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Mascardo KC, Tomack J, Chen CY, Mancini L, Kim DM, Friedland B, Barootchi S, Tavelli L. Risk indicators for gingival recession in the esthetic zone: A cross-sectional clinical, tomographic, and ultrasonographic study. J Periodontol 2024; 95:432-443. [PMID: 38196327 DOI: 10.1002/jper.23-0357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 12/09/2023] [Accepted: 12/13/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND To evaluate the risk indicators associated with midfacial gingival recessions (GR) in the natural dentition esthetic regions. METHODS Cone-beam computed tomography (CBCT) results of thirty-seven subjects presenting with 268 eligible teeth were included in the cross-sectional study. Clinical measurements included presence/absence of midfacial GR; the depth of the midfacial, mesial, and distal gingival recession; the recession type (RT); keratinized tissue width (KT); and attached gingiva width (AG). Questionnaires were utilized to capture patient-reported esthetics and dental hypersensitivity for each study tooth. Buccal bone dehiscence (cBBD) and buccal bone thickness (cBBT) were measured on the CBCT scans. High-frequency ultrasonography was performed to assess gingival thickness (GT) and buccal bone dehiscence (uBBD). Intraoral optical scanning was obtained to quantify the buccolingual position of each study site (3D profile analysis). Multilevel logistic regression analyses with generalized estimation equations were performed to assess the factors associated with the conditions of interest. RESULTS The presence of midfacial GR was significantly associated with the history of periodontal treatment for pocket reduction (OR 7.99, p = 0.006), KT (OR 0.62, p < 0.001), cBBD (OR 2.30, p = 0.015), GT 1.5 mm from the gingival margin (OR 0.18, p = 0.04) and 3D profile 1 mm from the gingival margin (OR 1.04, p = 0.001). The depth of midfacial GR was significantly correlated to previous history of periodontal treatment (OR 0.96, p = 0.001), KT (OR -0.18, p < 0.001), presence of bone fenestration (OR 0.24, p = 0.044), and cBBD (OR 0.43, p < 0.001). The depth of midfacial GR was also the only factor associated with patient-reported esthetics (OR -3.38, p = 0.022), while KT (OR 0.77, p = 0.018) and AG (OR 0.82, p = 0.047) were significantly correlated with patient-reported dental hypersensitivity. CONCLUSIONS Several risk indicators of midfacial and interproximal GR in the esthetic region were identified. The use of imaging technologies allowed for detection of parameters associated with the conditions of interest, and, therefore, their incorporation in future clinical studies is advocated. Ultrasonography could be preferred over CBCT for a noninvasive assessment of periodontal phenotype.
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Affiliation(s)
- Kathleen Chloe Mascardo
- Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Justin Tomack
- Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Chia-Yu Chen
- Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Leonardo Mancini
- Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - David M Kim
- Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Bernard Friedland
- Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Shayan Barootchi
- Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Lorenzo Tavelli
- Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
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Galarraga-Vinueza ME, Barootchi S, Nevins ML, Nevins M, Miron RJ, Tavelli L. Twenty-five years of recombinant human growth factors rhPDGF-BB and rhBMP-2 in oral hard and soft tissue regeneration. Periodontol 2000 2024; 94:483-509. [PMID: 37681552 DOI: 10.1111/prd.12522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 08/19/2023] [Accepted: 08/21/2023] [Indexed: 09/09/2023]
Abstract
Contemporary oral tissue engineering strategies involve recombinant human growth factor approaches to stimulate diverse cellular processes including cell differentiation, migration, recruitment, and proliferation at grafted areas. Recombinant human growth factor applications in oral hard and soft tissue regeneration have been progressively researched over the last 25 years. Growth factor-mediated surgical approaches aim to accelerate healing, tissue reconstruction, and patient recovery. Thus, regenerative approaches involving growth factors such as recombinant human platelet-derived growth factor-BB (rhPDGF-BB) and recombinant human bone morphogenetic proteins (rhBMPs) have shown certain advantages over invasive traditional surgical approaches in severe hard and soft tissue defects. Several clinical studies assessed the outcomes of rhBMP-2 in diverse clinical applications for implant site development and bone augmentation. Current evidence regarding the clinical benefits of rhBMP-2 compared to conventional therapies is inconclusive. Nevertheless, it seems that rhBMP-2 can promote faster wound healing processes and enhance de novo bone formation, which may be particularly favorable in patients with compromised bone healing capacity or limited donor sites. rhPDGF-BB has been extensively applied for periodontal regenerative procedures and for the treatment of gingival recessions, showing consistent and positive outcomes. Nevertheless, current evidence regarding its benefits at implant and edentulous sites is limited. The present review explores and depicts the current applications, outcomes, and evidence-based clinical recommendations of rhPDGF-BB and rhBMPs for oral tissue regeneration.
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Affiliation(s)
- Maria Elisa Galarraga-Vinueza
- Tufts University School of Dental Medicine, Boston, Massachusetts, USA
- School of Dentistry, Universidad de las Américas (UDLA), Quito, Ecuador
| | - Shayan Barootchi
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA
| | - Marc L Nevins
- Division of Periodontology, Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Myron Nevins
- Division of Periodontology, Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Lorenzo Tavelli
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA
- Division of Periodontology, Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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Rodriguez Betancourt A, Samal A, Chan HL, Kripfgans OD. Overview of Ultrasound in Dentistry for Advancing Research Methodology and Patient Care Quality with Emphasis on Periodontal/Peri-implant Applications. Z Med Phys 2023; 33:336-386. [PMID: 36922293 PMCID: PMC10517409 DOI: 10.1016/j.zemedi.2023.01.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 12/20/2022] [Accepted: 01/11/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND Ultrasound is a non-invasive, cross-sectional imaging technique emerging in dentistry. It is an adjunct tool for diagnosing pathologies in the oral cavity that overcomes some limitations of current methodologies, including direct clinical examination, 2D radiographs, and cone beam computerized tomography. Increasing demand for soft tissue imaging has led to continuous improvements on transducer miniaturization and spatial resolution. The aims of this study are (1) to create a comprehensive overview of the current literature of ultrasonic imaging relating to dentistry, and (2) to provide a view onto investigations with immediate, intermediate, and long-term impact in periodontology and implantology. METHODS A rapid literature review was performed using two broad searches conducted in the PubMed database, yielding 576 and 757 citations, respectively. A rating was established within a citation software (EndNote) using a 5-star classification. The broad search with 757 citations allowed for high sensitivity whereas the subsequent rating added specificity. RESULTS A critical review of the clinical applications of ultrasound in dentistry was provided with a focus on applications in periodontology and implantology. The role of ultrasound as a developing dental diagnostic tool was reviewed. Specific uses such as soft and hard tissue imaging, longitudinal monitoring, as well as anatomic and physiological evaluation were discussed. CONCLUSIONS Future efforts should be directed towards the transition of ultrasonography from a research tool to a clinical tool. Moreover, a dedicated effort is needed to introduce ultrasonic imaging to dental education and the dental community to ultimately improve the quality of patient care.
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Affiliation(s)
| | - Ankita Samal
- Department of Radiology, Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Hsun-Liang Chan
- Department of Periodontology and Oral Medicine, Dental School, University of Michigan, Ann Arbor, MI, USA
| | - Oliver D Kripfgans
- Department of Radiology, Medical School, University of Michigan, Ann Arbor, MI, USA
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Tavelli L, Majzoub J, Kauffmann F, Rodriguez MV, Mancini L, Chan HL, Kripfgans OD, Giannobile WV, Wang HL, Barootchi S. Coronally advanced flap versus tunnel technique for the treatment of peri-implant soft tissue dehiscences with the connective tissue graft: A randomized, controlled clinical trial. J Clin Periodontol 2023; 50:980-995. [PMID: 36935199 DOI: 10.1111/jcpe.13806] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 02/27/2023] [Accepted: 03/10/2023] [Indexed: 03/21/2023]
Abstract
AIM To evaluate the efficacy of coronally advanced flap (CAF) versus tunnel technique (TUN) in covering isolated mid-facial peri-implant soft tissue dehiscences (PSTDs). MATERIALS AND METHODS Twenty-eight participants presenting with isolated non-molar implants exhibiting PSTDs were enrolled and randomized to receive either CAF or TUN, both with a connective tissue graft (CTG). The primary outcome of the study was the percentage of mean PSTD coverage at 12 months. Secondary endpoints included the frequency of complete PSTD coverage, changes in keratinized mucosa width (KMW) and horizontal mucosal thickness (MT), as assessed with transgingival probing, 3D optical scanning and ultrasonography, professional aesthetic evaluation and patient-reported outcome measures (PROMs). RESULTS At 12 months, the mean PSTD coverage of the CAF and TUN groups was 90.23% and 59.76%, respectively (p = .03). CAF-treated sites showed a substantially higher frequency of complete PSTD coverage (p = .07), together with significantly greater gain of KMW (p = .01), increase in MT (p = .02), volumetric gain (p < .01) and professional aesthetic outcomes (p = .01). Both interventions showed an improvement in patient-reported aesthetics and a reduction of the anxiety related to the appearance of the implant compared to baseline, with the CAF group obtaining significantly higher scores (p = .03 for both PROMs). CONCLUSIONS CAF + CTG resulted in superior PSTD coverage outcomes, greater gain in KMW and MT, and better PROMs than TUN + CTG for the treatment of isolated PSTDs (ClinicalTrials.gov NCT03498911).
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Affiliation(s)
- Lorenzo Tavelli
- Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA
| | - Jad Majzoub
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Frederic Kauffmann
- Department of Periodontology, School of Dentistry, Faculty of Health, Witten, Germany
| | - Maria Vera Rodriguez
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Postgraduate Periodontics, Division of Periodontics, Columbia University College of Dental Medicine, New York City, New York, USA
| | - Leonardo Mancini
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Hsun-Liang Chan
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Oliver D Kripfgans
- Biointerfaces Institute and Department of Biomedical Engineering, College of Engineering, Ann Arbor, Michigan, USA
- Department of Radiology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - William V Giannobile
- Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Shayan Barootchi
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA
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Barootchi S, Giannobile WV, Tavelli L. PDGF-BB-enriched collagen matrix to treat multiple gingival recessions with the tunneled coronally advanced flap. Clin Adv Periodontics 2022; 12:224-232. [PMID: 35665500 DOI: 10.1002/cap.10211] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 06/01/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND With technological advancements in reconstructive periodontology, traditional protocols for the treatment of gingival recessions (GRs) can be challenged. This manuscript presents preliminary findings of a novel minimally-invasive approach for the regenerative treatment of multiple adjacent GR defects. METHODS Two healthy adults were treated as part of this study. Multiple adjacent GRs in both subjects (1 in the mandible, and 1 in the maxilla) were treated employing a tunneled coronally advanced flap (TCAF) design, with the application of a cross-linked collagen matrix (CCM) that was enriched with recombinant human platelet-derived growth factor-BB (PDGF-BB) that was also applied on the prepared root surfaces. Clinical, ultrasonographic, esthetic, and patient-reported outcomes were observed at approximately 6- and 18-month time points. RESULTS All sites healed uneventfully after the treatments. Complete root coverage was achieved and maintained throughout the follow-up observations, from 6 to 18 months. Patients reported minimal discomfort and reduction of dentinal hypersensitivity at the augmented sites. The areas augmented with CCM + PDGF-BB revealed an increased soft tissue thickness relative to baseline (pretreatment) measures, as well as reduction in the level of the facial bone dehiscences. CONCLUSION This article describes the success of two cases of a novel minimally invasive regenerative approach for the treatment of multiple adjacent GR defects by the TCAF, using a CCM loaded with PDGF-BB. This approach offers potential as a minimally-invasive method to repair multiple adjacent GRs.
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Affiliation(s)
- Shayan Barootchi
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA.,Center for clinical Research and evidence synthesis In oral TissuE RegeneratION (CRITERION), Ann Arbor, Michigan, USA.,Center for clinical Research and evidence synthesis In oral TissuE RegeneratION (CRITERION), Boston, Massachusetts, USA
| | - William V Giannobile
- Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Lorenzo Tavelli
- Center for clinical Research and evidence synthesis In oral TissuE RegeneratION (CRITERION), Ann Arbor, Michigan, USA.,Center for clinical Research and evidence synthesis In oral TissuE RegeneratION (CRITERION), Boston, Massachusetts, USA.,Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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Influence of Exposure Parameters and Implant Position in Peri-Implant Bone Assessment in CBCT Images: An In Vitro Study. J Clin Med 2022; 11:jcm11133846. [PMID: 35807131 PMCID: PMC9267359 DOI: 10.3390/jcm11133846] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/22/2022] [Accepted: 06/30/2022] [Indexed: 02/01/2023] Open
Abstract
The aim of this study was to assess the impact of dimensional distortion and its changes with modification of exposure setting parameters on the measurements of peri-implant bone margin. Ten titanium dental implants (InKone Primo, Global D, Paris, France) were placed in two prepared bovine ribs. Two bone models and an implant-with-transfer model were scanned with 3shape E4 (3shape, Copenhagen, Denmark) laboratory scanner. Cone beam computed tomography (CBCT) images of two bone models were taken with different values of voltage (60, 70, 80, 90 kV), tube current (4, 10 mA) and voxel size (200, 300 µm). All the data were superimposed using planning software, and the measurements of buccal bone thickness in two selected regions were performed both using CBCT and scan cross-sections. The mean squared error (MSE) being the squared differences between measurements was used in the accuracy assessment of the CBCT device. A one-way ANOVA revealed significant differences between voltage and MSE (p = 0.044), as well as implant position and MSE (p = 0.005). The distortions of measurements depend on bone margin thickness, and the higher the distance to measure, the higher the error. Accurate measurements of buccal bone thickness (MSE below 0.25) were achieved with voltage values of 70, 80, and 90 kV.
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Tattan M, Tattan O, Majzoub J, Salami A, Chan HL, Kripfgans OD. Three-Dimensional Ultrasound Imaging of the Jawbone for Ridge Width Determination: A Pre-clinical Ex-Vivo Porcine Study. J Dent 2022; 123:104167. [DOI: 10.1016/j.jdent.2022.104167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 04/24/2022] [Accepted: 05/17/2022] [Indexed: 10/18/2022] Open
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Ultrasound Imaging in Dentistry: A Literature Overview. J Imaging 2021; 7:jimaging7110238. [PMID: 34821869 PMCID: PMC8624259 DOI: 10.3390/jimaging7110238] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 11/07/2021] [Accepted: 11/12/2021] [Indexed: 12/26/2022] Open
Abstract
(1) Background: the frequency with which diagnostic tests are prescribed with exposure to ionizing radiation, a cause of biological damage, has been studied, and with much more attention, patients are subjected to these diagnostic tests for diagnosis and follow-up. This review aimed, given the recent developments of this technology, to evaluate the possible use of ultrasound in different branches of dentistry. The possibility of applying ionizing-radiation-free diagnostic exams in dentistry, overcoming the limits of this application, has led scientific research in this area to obtain interesting results that bode well for the future. (2) Methods: a search for articles on the application of ultrasounds in dentistry was performed using the PubMed electronic database. (3) Results: only 32 studies were included, and these clearly stated that this examination is widely usable and in great progress. (4) Conclusions: regarding the modern application techniques of this diagnostic test, it is essential to consider technological evolution as an objective to reduce the damage and side effects of necessary diagnostic tests. The use of ultrasound in dentistry can represent a valid radiation-free alternative, in certain contexts, to the other most used exams.
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Thöne-Mühling M, Kripfgans OD, Mengel R. Ultrasonography for noninvasive and real-time evaluation of peri-implant soft and hard tissue: a case series. Int J Implant Dent 2021; 7:95. [PMID: 34518926 PMCID: PMC8438098 DOI: 10.1186/s40729-021-00375-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 06/25/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The diagnosis of soft and hard tissue at dental implants will be challenging in the future, as high prevalence of mucositis and peri-implantitis were described in the population. Ultrasonography is a promising non-invasive, inexpensive, painless, and radiation-free method for imaging hard and soft tissue at implants, especially an ultrasound device with a 25-MHz probe demonstrating a high correlation between ultrasound, clinical, and radiological measurements. CASE PRESENTATION The following case series demonstrates the use of ultrasonography with high spatial resolution probe in patients with dental implants affected by soft tissue recession and/or crestal bone loss. CONCLUSION These ultrasound images can provide valuable additional information for the assessment of peri-implant soft and hard tissue.
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Affiliation(s)
- Miriam Thöne-Mühling
- Department of Prosthetic Dentistry, School of Dental Medicine, Philipps-University Marburg, Georg-Voigt Str. 3, 35039, Marburg/Lahn, Germany
| | - Oliver D Kripfgans
- Department of Radiology, BME, and Appl. Phys., University of Michigan, 3218D Med Sci I, 1301 Catherine Street, Ann Arbor, MI, 48109-5667, USA
| | - Reiner Mengel
- Department of Prosthetic Dentistry, School of Dental Medicine, Philipps-University Marburg, Georg-Voigt Str. 3, 35039, Marburg/Lahn, Germany.
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Bohner L, Hanisch M, Chilvarquer I, Kleinheinz J, Tortamano P. Assessment of Peri-implant Buccal Bone Thickness Using Digital Imaging Techniques: A Systematic Review and Meta-analysis. Open Dent J 2020. [DOI: 10.2174/1874210602014010150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objectives:
This systematic review aimed to answer the following focused question: Do the currently available imaging techniques provide accuracy in the assessment of peri-implant buccal bone thickness?
Methods:
A search strategy was conducted in eight electronic databases, followed by an additional manual search in grey literature and references of selected articles. Studies evaluating the accuracy of imaging techniques to measure peri-implant buccal bone thickness were included. Individual risk of bias was assessed by the Quality Assessment Tool for Diagnostic Accuracy Studies-2 (QUADAS-2). Meta-analysis was performed to evaluate CBCT accuracy. The overall effect size was determined by means of the Z-test. Q test was used to evaluate the homogeneity of effect sizes among studies and I2 was applied to determine the variance within studies.
Results:
After an initial screening, 83 studies were further selected for full reading and 13 of them were considered eligible for this review. In sum, the accuracy of Cone-beam Computed Tomography (CBCT), of ultrasound, and of computed tomography were assessed. There was no statistically significant difference between CBCT and the gold standard (p=0.81). The mean difference between measurements of bone thickness obtained by CBCT and the goldstandard was -0.0.3mm [95%CI -0.29;0.253mm].
Conclusion:
CBCT showed acceptable accuracy for assessing peri-implant bone. No meaningful conclusion could be drawn about other techniques.
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Marotti J, Neuhaus S, Habor D, Bohner L, Heger S, Radermacher K, Wolfart S. High-Frequency Ultrasound for Assessment of Peri-Implant Bone Thickness. J Clin Med 2019; 8:jcm8101539. [PMID: 31557872 PMCID: PMC6832403 DOI: 10.3390/jcm8101539] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 09/20/2019] [Accepted: 09/23/2019] [Indexed: 01/20/2023] Open
Abstract
Purpose: The aim of this study was to evaluate the accuracy of high-frequency ultrasound (HFUS) for measurement of bone thickness surrounding dental implants. Methods: Eight porcine bone samples containing dental implants were scanned by a HFUS scanner and compared using cone-beam computed tomography (CBCT) and an optical scanner. Bone thickness was measured in the buccolingual region of dental implants in 10 points distributed between the platform and apical portion of the implant. Results: The mean measurement error for the ultrasound method was 0.11 mm, whereas CBCT showed a measurement error of 0.20 mm. For both devices, the maximal measurement error was 0.28 mm. Conclusion: Within the simulated limited conditions of this study, high-frequency ultrasound, with optical scanning used as a reference, presented higher accuracy in comparison to CBCT, and seems to be a promising tool for measuring peri-implant bone.
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Affiliation(s)
- Juliana Marotti
- Department of Prosthodontics and Biomaterials, Centre for Implantology, Medical School of the RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany.
| | - Sarah Neuhaus
- Department of Prosthodontics and Biomaterials, Centre for Implantology, Medical School of the RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany.
| | - Daniel Habor
- Department of Medical Engineering, RWTH Aachen University, Pauwelsstrasse 20, 52074 Aachen, Germany.
| | - Lauren Bohner
- Department of Prosthodontics and Biomaterials, Centre for Implantology, Medical School of the RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany.
| | - Stefan Heger
- Institute for Biomedical Engineering, Mannheim University, John-Deere-Strasse 85, 68163 Mannheim, Germany.
| | - Klaus Radermacher
- Department of Medical Engineering, RWTH Aachen University, Pauwelsstrasse 20, 52074 Aachen, Germany.
| | - Stefan Wolfart
- Department of Prosthodontics and Biomaterials, Centre for Implantology, Medical School of the RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany.
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