The crestal bone level and soft tissue dimension are essential for periodontal diagnosis and phenotype determination; yet, existing measurement methods have limitations. The aim of this clinical study was to evaluate the correlation and accuracy of ultrasound in measuring periodontal dimensions, compared to direct clinical and cone-beam computed tomography (CBCT) methods.

Methods: A 24-MHz ultrasound probe prototype, specifically designed for intraoral use, was employed. Periodontal soft tissue dimensions and crestal bone levels were measured at 40 teeth and 20 single missing tooth gaps from 20 patients scheduled to receive a dental implant surgery. The ultrasound images were interpreted by two calibrated examiners. Inter-rater agreement was calculated by using inter-rater correlation coefficient (ICC). Ultrasound readings were compared with direct clinical and CBCT readings by using ICC and Bland-Altman analysis.

Results: The following six parameters were measured: 1) interdental papilla height (tooth), 2) mid-facial soft tissue height (tooth), 3) mucosal thickness (tooth), 4) soft tissue height (edentulous ridge), 5) mucosal thickness (edentulous ridge), and 6) crestal bone level (tooth). Intra-examiner calibrations were exercised to achieve an agreement of at least 0.8. ICC between the two readers ranged from 0.482 to 0.881. ICC between ultrasound and direct readings ranged from 0.667 to 0.957. The mean difference in mucosal thickness (tooth) between the ultrasound and direct readings was -0.015 mm (95% CI: -0.655 to 0.624 mm) without statistical significance. ICC between ultrasound and CBCT ranged from 0.654 to 0.849 among the measured parameters. The mean differences between ultrasound and CBCT range from -0.213 to 0.455 mm, without statistical significance.

Conclusion: Ultrasonic imaging can be valuable for accurate and real-time periodontal diagnosis without concerns about ionizing radiation.

Keywords: alveolar ridge, bone; cone-beam computed tomography, dental implants, periodontium, ultrasonography.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Cone-Beam Computed Tomography
Humans
Pilot Projects
Tooth Diseases*
Tooth* / diagnostic imaging
Ultrasonography

Grants and funding

UL1TR000433/Michigan Institute for Clinical and Health Research/International