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Jacobs R, Fontenele RC, Lahoud P, Shujaat S, Bornstein MM. Radiographic diagnosis of periodontal diseases - Current evidence versus innovations. Periodontol 2000 2024. [PMID: 38831570 DOI: 10.1111/prd.12580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 04/23/2024] [Accepted: 05/16/2024] [Indexed: 06/05/2024]
Abstract
Accurate diagnosis of periodontal and peri-implant diseases relies significantly on radiographic examination, especially for assessing alveolar bone levels, bone defect morphology, and bone quality. This narrative review aimed to comprehensively outline the current state-of-the-art in radiographic diagnosis of alveolar bone diseases, covering both two-dimensional (2D) and three-dimensional (3D) modalities. Additionally, this review explores recent technological advances in periodontal imaging diagnosis, focusing on their potential integration into clinical practice. Clinical probing and intraoral radiography, while crucial, encounter limitations in effectively assessing complex periodontal bone defects. Recognizing these challenges, 3D imaging modalities, such as cone beam computed tomography (CBCT), have been explored for a more comprehensive understanding of periodontal structures. The significance of the radiographic assessment approach is evidenced by its ability to offer an objective and standardized means of evaluating hard tissues, reducing variability associated with manual clinical measurements and contributing to a more precise diagnosis of periodontal health. However, clinicians should be aware of challenges related to CBCT imaging assessment, including beam-hardening artifacts generated by the high-density materials present in the field of view, which might affect image quality. Integration of digital technologies, such as artificial intelligence-based tools in intraoral radiography software, the enhances the diagnostic process. The overarching recommendation is a judicious combination of CBCT and digital intraoral radiography for enhanced periodontal bone assessment. Therefore, it is crucial for clinicians to weigh the benefits against the risks associated with higher radiation exposure on a case-by-case basis, prioritizing patient safety and treatment outcomes.
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Affiliation(s)
- Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Rocharles Cavalcante Fontenele
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Pierre Lahoud
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- Periodontology and Oral Microbiology, Department of Oral Health Sciences, KU Leuven, Leuven, Belgium
| | - Sohaib Shujaat
- King Abdullah International Medical Research Center, Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Michael M Bornstein
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
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Alizad-Rahvar M, Safi Y, Kadkhodazadeh M, Ghomashi MP. Clinical efficacy of intraoral ultrasonography versus transgingival probing for measurement of gingival thickness in different gingival biotypes: a clinical trial. Head Face Med 2024; 20:23. [PMID: 38566169 PMCID: PMC10985878 DOI: 10.1186/s13005-024-00422-4] [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: 11/07/2023] [Accepted: 03/15/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Transgingival probing is conventionally used for gingival thickness (GT) measurement. However, invasiveness is a major drawback of transgingival probing. Thus, researchers have been in search of alternative methods for measurement of GT. This study compared the clinical efficacy of intraoral ultrasonography and transgingival probing for measurement of GT in different biotypes. MATERIALS AND METHODS This clinical trial was conducted on 34 patients requiring crown lengthening surgery. GT was measured at 40 points with 2- and 4-mm distances from the free gingival margin (FGM) of anterior and premolar teeth of both jaws in each patient by an intraoral ultrasound probe. For measurement of GT by the transgingival probing method, infiltration anesthesia was induced, and a #25 finger spreader (25 mm) was vertically inserted into the soft tissue until contacting bone. The inserted length was measured by a digital caliper with 0.01 mm accuracy. All measurements were made by an operator with high reliability under the supervision of a radiologist. Data were analyzed by t-test, Power and Effect Size formula, and intraclass correlation coefficient (ICC). RESULTS The two methods were significantly different in measurement of GT in both thick and thin biotypes at 2- and 4-mm distances (P < 0.001). The two methods had a significant difference in both the mandible (P < 0.001) and maxilla (P < 0.001) and in both the anterior (P < 0.003) and premolar (P < 0.003) regions. Although the difference was statistically significant in t-tests, the power and effect formula proved it to be clinically insignificant. Also, the ICC of the two methods revealed excellent agreement. CONCLUSION The results showed optimal agreement of ultrasound and transgingival probing for measurement of GT. TRIAL REGISTRATION The study was approved by the ethics committee of Shahid Beheshti University of Medical Sciences on 2021-12-28 (IR.SBMU.DRC.REC.1400.138) and registered in the Iranian Registry of Clinical Trials on 2022-03-14 (IRCT20211229053566N1).
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Affiliation(s)
- Maryam Alizad-Rahvar
- Dept. Oral and Maxillofacial Radiology, School of Dentistry, Razi Herbal Medicines Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Yaser Safi
- Dept. Oral and Maxillofacial Radiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdi Kadkhodazadeh
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Parham Ghomashi
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Strauss FJ, Gil A, Smirani R, Rodriguez A, Jung R, Thoma D. The use of digital technologies in peri-implant soft tissue augmentation - A narrative review on planning, measurements, monitoring and aesthetics. Clin Oral Implants Res 2024. [PMID: 38308466 DOI: 10.1111/clr.14238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 11/21/2023] [Accepted: 01/11/2024] [Indexed: 02/04/2024]
Abstract
OBJECTIVE To identify the different uses and modalities of digital technologies to diagnose, plan and monitor peri-implant soft tissue conditions and aesthetics. METHODS A comprehensive narrative review of pertinent literature was conducted, critically appraising key digital technologies that may assist peri-implant soft tissue augmentation and assessment. An electronic search on four databases including studies published prior to 1st July 2023 was performed and supplemented by a manual search. RESULTS Predominantly, tools such as cone beam computed tomography (CBCT), intraoral scanning (iOS), intraoral ultrasonography and digital spectrophotometry were commonly to assess and monitor peri-implant soft tissues. The main clinical and research applications included: (i) initial assessment of mucosal thickness, supra-crestal tissue height and keratinized mucosa width, (ii) evaluation of peri-implant soft tissue health and inflammation, (iii) monitoring profilometric changes and midfacial mucosal margin stability over time and (iv) aesthetic evaluation through colour assessment. While evidence for some digital tools may be limited, the integration of digital technologies into peri-implant soft tissue management holds great promise. These technologies offer improved precision, comfort and speed in assessment, benefiting both patients and clinicians. CONCLUSION As digital technologies progress, their full potential in peri-implant soft tissue augmentation and their value will become more evident with ongoing research. Embracing these innovations and their potential benefits is recommended to ensure that during progress in implant dentistry, patient care is not hindered.
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Affiliation(s)
- Franz Josef Strauss
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Alfonso Gil
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Rawen Smirani
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Univ. Bordeaux, INSERM, BioTis, U1026, Bordeaux, France
- CHU de Bordeaux, Service de Médecine Bucco-Dentaire, Bordeaux, France
| | - Amanda Rodriguez
- Department of Periodontics and Oral Medicine, Dental School, University of Michigan, Ann Arbor, Michigan, USA
| | - Ronald Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Daniel Thoma
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Fan S, Sáenz-Ravello G, Al-Nawas B, Schiegnitz E, Diaz L, Sagheb K. The feasibility of ultrasonography for the measurement of periodontal and peri-implant phenotype: A systematic review and meta-analysis. Clin Implant Dent Relat Res 2023; 25:892-909. [PMID: 37337110 DOI: 10.1111/cid.13231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/15/2023] [Accepted: 05/22/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND Screening ultrasonography was proposed for monitoring periodontal soft tissues in the early 1960s, owing to its nonionizing, real-time, and cost-effective properties. Studies have provided convincing preliminary evidence for the use of ultrasound (US) in implant dentistry. PURPOSE To assess the feasibility of ultrasonography (US) for measuring the buccal thickness of periodontal and peri-implant tissues. The secondary objective was to evaluate the reliability of US measurements compared to classic techniques, such as CBCT and directly measurements. MATERIALS AND METHODS An electronic literature search was conducted by three independent reviewers through February 2023. The inclusion criteria were articles investigating at least five patients/cadavers with US measurements in periodontal or peri-implant buccal tissues. Compliance with methodological reporting standards and risk of bias was assessed using EULAR and QUADAS-C tools, respectively. Random-effects meta-analysis was conducted, using Bland-Altman analysis. Certainty of the evidence was assessed using GRADE. RESULTS The final selection included 12 studies examining 458 patients and 13 cadavers, with a total of 226 implants, 1958 teeth and 60 edentulous sites. The body of evidence was assessed as partially compliant with methodological reporting standards for US studies and had an unclear to high risk of bias. Meta-analysis of five comparative studies showed no evidence of clinically significant bias between US and direct measurements (very low certainty), and between US and CBCT (very low certainty) for soft-tissue thickness. Likewise, for bone thickness, there is no evidence of clinically significant bias between US and CBCT (low certainty). CONCLUSIONS Compared to the CBCT and direct measurements, ultrasonography might be a reliable approach for monitoring on periodontal and peri-implant phenotype. However, there is uncertainty about estimates of the actual effect, so further standardized and larger sample size of clinical research is needed.
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Affiliation(s)
- Shengchi Fan
- Department of Oral and Maxillofacial Surgery - Plastic Operations, University Medical Center Mainz, Mainz, Germany
- School of Medicine; National Clinical Research Center for Oral Disease, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Second Dental Clinic, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
| | - Gustavo Sáenz-Ravello
- Center for Epidemiology and Surveillance of Oral Diseases (CESOD), Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery - Plastic Operations, University Medical Center Mainz, Mainz, Germany
| | - Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery - Plastic Operations, University Medical Center Mainz, Mainz, Germany
| | - Leonardo Diaz
- Postgraduate School, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Keyvan Sagheb
- Department of Oral and Maxillofacial Surgery - Plastic Operations, University Medical Center Mainz, Mainz, Germany
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Kripfgans OD, Chan HL. Preliminary Experience in Transducer Preparation for Intraoral Imaging. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023; 42:2155-2166. [PMID: 36965167 PMCID: PMC10518367 DOI: 10.1002/jum.16224] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 02/28/2023] [Indexed: 06/18/2023]
Abstract
Intraoral scanning must meet a stringent infection control standard because of contact with the oral mucosa. A preparation protocol is thus presented for increased inquiries about intraoral scanning requirements. Materials required for such a preparation include: a single-use bubble-free gel packet, a gel standoff pad, and a transducer probe cover. Postscan reprocessing of the ultrasound transducer requires high-level disinfection. Examples for proper and improper use are provided as well as limitations of this preparation protocol and recommendations for future development. This guidance meets the current infection control standard and may guide the user to obtain consistent ultrasound image quality.
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Affiliation(s)
- Oliver D Kripfgans
- Department of Radiology, University of Michigan School of Medicine, Ann Arbor, Michigan, USA
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA
| | - Hsun-Liang Chan
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, 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: 5] [Impact Index Per Article: 5.0] [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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Ultrasound Imaging of the Periodontium Complex: A Reliability Study. Int J Dent 2023; 2023:5494429. [PMID: 36845629 PMCID: PMC9949946 DOI: 10.1155/2023/5494429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/25/2023] [Accepted: 01/30/2023] [Indexed: 02/18/2023] Open
Abstract
Background Ultrasonography is a noninvasive, low-cost diagnostic tool widely used in medicine. Recent studies have demonstrated that ultrasound imaging might have the potential to be used intraorally to assess periodontal biomarkers. Objectives To evaluate the reliability of interlandmark distance measurements on intraoral ultrasound images of the periodontal tissues. Materials and Methods Sixty-four patients from the graduate periodontics (n = 33) and orthodontics (n = 31) clinics were recruited. A 20 MHz handheld intraoral ultrasound transducer was used to scan maxillary and mandibular incisors, canines, and premolars. Distances between the alveolar bone crest and cementoenamel junction (ABC-CEJ), gingival thickness (GT), and alveolar bone thickness (ABT) were measured by 3 raters. The intercorrelation coefficient (ICC) and mean absolute deviation (MAD) were calculated among and between the raters. Raters also scored images according to quality. Results The ICC scores for intrarater reliability were 0.940 (0.932-0.947), 0.953 (0.945-0.961), and 0.859 (0.841-0.876) for ABC-CEJ, GT, and ABT, respectively. The intrarater MAD values were 0.023 (±0.019) mm, 0.014 (±0.005) mm, and 0.005 (±0.003) mm, respectively. The ICC scores for interrater reliability were 0.872 (95% CI: 0.836-0.901), 0.958 (95% CI: 0.946-0.968), and 0.836 (95% CI: 0.789-0.873) for ABC-CEJ, GT, and ABT, respectively. The interrater MAD values were 0.063 (±0.029) mm, 0.023 (±0.018) mm, and 0.027 (±0.012) mm, respectively. Conclusions The present study showed the high reliability of ultrasound in both intrarater and interrater assessments. Results suggest there might be a potential use of intraoral ultrasound to assess periodontium.
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Cotti E, Schirru E. Present status and future directions: Imaging techniques for the detection of periapical lesions. Int Endod J 2022; 55 Suppl 4:1085-1099. [PMID: 36059089 DOI: 10.1111/iej.13828] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 08/25/2022] [Accepted: 08/26/2022] [Indexed: 11/29/2022]
Abstract
Diagnosing and treating apical periodontitis (AP) in an attempt to preserve the natural dentition, and to prevent the direct and indirect systemic effects of this condition, is the major goal in endodontics. Considering that AP is frequently asymptomatic, and is most often associated with a lesion in the periapex of the affected tooth, within the maxillary bones, imaging becomes of paramount importance for the diagnosis of the disease. The aim of this narrative review was to investigate the most relevant classic and current literature to describe which are, to date, the diagnostic imaging systems most reliable and advanced to achieve the early and predictable detection of AP, the best measures of the lesions and the disclosure of the different features of the disease. Dental panoramic tomography (DPT) is a classic exam, considered still useful to provide the basic diagnosis of AP in certain districts of the maxillary bones. Periapical radiographs (PRs) represent a valid routine examination, with few, known limitations. Cone-beam computed tomography (CBCT) is the only system that ensures the early and predictable detection of all periapical lesions in the jaws, with the minor risk of false positives. These techniques can be successfully implemented, with ultrasounds (USI) or magnetic resonance (MRI) imaging, exams that do not use ionising radiations. MRI and USI provide information on specific features of the lesions, like the presence and amount of vascular supply, their content and their relationship with the surrounding soft tissues, leading to differential diagnoses. Further, all the three-dimensional systems (CBCT, USI and MRI) allow the volumetric assessment of AP. Pioneering research on artificial intelligence is slowly progressing in the detection of periapical radiolucencies on DPTs, PRs and CBCTs, however, with promising results. Finally, it is established that all imaging techniques have to be associated with a thorough clinical examination and a good degree of calibration of the operator.
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Affiliation(s)
- Elisabetta Cotti
- Department of Conservative Dentistry and Endodontics, University of Cagliari, Cagliari, Italy
| | - Elia Schirru
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
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Lee KH, Park W, Cheong J, Park KM, Kim JW, Kim KD. Identifying the course of the greater palatine artery using intraoral ultrasonography: cohort study. SURGICAL AND RADIOLOGIC ANATOMY : SRA 2022; 44:1139-1146. [PMID: 35913512 DOI: 10.1007/s00276-022-02967-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 05/20/2022] [Indexed: 10/16/2022]
Abstract
AIMS The greater palatine artery (GPA) is one of the most important anatomical structure for free gingival grafts or connective-tissue grafts during soft tissue surgery for dental implants. Several studies have identified the approximate location of the GPA, but it is impossible to detect its exact location during surgery due to large variability between individuals. The authors, therefore, investigated the course of the GPA using intraoral ultrasonography to determine the feasibility of using real-time nonionizing ultrasonography for implant surgery. MATERIALS AND METHODS This study included 40 healthy young participants. The courses of the GPA were identified using intraoral ultrasound probes from the first premolar to the second molar. The distance from the gingival margin to the GPA (GM-GPA) and the depth of the palatal gingiva from the GPA (PG-GPA) were measured by two independent examiners. Measurements were analyzed statistically, and interexaminer reliability was determined. RESULTS The distance of the GM-GPA and the mean depth of the PG-GPA were 14.8 ± 1.6 mm and 4.10 ± 0.51 mm (mean ± SD), respectively. GM-GPA decreased when the GPA ran from the second molar to the first molar, and GM-GPA was significantly shorter in females (P < 0.05). PG-GPA increased when the GPA ran to the posterior teeth. Interexaminer measurement agreements were excellent, with intraclass correlation coefficient values of 0.983 and 0.918 for GM-GPA and PG-GPA, respectively. CONCLUSIONS Using an intraoral ultrasound probe, real-time GPA tracking is possible, which is expected to help reduce the possibility of bleeding during surgery.
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Affiliation(s)
- Kang-Hee Lee
- Department of Advanced General Dentistry, College of Dentistry, Yonsei University, Yonseiro 50-1, Shinchondong, Seoul, 03722, South Korea
| | - Wonse Park
- Department of Advanced General Dentistry, College of Dentistry, Yonsei University, Yonseiro 50-1, Shinchondong, Seoul, 03722, South Korea
| | - Jieun Cheong
- Department of Advanced General Dentistry, College of Dentistry, Yonsei University, Yonseiro 50-1, Shinchondong, Seoul, 03722, South Korea
| | - Kyeong-Mee Park
- Department of Advanced General Dentistry, College of Dentistry, Human Identification Research Institute, Yonsei University, Seoul, South Korea
| | - Jin-Woo Kim
- Department of Oral and Maxillofacial Surgery, School of Medicine, Ewha Womans University, Seoul, South Korea
| | - Kee-Deog Kim
- Department of Advanced General Dentistry, College of Dentistry, Yonsei University, Yonseiro 50-1, Shinchondong, Seoul, 03722, South Korea.
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Assessment of Negative Gingival Recession: A Critical Component of Periodontal Diagnosis. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12147015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Accurate measurement of negative gingival recession (GR) is essential to accurately determine the clinical attachment loss, which leads to an accurate diagnosis and optimal therapy of periodontal disease. However, the accuracy of measuring the negative GR has been shown to be low and highly variable between examiners. The position of the gingiva margin in relation to the cemento-enamel junction (CEJ) varies among different stages of passive eruption. The amount of negative GR is about 2 mm on average at the mid-facial sites and ranges from 2 to 3.5 mm at interproximal sites in periodontally healthy patients. Some other clinical conditions may change the gingival dimension coronal to the CEJ, such as altered passive eruption and gingival enlargement. In addition to the traditional approach using a periodontal probe to assess the negative GR, nowadays dental ultrasound imaging may be able to assist in accurately measuring the amount of negative GR. This narrative review will discuss the existing evidence of the dimension of dentogingival tissue and the clinical assessment of negative GR using different clinical tools.
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Rodriguez-Sendra J, Torres I, Jimenez N, Sauro S, Camarena F. Ultrasonic Monitoring of Dentin Demineralization. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2021; 68:570-578. [PMID: 32776879 DOI: 10.1109/tuffc.2020.3015668] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Demineralization is a process of loss of minerals in the dental hard tissue that affects seriously the health of the patients, as it diminishes the tooth resistance, generating chewing problems by altering the occlusal structure, hypersensitivity, and pulpal problems. Demineralization can be produced by pathological processes as erosion or caries, or by surgical processes as etching. Due to the complexity of natural demineralization processes, it is mandatory to provide quantitative and standardized tests to allow their study in controlled laboratory conditions. Ultrasonic techniques are suitable for this purpose as they are nondestructive, quick, and provide localized mechanical information about the tissue, which is related with its degree of demineralization. In the present work, we evaluate the complete process of demineralization of the human dentin under controlled laboratory conditions using a pulse-echo ultrasonic technique. Up to 15 human dentin teeth have been demineralized with phosphoric acid at 10%. The time-of-flight measurements using the pulse-echo system allows to obtain the speed of sound in healthy (3415 m/s) and demineralized dentin tissue (1710 m/s), as well as to characterize the dynamical process of the acid penetration, which generates well-defined boundaries between two media (demineralized and mineralized dentin), showing very different mechanical properties. These boundaries advance in depth at an initial rate of [Formula: see text]/min, decelerating at -9.3 nm/min2 until the whole demineralization of the sample is achieved. In addition, the technique allows to measure the relevance of the demineralization produced by the acid residues inside the tooth once it has been removed from the acidic solution. Beyond the assessment of artificial demineralization lesions under laboratory conditions, as demonstrated in this article, the proposed technique opens new approaches to the assessment of demineralization caused by natural caries in vivo.
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Cosoli G, Scalise L, De Leo A, Russo P, Tricarico G, Tomasini EP, Cerri G. Development of a Novel Medical Device for Mucositis and Peri-Implantitis Treatment. Bioengineering (Basel) 2020; 7:E87. [PMID: 32764313 PMCID: PMC7552606 DOI: 10.3390/bioengineering7030087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/14/2020] [Accepted: 08/03/2020] [Indexed: 11/24/2022] Open
Abstract
In spite of all the developments in dental implantology techniques, peri-implant diseases are frequent (prevalence up to 80% and 56% of subjects for mucositis and peri-implantitis, respectively) and there is an urgency for an effective treatment strategy. This paper presents an innovative electromedical device for the electromagnetic treatment of mucositis and peri-implantitis diseases. This device is also equipped with a measurement part for bioimpedance, which reflects the health conditions of a tissue, thus allowing clinicians to objectively detect impaired areas and to monitor the severity of the disease, evaluate the treatment efficacy, and adjust it accordingly. The design of the device was realized considering literature data, clinical evidence, numerical simulation results, and electromagnetic compatibility (EMC) pre-compliance tests, involving both clinicians and engineers, to better understand all the needs and translate them into design requirements. The reported system is being tested in more than 50 dental offices since 2019, providing efficient treatments for mucositis and peri-implantitis, with success rates of approximately 98% and 80%, respectively.
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Affiliation(s)
- Gloria Cosoli
- Department of Industrial Engineering and Mathematical Sciences, Università Politecnica delle Marche, 60131 Ancona, Italy; (L.S.); (E.P.T.)
| | - Lorenzo Scalise
- Department of Industrial Engineering and Mathematical Sciences, Università Politecnica delle Marche, 60131 Ancona, Italy; (L.S.); (E.P.T.)
| | - Alfredo De Leo
- Department of Information Engineering, Università Politecnica delle Marche, 60131 Ancona, Italy; (A.D.L.); (P.R.); (G.C.)
| | - Paola Russo
- Department of Information Engineering, Università Politecnica delle Marche, 60131 Ancona, Italy; (A.D.L.); (P.R.); (G.C.)
| | - Gerardo Tricarico
- Department of Health Sciences, Università del Piemonte Orientale, 28100 Novara, Italy;
| | - Enrico Primo Tomasini
- Department of Industrial Engineering and Mathematical Sciences, Università Politecnica delle Marche, 60131 Ancona, Italy; (L.S.); (E.P.T.)
| | - Graziano Cerri
- Department of Information Engineering, Università Politecnica delle Marche, 60131 Ancona, Italy; (A.D.L.); (P.R.); (G.C.)
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13
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Rathod VT. A Review of Acoustic Impedance Matching Techniques for Piezoelectric Sensors and Transducers. SENSORS (BASEL, SWITZERLAND) 2020; 20:E4051. [PMID: 32708159 PMCID: PMC7411934 DOI: 10.3390/s20144051] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 07/06/2020] [Accepted: 07/16/2020] [Indexed: 01/28/2023]
Abstract
The coupling of waves between the piezoelectric generators, detectors, and propagating media is challenging due to mismatch in the acoustic properties. The mismatch leads to the reverberation of waves within the transducer, heating, low signal-to-noise ratio, and signal distortion. Acoustic impedance matching increases the coupling largely. This article presents standard methods to match the acoustic impedance of the piezoelectric sensors, actuators, and transducers with the surrounding wave propagation media. Acoustic matching methods utilizing active and passive materials have been discussed. Special materials such as nanocomposites, metamaterials, and metasurfaces as emerging materials have been presented. Emphasis is placed throughout the article to differentiate the difference between electric and acoustic impedance matching and the relation between the two. Comparison of various techniques is made with the discussion on capabilities, advantages, and disadvantages. Acoustic impedance matching for specific and uncommon applications has also been covered.
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Affiliation(s)
- Vivek T Rathod
- Department of Electrical and Computer Engineering, Michigan State University, East Lansing, MI 48824, USA
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14
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Chan HL, Kripfgans OD. Ultrasonography for diagnosis of peri-implant diseases and conditions: a detailed scanning protocol and case demonstration. Dentomaxillofac Radiol 2020; 49:20190445. [PMID: 32017634 DOI: 10.1259/dmfr.20190445] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES Ultrasonography has shown its promising diagnostic value in dental implant imaging research in the three treatment phases, namely, planning, intraoperative, and postoperative phase. With increasing awareness of peri-implant diseases and a lack of an efficient diagnostic method, the aim is to propose ultrasound imaging as a potential solution by providing a detailed scanning protocol and case demonstration. METHODS Ultrasound device specification and the setup for optimizing peri-implant tissue imaging was described. Two useful imaging modes, viz. B-mode and color flow, were introduced. Important anatomical structures for accurate diagnosis of peri-implant diseases were illustrated. Finally, a detailed scanning sequence was proposed. RESULTS Ultrasound images were acquired on live humans to exemplify the four peri-implant diseases and conditions, endorsed by the 2017 World Workshop organized by the American Academy of Periodontology and the European Federation of Periodontology. Ultrasound can provide not only cross-sectional anatomical images but also functional images (color flow images) that may be useful for evaluating the degree of peri-implant tissue inflammation. CONCLUSIONS High-frequency ultrasonography could be another cross-sectional imaging modality in adjunct to radiographs for diagnosing imminent peri-implant diseases and conditions that negatively influence quality of life of millions of patients with implants. This case study provides a framework for future related research work and clinical scanning guidelines.
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Affiliation(s)
- Hsun-Liang Chan
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Oliver D Kripfgans
- Department of Biomedical Engineering, College of Engineering, Ann Arbor, MI, USA.,Department of Radiology, University of Michigan Medical School, Ann Arbor, MI, USA
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15
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Tattan M, Sinjab K, Lee E, Arnett M, Oh TJ, Wang HL, Chan HL, Kripfgans OD. Ultrasonography for chairside evaluation of periodontal structures: A pilot study. J Periodontol 2020; 91:890-899. [PMID: 31837020 DOI: 10.1002/jper.19-0342] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 12/02/2019] [Accepted: 12/03/2019] [Indexed: 12/17/2022]
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.
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Affiliation(s)
- Mustafa Tattan
- Department of Periodontics and Iowa Institute for Oral Health Research, University of Iowa College of Dentistry, Iowa City, IA, USA
| | - Khaled Sinjab
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Eunjee Lee
- Department of Information and Statistics, Chungnam National University, Daejoen, South Korea
| | - Michelle Arnett
- Department of Primary Dental Care, Division of Dental Hygiene, University of Minnesota, Minneapolis, MN, USA
| | - Tae-Ju Oh
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Hsun-Liang Chan
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Oliver D Kripfgans
- Department of Radiology, University of Michigan Medical School, Ann Arbor, MI, USA.,Department of Biomedical Engineering, College of Engineering, Ann Arbor, MI, USA
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16
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Chifor R, Badea AF, Chifor I, Mitrea DA, Crisan M, Badea ME. Periodontal evaluation using a non-invasive imaging method (ultrasonography). Med Pharm Rep 2019; 92:S20-S32. [PMID: 31989105 PMCID: PMC6978923 DOI: 10.15386/mpr-1521] [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: 07/23/2019] [Revised: 09/16/2019] [Accepted: 09/30/2019] [Indexed: 12/14/2022] Open
Abstract
The periodontal disease and gingival bleeding are highly prevalent in the adult population worldwide. The World Health Organization (WHO) data shows that 90–100% of the 34-year-old adults present gingival inflammation. Therefore, an investigation method is required to allow the assessment of the periodontal disease as well as the monitoring of the evolution of the gingival inflammation after periodontal treatments. Non-invasive and operator-independent methods for periodontal examination are necessary for diagnosing and monitoring the periodontal disease. The periodontal ultrasonography is a reliable technique for visualizing the anatomical elements which are necessary to diagnose the periodontal status. Using this imaging technique the dentino-enamel junction, the cortical bone, the radicular surface from the crown to the alveolar bone, the gingival tissue can be seen without interfering with those elements during the examination. Also, calculus visualization is possible before and after scaling in order to evaluate the quality of the treatment. Using 2D ultrasonography is not feasible in dental practice as it requires extensive experience and is also time consuming. The reproducibility of the 2D slices is very difficult in order to have the possibility to compare different investigations efficiently. 3D reconstructions of the periodontal tissue can be a very good alternative to eliminate the operator dependence. Ultrasonography allows the practitioner to visualize the anatomic elements involved in making a periodontal diagnosis. It also allows tracking of subsequent changes. This method is not commonly used for periodontal examination and further studies are required. Previous studies show that ultrasonography can be a reliable non-invasive method to diagnose and monitor the periodontal disease.
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Affiliation(s)
- Radu Chifor
- Dental Prevention Department, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Alexandru Florin Badea
- Discipline of Anatomy and Embryology, Faculty of General Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ioana Chifor
- Dental Prevention Department, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | | | - Maria Crisan
- Department of Histology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mindra Eugenia Badea
- Dental Prevention Department, Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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17
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Rodriguez-Sendra J, Jimenez N, Pico R, Faus J, Camarena F. Monitoring the Setting of Calcium Sulfate Bone-Graft Substitute Using Ultrasonic Backscattering. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2019; 66:1658-1666. [PMID: 31283503 DOI: 10.1109/tuffc.2019.2926827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
We report a method to monitor the setting process of bone-graft substitutes (calcium sulfate) using ultrasonic backscattering techniques. Analyzing the backscattered fields using a pulse-echo technique, we show that it is possible to dynamically describe the acoustic properties of the material which are linked to its setting state. Several experiments were performed to control the setting process of calcium sulfate using a 3.5-MHz transducer. The variation of the apparent integrated backscatter (AIB) with time during the setting process is analyzed and compared with measurements of the speed of sound (SOS) and temperature of the sample. The correlation of SOS and AIB allows us to clearly identify two different states of the samples, liquid and solid, in addition to the transition period. Results show that using backscattering analysis, the setting state of the material can be estimated with a threshold of 15 dB. This ultrasonic technique is indeed the first step to develop real-time monitoring systems for time-varying complex media as those present in bone regeneration for dental implantology applications.
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18
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Kim J, Shin TJ, Kong HJ, Hwang JY, Hyun HK. High-Frequency Ultrasound Imaging for Examination of Early Dental Caries. J Dent Res 2018; 98:363-367. [PMID: 30412680 DOI: 10.1177/0022034518811642] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The extent of dental tissue destruction during the treatment of white spot lesions (WSLs) increases with the severity of the lesion. If the depth and shape of WSLs can be predicted with a noninvasive diagnostic method before dental caries treatment, more conservative interventions can be planned. Given the superiority of high-frequency ultrasound (HFUS) imaging in observing the internal structures of the body, the present study aimed to verify the possibility of HFUS imaging to examine the depth and shape of WSLs. We prepared tooth samples and developed a biomicroscopic system with a HFUS transducer to obtain images of normal and WSL regions. HFUS images were compared with conventional ultrasound images and micro-computed tomography images. HFUS distinctly differentiated demineralization within WSL and normal regions. WSL depth calculated in the micro-computed tomography image was similar to that in HFUS. This study revealed that HFUS imaging has the potential to detect early dental caries and offer information on the invasion depth of early dental caries quantitatively.
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Affiliation(s)
- J Kim
- 1 Department of Information and Communication Engineering, Daegu Gyeongbuk Institute of Science and Technology, Daegu, Republic of Korea
| | - T J Shin
- 2 Department of Pediatric Dentistry, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - H J Kong
- 3 Department of Biomedical Engineering, College of Medicine, Chungnam National University, and Chungnam National University Hospital, Daejeon, Republic of Korea
| | - J Y Hwang
- 1 Department of Information and Communication Engineering, Daegu Gyeongbuk Institute of Science and Technology, Daegu, Republic of Korea
| | - H K Hyun
- 2 Department of Pediatric Dentistry, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
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19
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Lee KH, Jeong HG, Kwak EJ, Park W, Kim KD. Ultrasound Guided Free Gingival Graft: Case Report. J ORAL IMPLANTOL 2018; 44:385-388. [DOI: 10.1563/aaid-joi-d-17-00298] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Kang-Hee Lee
- Department of Advanced General Dentistry, College of Dentistry, Yonsei University, Seoul, Korea
| | - Ho-Gul Jeong
- Department of Oral and Maxillofacial Radiology, College of Dentistry, Yonsei University, Seoul, Korea
| | | | - Wonse Park
- Department of Advanced General Dentistry, College of Dentistry, Yonsei University, Seoul, Korea
| | - Kee-Deog Kim
- Department of Advanced General Dentistry, College of Dentistry, Yonsei University, Seoul, Korea
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20
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YABUKI C, RIKUTA A, MURAYAMA R, AKIBA S, SUZUKI S, TAKAMIZAWA T, KUROKAWA H, MIYAZAKI M. Effect of acid erosion on enamel bond strength of self-etch adhesives and sonic velocity measurement of enamel. Dent Mater J 2018; 37:542-548. [DOI: 10.4012/dmj.2017-117] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Chiaki YABUKI
- Department of Operative Dentistry, Nihon University School of Dentistry
| | - Akitomo RIKUTA
- Department of Operative Dentistry, Nihon University School of Dentistry
| | - Ryosuke MURAYAMA
- Department of Operative Dentistry, Nihon University School of Dentistry
| | - Syunsuke AKIBA
- Department of Operative Dentistry, Nihon University School of Dentistry
| | - Soshi SUZUKI
- Department of Operative Dentistry, Nihon University School of Dentistry
| | | | - Hiroyasu KUROKAWA
- Department of Operative Dentistry, Nihon University School of Dentistry
| | - Masashi MIYAZAKI
- Department of Operative Dentistry, Nihon University School of Dentistry
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21
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Chan HL, Sinjab K, Li J, Chen Z, Wang HL, Kripfgans OD. Ultrasonography for noninvasive and real-time evaluation of peri-implant tissue dimensions. J Clin Periodontol 2018; 45:986-995. [PMID: 29757464 DOI: 10.1111/jcpe.12918] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 04/17/2018] [Accepted: 05/08/2018] [Indexed: 11/30/2022]
Abstract
AIM Existing methods for evaluating marginal bone loss and tissue biotype around dental implants present with many limitations. The aim of this study was to examine the accuracy of high-resolution, 3-dimensional ultrasound to measure peri-implant tissue dimensions. MATERIAL AND METHODS A 25-MHz ultrasound probe prototype was used to scan peri-implant tissues of 17 implants from seven fresh human cadavers. Four ultrasonic measurements were made as follows: the marginal bone level/thickness, and mucosal level/thickness. The readings were statistically compared to cone beam computed tomography (CBCT) and/or open bone measurements. RESULTS The correlations (r) between the ultrasound and direct/CBCT readings of the four parameters ranged from 0.85 to 0.98 (p < 0.0001). The mean absolute difference in the four parameters between ultrasound-direct and ultrasound-CBCT ranged from 0.033 to 0.24 mm. CONCLUSION Encouraging evidence is shown that ultrasound can accurately measure peri-implant tissue dimensions. Following clinical trial validations, ultrasound offers potential as a valuable tool to evaluate long-term peri-implant tissue stability without concerns of ionizing radiation and image artefacts around implants.
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Affiliation(s)
- Hsun-Liang Chan
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan
| | - Khaled Sinjab
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan
| | - Junying Li
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan.,Department of Prosthodontics, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Zhaozhao Chen
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan.,Department of Prosthodontics, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan.,Department of Prosthodontics, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Oliver D Kripfgans
- Department of Biomedical Engineering, College of Engineering, Ann Arbor, Michigan.,Department of Radiology, University of Michigan Medical School, Ann Arbor, Michigan
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22
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Bhaskar V, Chan HL, MacEachern M, Kripfgans OD. Updates on ultrasound research in implant dentistry: a systematic review of potential clinical indications. Dentomaxillofac Radiol 2018; 47:20180076. [PMID: 29791198 DOI: 10.1259/dmfr.20180076] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES Ultrasonography has shown promising diagnostic value in dental implant imaging research; however, exactly how ultrasound was used and at what stage of implant therapy it can be applied has not been systematically evaluated. Therefore, the aim of this review is to investigate potential indications of ultrasound use in the three implant treatment phases, namely planning, intraoperative and post-operative phase. METHODS Eligible manuscripts were searched in major databases with a combination of keywords related to the use of ultrasound imaging in implant therapy. An initial search yielded 414 articles, after further review, 28 articles were finally included for this systematic review. RESULTS Ultrasound was found valuable, though at various development stages, for evaluating (1) soft tissues, (2) hard tissues (3) vital structures and (4) implant stability. B-mode, the main function to image anatomical structures of interest, has been evaluated in pre-clinical and clinical studies. Quantitative ultrasound parameters, e.g. sound speed and amplitude, are being developed to evaluate implant-bone stability, mainly in simulation and pre-clinical studies. Ultrasound could be potentially useful in all three treatment phases. In the planning phase, ultrasound could evaluate vital structures, tissue biotype, ridge width/density, and cortical bone thickness. During surgery, it can provide feedback by identifying vital structures and bone boundary. At follow-up visits, it could evaluate marginal bone level and implant stability. CONCLUSIONS Understanding the current status of ultrasound imaging research for implant therapy would be extremely beneficial for accelerating translational research and its use in dental clinics.
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Affiliation(s)
| | - Hsun-Liang Chan
- 2 Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry , Ann Arbor, MI , USA
| | - Mark MacEachern
- 3 Taubman Health Sciences Library, University of Michigan , Ann Arbor, MI , USA
| | - Oliver D Kripfgans
- 4 Department of Biomedical Engineering, College of Engineering , Ann Arbor, MI , USA.,5 Department of Radiology, University of Michigan Medical School , Ann Arbor, MI , USA
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23
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SAYED AHMEDM, LAMARCK RACHEL, CRUZ ELISA, CHAVES EROS, MUKDADI OSAMAM. QUANTITATIVE ASSESSMENT OF GINGIVAL INFLAMMATION USING HIGH-RESOLUTION ULTRASOUND EX-VIVO. J MECH MED BIOL 2018. [DOI: 10.1142/s0219519418500124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This study investigates the feasibility of using high-resolution ultrasound imaging echogenicity to quantitatively diagnose gingival inflammation. Gingival samples were extracted from the study participants during gingivectomy procedures. Ultrasound mechanical scanning of the samples was immediately conducted ex-vivo to render cross-sectional images of high resolution, at different locations. Samples’ histological preparation and analysis was followed after performing ultrasound imaging. Histological sections were then matched with ultrasound images at different sections for each gingival sample. The matched image pairs were used to estimate two quantitative measures; relative inflammation area and ultrasound image echogenicity. These parameters were employed to judge the diagnostic potential of gingival ultrasound imaging. The results show that ultrasound images exhibited low intensity levels at the inflamed gingival regions, while healthy layers showed higher intensity levels. The relative area parameter implied a strong relationship between ultrasound and histological images. Ultrasound echogenicity was found to be statistically significant in differentiating between some inflammation degrees in the studied gingival samples. In summary, ultrasound imaging has the potential to be a noninvasive adjunct diagnostic tool for gingival inflammation, and may help assess the stage of the disease and ultimately limit periodontal disease occurrence; taking into consideration the limits of this study.
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Affiliation(s)
- AHMED M. SAYED
- Biomedical Engineering Department, Helwan University, Helwan, Cairo, Egypt
| | - RACHEL LAMARCK
- Piracicaba Dentistry College, University of Campina, Piracicaba, Brazil
| | - ELISA CRUZ
- Paulista Association for Medicine Development, Sao Paulo, Brazil
| | - EROS CHAVES
- College of Dentistry, University of Oklahoma, Oklahoma, USA
| | - OSAMA M. MUKDADI
- Mechanical and Aerospace Engineering Department, West Virginia University, Morgantown, West Virginia, USA
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24
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Lee CH, Kim E, Kim D. Detection of atrial fibrillation during pulpal blood flow assessment using Doppler ultrasound: a case report. Dentomaxillofac Radiol 2018; 47:20170354. [PMID: 29583037 DOI: 10.1259/dmfr.20170354] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
This report describes the case of a 52-year-old male patient who exhibited suspicious pulsation patterns during pulpal blood flow assessment using Doppler ultrasound. Initially, he was not aware of his cardiovascular problem; however, after referral to a medical clinic, he was diagnosed with atrial fibrillation. The patient was injured in a motor vehicle accident and referred to our clinic for management of multiple traumatized teeth. On clinical examination, several teeth exhibited negative responses to cold and electrical sensibility tests. For accurate diagnosis, pulpal blood flow assessment using a Doppler ultrasound device was performed. During the tests, irregular pulsation patterns were detected, indicating the possibility of a cardiovascular problem. As he denied any history of cardiovascular problems, he was recommended to visit a medical doctor for further evaluation. The following day, he visited a medical clinic, and a 12-lead electrocardiogram was performed. He was ultimately diagnosed with atrial fibrillation with idioventricular rhythm, and was started on anticoagulant medication for prevention of thrombogenesis, which is a possible complication of atrial fibrillation. As presented in this case, Doppler ultrasound can provide useful information, not only about blood flow in the dental pulp, but also about an individual's pulsation rhythm. When a patient presents with irregular pulsation patterns in certain situations, the possibility of cardiovascular problems should be considered.
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Affiliation(s)
- Chan-Hyun Lee
- 1 Department of Conservative Dentistry and Oral Science Research Center, Microscope Center, Yonsei University College of Dentistry , Seodaemun-gu, Seoul , South Korea.,2 The Armed Forces Capital Hospital , Bundang-gu, Seongnam-si, Gyeonggi-do , South Korea
| | - Euiseong Kim
- 3 Department of Conservative Dentistry and Oral Science Research Center, Yonsei University College of Dentistry , Seoul , South Korea.,4 Department of Electrical and Electronic Engineering, Yonsei University College of Engineering , Seoul , South Korea
| | - Dohyun Kim
- 1 Department of Conservative Dentistry and Oral Science Research Center, Microscope Center, Yonsei University College of Dentistry , Seodaemun-gu, Seoul , South Korea
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25
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Gad K, Ellabban M, Sciubba J. Utility of Transfacial Dental Ultrasonography in Evaluation of Cystic Jaw Lesions. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2018; 37:635-644. [PMID: 28877358 DOI: 10.1002/jum.14374] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 06/05/2017] [Accepted: 06/06/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES Plain radiography has been widely used in dentistry. Because of the variability of the quality of equipment, radiographic technique, accuracy of interpretation, and radiation risk to the patients, the field is ripe for the introduction of other newer diagnostic modalities. In this report, we demonstrate the utility of ultrasonography in the diagnostic workup of cystic or cystlike lesions of the jaw. METHODS We used a transfacial ultrasonographic scanning approach to examine 32 patients with clinical or radiographic presentation of a jaw cyst. Computed tomography and histopathologic analysis were used as the reference standards to confirm the findings. RESULTS Ultrasonography could establish the presence or absence of a lesion, erosion of the buccal cortical plate, and identification of associated soft tissue involvement in all cases (sensitivity and specificity, 100% and 100%, respectively; area under the receiver operating characteristic curve, 1.0; P < .001). CONCLUSIONS Our observations revealed the usefulness of ultrasonography and demonstrated its potential value when introduced as a routine office-based imaging method for dentistry.
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Affiliation(s)
- Khaled Gad
- Department of Radiology, Suez Canal University School of Medicine, Ismailia, Egypt
| | - Mohamed Ellabban
- Division of Plastic and Reconstructive Surgery, Suez Canal University School of Medicine, Ismailia, Egypt
| | - James Sciubba
- Department of Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Milton J. Dance Head and Neck Center Greater Baltimore Medical Center, Baltimore, Maryland, USA
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26
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Kondrashova T, De Wan D, Briones MU, Kondrashov P. Integration of ultrasound imaging into pre-clinical dental education. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2017; 21:228-234. [PMID: 27041147 DOI: 10.1111/eje.12205] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/15/2016] [Indexed: 06/05/2023]
Abstract
INTRODUCTION Patients have complex healthcare needs and typically require more than one healthcare discipline to address issues regarding their health. Interprofessional teams of healthcare professionals may be able to address these complex needs and improve patient outcomes by combining resources. To evaluate the feasibility of integrating ultrasound into a dental school curriculum to teach anatomy as part of an interprofessional education experience, the current study surveyed first-year dental students to determine their perceptions of the integration of ultrasound techniques into the curriculum. MATERIALS AND METHODS Ultrasound laboratory exercises were developed for first-year dental students as part of their anatomy course. The exercises were focused on head, neck and abdominal anatomy. To assess student perception of the integration of ultrasound into the dental curriculum, a survey was created specifically for the current study. RESULTS Between 2013 and 2015, two classes of first-year dental students participated in the ultrasound laboratory exercise and completed the survey (n = 83). Student survey responses suggested ultrasound was a valuable teaching tool because it allowed them to visualise anatomical structures using live imaging. They also agreed that the ultrasound laboratory exercises were an efficient learning tool, but the majority did not believe that they would use ultrasound regularly in their future practice. CONCLUSIONS Results of the current study suggested first-year dental students were satisfied with the integration of ultrasound techniques into the dental curriculum. Survey results indicated that the students enjoyed the ultrasound laboratory exercise and felt ultrasound was an effective learning tool.
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Affiliation(s)
- T Kondrashova
- Department of Family Medicine, Preventive Medicine and Community Health, Kirksville College of Osteopathic Medicine, A.T. Still University, Kirksville, MO, USA
| | - D De Wan
- Missouri School of Dentistry & Oral Health, A.T. Still University, Kirksville, MO, USA
| | - M U Briones
- Academic Affairs, Kirksville College of Osteopathic Medicine, A.T. Still University, Kirksville, MO, USA
| | - P Kondrashov
- Anatomy Department, Kirksville College of Osteopathic Medicine, A.T. Still University, Kirksville, MO, USA
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Kim D, Park SH. A Microfluidics-based Pulpal Arteriole Blood Flow Phantom for Validation of Doppler Ultrasound Devices in Pulpal Blood Flow Velocity Measurement. J Endod 2016; 42:1660-1666. [DOI: 10.1016/j.joen.2016.08.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 08/09/2016] [Accepted: 08/09/2016] [Indexed: 10/21/2022]
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High-Resolution Ultrasonic Imaging of Dento-Periodontal Tissues Using a Multi-Element Phased Array System. Ann Biomed Eng 2016; 44:2874-2886. [DOI: 10.1007/s10439-016-1634-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 04/29/2016] [Indexed: 10/21/2022]
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Nguyen KCT, Le LH, Kaipatur NR, Major PW. Imaging the Cemento-Enamel Junction Using a 20-MHz Ultrasonic Transducer. ULTRASOUND IN MEDICINE & BIOLOGY 2016; 42:333-8. [PMID: 26546266 DOI: 10.1016/j.ultrasmedbio.2015.09.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 09/08/2015] [Accepted: 09/11/2015] [Indexed: 05/22/2023]
Abstract
The cemento-enamel junction (CEJ), which is the intersection between enamel and cementum, is an important landmark in the diagnosis of periodontal disease. Pulse-echo ultrasound was used to image the CEJs of six porcine lower central incisors with a single 20-MHz transducer. A notch was longitudinally created on the enamel as a stable marker, from which the CEJ was measured. Data were acquired along the tooth's axis at 0.4-mm intervals. Time-distance data were bandpass-filtered to enhance signal-to-noise ratio and record density was increased fourfold to 0.1-mm spacing by a frequency-distance interpolation scheme. Reflections from the CEJ were unambiguously identified along with those from enamel, dentin and cementum. The notch-CEJ distances measured by the ultrasound and micro-computed tomography methods correlated strongly (r = 0.996, p < 0.05) and were in good agreement with the 95% lines of agreement between -0.49 and 0.17 mm, as statistically determined by Bland-Altman analysis. The results indicate the potential of ultrasound to be a reliable and non-ionizing technique to image the CEJ.
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Affiliation(s)
- Kim-Cuong T Nguyen
- School of Dentistry, University of Alberta, Edmonton, Alberta, Canada; Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada
| | - Lawrence H Le
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada.
| | | | - Paul W Major
- School of Dentistry, University of Alberta, Edmonton, Alberta, Canada
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Effect of Cortical Bone Thickness on Detection of Intraosseous Lesions by Ultrasonography. Radiol Res Pract 2015; 2015:797593. [PMID: 26366296 PMCID: PMC4561116 DOI: 10.1155/2015/797593] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2015] [Revised: 08/02/2015] [Accepted: 08/04/2015] [Indexed: 11/18/2022] Open
Abstract
Background. Usefulness of ultrasound (US) in detection of intrabony lesions has been showed. A cortical bone perforation or a very thin and intact cortical bone is prerequisite for this purpose. Objective. The current in vitro study was aimed at measuring the cut-off thickness of the overlying cortical bone which allows ultrasonic assessment of bony defects. Materials and Methods. 20 bovine scapula blocks were obtained. Samples were numbered from 1 to 20. In each sample, 5 artificial lesions were made. The lesions were made in order to increase the overlying bone thickness, from 0.1 mm in the first sample to 2 mm in the last one (with 0.1 mm interval). After that, the samples underwent ultrasound examinations by two practicing radiologists. Results. All five lesions in samples numbered 1 to 11 were detected as hypoechoic area. Cortical bone thickness more than 1.1 mm resulted in a failure in the detection of central lesions. Conclusion. We can conclude that neither bony perforation nor very thin cortical bones are needed to consider US to be an effective imaging technique in the evaluation of bony lesion.
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Patel US, Ghorayeb SR, Yamashita Y, Atanda F, Walmsley AD, Scheven BA. Ultrasound field characterization and bioeffects in multiwell culture plates. J Ther Ultrasound 2015; 3:8. [PMID: 26146556 PMCID: PMC4490766 DOI: 10.1186/s40349-015-0028-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 05/05/2015] [Indexed: 12/04/2022] Open
Abstract
Background Ultrasound with frequencies in the kilohertz range has been demonstrated to promote biological effects and has been suggested as a non-invasive tool for tissue healing and repair. However, many challenges exist to characterize and develop kilohertz ultrasound for therapy. In particular there is a limited evidence-based guidance and standard procedure in the literature concerning the methodology of exposing biological cells to ultrasound in vitro. Methods This study characterized a 45-kHz low-frequency ultrasound at three different preset intensity levels (10, 25, and 75 mW/cm2) and compared this with the thermal and biological effects seen in a 6-well culture setup using murine odontoblast-like cells (MDPC-23). Ultrasound was produced from a commercially available ultrasound-therapy system, and measurements were recorded using a needle hydrophone in a water tank. The transducer was displaced horizontally and vertically from the hydrophone to plot the lateral spread of ultrasound energy. Calculations were performed using Fourier transform and average intensity plotted against distance from the transducer. During ultrasound treatment, cell cultures were directly exposed to ultrasound by submerging the ultrasound transducer into the culture media. Four groups of cell culture samples were treated with ultrasound. Three with ultrasound at an intensity level of 10, 25, and 75 mW/cm2, respectively, and the final group underwent a sham treatment with no ultrasound. Cell proliferation and viability were analyzed from each group 8 days after three ultrasound treatments, each separated by 48 h. Results The ultrasonic output demonstrated considerable lateral spread of the ultrasound field from the exposed well toward the adjacent culture wells in the multiwell culture plate; this correlated well with the dose-dependent increase in the number of cultured cells where significant biological effects were also seen in adjacent untreated wells. Significant thermal variations were not detected in adjacent untreated wells. Conclusions This study highlights the pitfalls of using multiwell plates when investigating the biological effect of kilohertz low-frequency ultrasound on adherent cell cultures.
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Affiliation(s)
- Upen S Patel
- School of Dentistry, College of Medical and Dental Sciences, University of Birmingham, St Chad's Queensway, Birmingham, B4 6NN UK
| | - Sleiman R Ghorayeb
- School of Engineering and Applied Sciences, Ultrasound Research Laboratory, Hofstra University, Hempstead, NY USA ; Immunology and Inflammation-FIMR, North Shore Hospital, Manhasset, NY USA
| | - Yuki Yamashita
- School of Engineering and Applied Sciences, Ultrasound Research Laboratory, Hofstra University, Hempstead, NY USA
| | - Folorunsho Atanda
- School of Engineering and Applied Sciences, Ultrasound Research Laboratory, Hofstra University, Hempstead, NY USA
| | - A Damien Walmsley
- School of Dentistry, College of Medical and Dental Sciences, University of Birmingham, St Chad's Queensway, Birmingham, B4 6NN UK
| | - Ben A Scheven
- School of Dentistry, College of Medical and Dental Sciences, University of Birmingham, St Chad's Queensway, Birmingham, B4 6NN UK
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Hughes DA, Sampathkumar A, Longbottom C, Kirk KJ. Imaging and detection of early stage dental caries with an all-optical photoacoustic microscope. ACTA ACUST UNITED AC 2015. [DOI: 10.1088/1742-6596/581/1/012002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Marotti J, Heger S, Tinschert J, Tortamano P, Chuembou F, Radermacher K, Wolfart S. Recent advances of ultrasound imaging in dentistry--a review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 115:819-32. [PMID: 23706922 DOI: 10.1016/j.oooo.2013.03.012] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Revised: 12/28/2012] [Accepted: 03/16/2013] [Indexed: 02/07/2023]
Abstract
Ultrasonography as an imaging modality in dentistry has been extensively explored in recent years due to several advantages that diagnostic ultrasound provides. It is a non-invasive, inexpensive, painless method and unlike X-ray, it does not cause harmful ionizing radiation. Ultrasound has a promising future as a diagnostic imaging tool in all specialties in dentistry, for both hard and soft tissue detection. The aim of this review is to provide the scientific community and clinicians with an overview of the most recent advances of ultrasound imaging in dentistry. The use of ultrasound is described and discussed in the fields of dental scanning, caries detection, dental fractures, soft tissue and periapical lesions, maxillofacial fractures, periodontal bony defects, gingival and muscle thickness, temporomandibular disorders, and implant dentistry.
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Affiliation(s)
- Juliana Marotti
- Department of Prosthodontics, School of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes 2227, 05508-000 São Paulo-SP.
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Szopinski KT, Regulski P. Visibility of dental pulp spaces in dental ultrasound. Dentomaxillofac Radiol 2013; 43:20130289. [PMID: 24170803 DOI: 10.1259/dmfr.20130289] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The purpose of this study was to assess the feasibility of dental ultrasound with conventional sonographic equipment. The teeth of three adult volunteers who had cone beam CT examinations performed previously with clinical indications and one extracted tooth were examined using linear and compact (hockey stick) sonographic probes. The sonographic images were compared with cone beam CT images reconstructed accordingly. Dental pulp spaces were demonstrated in all teeth not covered with prosthetic crowns. The dentin and pulp were best visualized at the level of the neck of the teeth. The dentin was hypoechoic, and the superficial layer comprising the cementum and the pulp spaces were hyperechoic. Dental ultrasound is feasible with general purpose sonographic machines. The buccal surfaces of all teeth are accessible with a compact (hockey stick) probe. Visualization and differentiation of dental pulp spaces, dentin and the superficial layer comprising cementum is possible in the portions of teeth not covered by the alveolar bone or prosthetic crowns. The dental pulp spaces are best seen at the level of the tooth neck. Pulp and endodontic fillings can be distinguished on ultrasound.
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Affiliation(s)
- K T Szopinski
- Department of Dental and Maxillofacial Radiology, Faculty of Medicine and Dentistry, Medical University of Warsaw, Warsaw, Poland
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Mathieu V, Vayron R, Richard G, Lambert G, Naili S, Meningaud JP, Haiat G. Biomechanical determinants of the stability of dental implants: influence of the bone-implant interface properties. J Biomech 2013; 47:3-13. [PMID: 24268798 DOI: 10.1016/j.jbiomech.2013.09.021] [Citation(s) in RCA: 92] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Revised: 09/18/2013] [Accepted: 09/24/2013] [Indexed: 12/19/2022]
Abstract
Dental implants are now widely used for the replacement of missing teeth in fully or partially edentulous patients and for cranial reconstructions. However, risks of failure, which may have dramatic consequences, are still experienced and remain difficult to anticipate. The stability of biomaterials inserted in bone tissue depends on multiscale phenomena of biomechanical (bone-implant interlocking) and of biological (mechanotransduction) natures. The objective of this review is to provide an overview of the biomechanical behavior of the bone-dental implant interface as a function of its environment by considering in silico, ex vivo and in vivo studies including animal models as well as clinical studies. The biomechanical determinants of osseointegration phenomena are related to bone remodeling in the vicinity of the implants (adaptation of the bone structure to accommodate the presence of a biomaterial). Aspects related to the description of the interface and to its space-time multiscale nature will first be reviewed. Then, the various approaches used in the literature to measure implant stability and the bone-implant interface properties in vitro and in vivo will be described. Quantitative ultrasound methods are promising because they are cheap, non invasive and because of their lower spatial resolution around the implant compared to other biomechanical approaches.
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Affiliation(s)
- Vincent Mathieu
- Université Paris-Est, Laboratoire Modélisation et Simulation Multi Echelle, UMR CNRS 8208, 61 avenue du Général de Gaulle, 94010 Créteil cedex, France
| | - Romain Vayron
- Université Paris-Est, Laboratoire Modélisation et Simulation Multi Echelle, UMR CNRS 8208, 61 avenue du Général de Gaulle, 94010 Créteil cedex, France
| | - Gilles Richard
- Septodont, 58 Rue Pont de Créteil, 94100 Saint-Maur-des-Fossés, France
| | - Grégory Lambert
- Septodont, 58 Rue Pont de Créteil, 94100 Saint-Maur-des-Fossés, France
| | - Salah Naili
- Université Paris-Est, Laboratoire Modélisation et Simulation Multi Echelle, UMR CNRS 8208, 61 avenue du Général de Gaulle, 94010 Créteil cedex, France
| | - Jean-Paul Meningaud
- Service de Chirurgie Plastique, Reconstructrice et Esthétique, CHU H. Mondor, 94017 Créteil cedex, France
| | - Guillaume Haiat
- CNRS, Laboratoire Modélisation et Simulation Multi Echelle, UMR CNRS 8208, 61 avenue du Général de Gaulle, 94010 Créteil cedex, France.
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Culjat MO, Choi M, Singh RS, White SN. Ultrasound imaging of dental implants. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2013; 2012:456-9. [PMID: 23365927 DOI: 10.1109/embc.2012.6345966] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Accurate measurement of soft tissue thickness is needed prior to dental implant placement and prior to surgical uncovering of the implant. Ultrasonography has many potential advantages for use in dental implant surgery, but has not yet been made suitable for clinical use. A 2D ultrasound imaging system and a mechanical positioning system were used to scan dental implants embedded in a porcine jaw, covered by soft tissue, submerged in a water tank. Results indicated that ultrasound can be used to accurately detect, locate, and measure dental implant fixtures and measure the thickness of the overlying soft tissue in an ex vivo environment.
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Ghorayeb SR, Patel US, Walmsley AD, Scheven BA. Biophysical characterization of low-frequency ultrasound interaction with dental pulp stem cells. J Ther Ultrasound 2013; 1:12. [PMID: 25516801 PMCID: PMC4265945 DOI: 10.1186/2050-5736-1-12] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Accepted: 06/01/2013] [Indexed: 11/26/2022] Open
Abstract
Background Low-intensity ultrasound is considered an effective non-invasive therapy to stimulate hard tissue repair, in particular to accelerate delayed non-union bone fracture healing. More recently, ultrasound has been proposed as a therapeutic tool to repair and regenerate dental tissues. Our recent work suggested that low-frequency kilohertz-range ultrasound is able to interact with dental pulp cells which could have potential to stimulate dentine reparative processes and hence promote the viability and longevity of teeth. Methods In this study, the biophysical characteristics of low-frequency ultrasound transmission through teeth towards the dental pulp were explored. We conducted cell culture studies using an odontoblast-like/dental pulp cell line, MDPC-23. Half of the samples underwent ultrasound exposure while the other half underwent ‘sham treatment’ where the transducer was submerged into the medium but no ultrasound was generated. Ultrasound was applied directly to the cell cultures using a therapeutic ultrasound device at a frequency of 45 kHz with intensity settings of 10, 25 and 75 mW/cm2 for 5 min. Following ultrasound treatment, the odontoblast-like cells were detached from the culture using a 0.25% Trypsin/EDTA solution, and viable cell numbers were counted. Two-dimensional tooth models based on μ-CT 2D images of the teeth were analyzed using COMSOL as the finite element analysis platform. This was used to confirm experimental results and to demonstrate the potential theory that with the correct combination of frequency and intensity, a tooth can be repaired using small doses of ultrasound. Frequencies in the 30 kHz–1 MHz range were analyzed. For each frequency, pressure/intensity plots provided information on how the intensity changes at each point throughout the propagation path. Spatial peak temporal average (SPTA) intensity was calculated and related to existing optimal spatial average temporal average (SATA) intensity deemed effective for cell proliferation during tooth repair. Results The results demonstrate that odontoblast MDPC-23 cell numbers were significantly increased following three consecutive ultrasound treatments over a 7-day culture period as compared with sham controls underscoring the anabolic effects of ultrasound on these cells. Data show a distinct increase in cell number compared to the sham data after ultrasound treatment for intensities of 10 and 25 mW/cm2 (p < 0.05 and p < 0.01, respectively). Using finite element analysis, we demonstrated that ultrasound does indeed propagate through the mineralized layers of the teeth and into the pulp chamber where it forms a ‘therapeutic’ force field to interact with the living dental pulp cells. This allowed us to observe the pressure/intensity of the wave as it propagates throughout the tooth. A selection of time-dependent snapshots of the pressure/intensity reveal that the lower frequency waves propagate to the pulp and remain within the chamber for a while, which is ideal for cell excitation. Input frequencies and pressures of 30 kHz (70 Pa) and 45 kHz (31 kPa), respectively, with an average SPTA of up to 120 mW/cm2 in the pulp seem to be optimal and agree with the SATA intensities reported experimentally. Conclusions Our data suggest that ultrasound can be harnessed to propagate to the dental pulp region where it can interact with the living cells to promote dentine repair. Further research is required to analyze the precise physical and biological interactions of low-frequency ultrasound with the dental pulp to develop a novel non-invasive tool for dental tissue regeneration.
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Affiliation(s)
- Sleiman R Ghorayeb
- School of Engineering and Applied Sciences, Ultrasound Research Laboratory, Hofstra University, 104 Weed Hall, Hempstead, NY 11549, USA ; Orthopaedics Research Laboratory, FIMR, North Shore Hospital, Manhassett, NY 11030, USA
| | - Upen S Patel
- School of Dentistry, College of Medical and Dental Sciences, University of Birmingham, St Chad's Queensway, Birmingham B4 6NN, UK
| | - A Damien Walmsley
- School of Dentistry, College of Medical and Dental Sciences, University of Birmingham, St Chad's Queensway, Birmingham B4 6NN, UK
| | - Ben A Scheven
- School of Dentistry, College of Medical and Dental Sciences, University of Birmingham, St Chad's Queensway, Birmingham B4 6NN, UK
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Choi M, Culjat MO, Singh RS, White SN. Ultrasound imagery for dental implant diagnosis and treatment planning in a porcine model. J Prosthet Dent 2012; 108:344-53. [PMID: 23217466 DOI: 10.1016/s0022-3913(12)60190-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Man J, Shelton RM, Cooper PR, Scheven BA. Low-intensity low-frequency ultrasound promotes proliferation and differentiation of odontoblast-like cells. J Endod 2012; 38:608-13. [PMID: 22515888 DOI: 10.1016/j.joen.2012.01.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2011] [Revised: 01/17/2012] [Accepted: 01/30/2012] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Ultrasound is a potential therapeutic tool for dental tissue repair, but its biological effects on odontoblasts have not been well characterized. In this study, the effects of low-intensity low-frequency ultrasound on the viability, proliferation, and differentiation of odontoblast-like cells were investigated. METHODS Cell viability and proliferation were assessed after the treatment of adherent clonal MDPC-23 odontoblast-like cells with a 25-mW/cm(2) 45-kHz ultrasound. An in vitro scratch wound healing assay was used to investigate the ultrasound effects on cell migration. Long-term cultures were used to study odontogenic differentiation and extracellular mineralization. RESULTS Ultrasound exposure for up to 30 minutes did not significantly affect odontoblast-like cell viability but significantly increased cell numbers after 2 days in culture. Ultrasound did not influence the scratch wound closure rate in the absence or presence of the mitogen inhibitor mitomycin C, indicating that ultrasound did not influence cellular migration. Single and consecutive exposures to ultrasound resulted in the enhancement of in vitro mineralization after 14 days in culture with an osteogenic differentiation medium. This coincided with the up-regulation of gene expression of collagen type I, osteoadherin, dentine matrix protein 1, and osteocalcin as well as the expression of cell markers alkaline phosphatase and nestin. CONCLUSIONS These findings indicate that low-frequency ultrasound is able to influence proliferation and differentiation of odontoblast-like cells and may potentially be considered as a therapeutic tool for dental pulp and dentine repair.
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Affiliation(s)
- Jennifer Man
- Oral Biology, School of Dentistry, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
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Harput S, Evans T, Bubb N, Freear S. Diagnostic ultrasound tooth imaging using fractional Fourier transform. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2011; 58:2096-2106. [PMID: 21989873 DOI: 10.1109/tuffc.2011.2059] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
An ultrasound contact imaging method is proposed to measure the enamel thickness in the human tooth. A delay-line transducer with a working frequency of 15 MHz is chosen to achieve a minimum resolvable distance of 400 μm in human enamel. To confirm the contact between the tooth and the transducer, a verification technique based on the phase shift upon reflection is used. Because of the high attenuation in human teeth, linear frequency-modulated chirp excitation and pulse compression are exploited to increase the penetration depth and improve the SNR. Preliminary measurements show that the enamel-dentin boundary creates numerous internal reflections, which cause the applied chirp signals to interfere arbitrarily. In this work, the fractional Fourier transform (FrFT) is employed for the first time in dental imaging to separate chirp signals overlapping in both time and frequency domains. The overlapped chirps are compressed using the FrFT and matched filter techniques. Micro-computed tomography is used for validation of the ultrasound measurements for both techniques. For a human molar, the thickness of the enamel layer is measured with an average error of 5.5% after compressing with the FrFT and 13.4% after compressing with the matched filter based on the average speed of sound in human teeth.
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Affiliation(s)
- Sevan Harput
- Ultrasound Group, School of Electronic and Electrical Engineering, University of Leeds, Leeds, UK.
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Dos Santos S, Prevorovsky Z. Imaging of human tooth using ultrasound based chirp-coded nonlinear time reversal acoustics. ULTRASONICS 2011; 51:667-674. [PMID: 21371732 DOI: 10.1016/j.ultras.2011.01.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2010] [Revised: 01/21/2011] [Accepted: 01/22/2011] [Indexed: 05/30/2023]
Abstract
Human tooth imaging sonography is investigated experimentally with an acousto-optic noncoupling set-up based on the chirp-coded nonlinear time reversal acoustic concept. The complexity of the tooth internal structure (enamel-dentine interface, cracks between internal tubules) is analyzed by adapting the nonlinear elastic wave spectroscopy (NEWS) with the objective of the tomography of damage. Optimization of excitations using intrinsic symmetries, such as time reversal (TR) invariance, reciprocity, correlation properties are then proposed and implemented experimentally. The proposed medical application of this TR-NEWS approach is implemented on a third molar human tooth and constitutes an alternative of noncoupling echodentography techniques. A 10 MHz bandwidth ultrasonic instrumentation has been developed including a laser vibrometer and a 20 MHz contact piezoelectric transducer. The calibrated chirp-coded TR-NEWS imaging of the tooth is obtained using symmetrized excitations, pre- and post-signal processing, and the highly sensitive 14 bit resolution TR-NEWS instrumentation previously calibrated. Nonlinear signature coming from the symmetry properties is observed experimentally in the tooth using this bi-modal TR-NEWS imaging after and before the focusing induced by the time-compression process. The TR-NEWS polar B-scan of the tooth is described and suggested as a potential application for modern echodentography. It constitutes the basis of the self-consistent harmonic imaging sonography for monitoring cracks propagation in the dentine, responsible of human tooth structural health.
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Affiliation(s)
- Serge Dos Santos
- Centre-Val de Loire Université, Unitè Mixte de Recherche "Imagerie et Cerveau" INSERM U930-CNRS ERL 3106, Universit'e François Rabelais ENI Val de Loire, Rue de la Chocolaterie, BP3410, 41034 Blois Cedex, France.
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Salmon B, Le Denmat D. Intraoral ultrasonography: development of a specific high-frequency probe and clinical pilot study. Clin Oral Investig 2011; 16:643-9. [PMID: 21380502 DOI: 10.1007/s00784-011-0533-z] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2010] [Accepted: 02/18/2011] [Indexed: 01/28/2023]
Abstract
Although ultrasonography is a non-invasive, inexpensive and painless diagnostic tool for soft tissue imaging, this technique is not currently used for oral exploration. Therefore, we developed a 25-MHz high-frequency ultrasound probe, specially designed for intraoral applications. This paper aims to present clinical intraoral ultrasound images actually interpretable, in order to identify the relevant applications of this novel tool and to design future oral studies. Two independent radiologists performed ultrasound examinations on three healthy volunteers. All the teeth were explored on the lingual and buccal sides (162 samples) to evaluate the ergonomics of the system and the visualisation of anatomic structures. Osseointegrated dental implants and a mucocele were also scanned. At the gingivodental junction of the maxillary and mandibular teeth, the device clearly identifies the tooth surfaces, the alveolar bone reflection with its surrounding subepithelial connective tissue of the gingiva and the gingival epithelia. The bone level and the thickness of soft tissue around the implant are measurable on the buccal and lingual sides. Therefore, intraoral ultrasonography provides additional morphological information that is not accessible by conventional dental x-rays. We propose a novel diagnostic tool that explores the biological width and is able to define the thin or thick nature of the gums. Moreover, intraoral ultrasonography may help to monitor precancerous lesions. This promising device requires large-scale clinical studies to determine whether it should remain a research tool or be used as a diagnostic tool for daily dental practice.
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Affiliation(s)
- Benjamin Salmon
- EA 2496/Laboratoire de Radiologie-Imagerie et Biophysique, Faculté de Chirurgie Dentaire, Paris Descartes University, 1, rue Maurice Arnoux, 92120 Montrouge, France.
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High-resolution 3D ultrasound jawbone surface imaging for diagnosis of periodontal bony defects: an in vitro study. Ann Biomed Eng 2010; 38:3409-22. [PMID: 20532630 DOI: 10.1007/s10439-010-0089-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2010] [Accepted: 05/26/2010] [Indexed: 02/07/2023]
Abstract
Although medical specialties have recognized the importance of using ultrasonic imaging, dentistry is only beginning to discover its benefit. This has particularly been important in the field of periodontics which studies infections in the gum and bone tissues that surround the teeth. This study investigates the feasibility of using a custom-designed high-frequency ultrasound imaging system to reconstruct high-resolution (< 50 μm) three-dimensional (3D) surface images of periodontal defects in human jawbone. The system employs single-element focused ultrasound transducers with center frequencies ranging from 30 to 60 MHz. Continuous acquisition using a 1 GHz data acquisition card is synchronized with a high-precision two-dimensional (2D) positioning system of ±1 μm resolution for acquiring accurate measurements of the mandible, in vitro. Signal and image processing algorithms are applied to reconstruct high-resolution ultrasound images and extract the jawbone surface in each frame. Then, all edges are combined and smoothed in order to render a 3D surface image of the jawbone. In vitro experiments were performed to assess the system performance using mandibles with teeth (dentate) or without (nondentate). The system was able to reconstruct 3D images for the mandible's outer surface with superior spatial resolution down to 24 μm, and to perform the whole scanning in < 30 s. Major anatomical landmarks on the images were confirmed with the anatomical structures on the mandibles. All the anatomical landmarks were detected and fully described as 3D images using this novel ultrasound imaging technique, whereas the 2D X-ray radiographic images suffered from poor contrast. These results indicate the great potential of utilizing high-resolution ultrasound as a noninvasive, nonionizing imaging technique for the early diagnosis of the more severe form of periodontal disease.
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Culjat MO, Goldenberg D, Tewari P, Singh RS. A review of tissue substitutes for ultrasound imaging. ULTRASOUND IN MEDICINE & BIOLOGY 2010; 36:861-73. [PMID: 20510184 DOI: 10.1016/j.ultrasmedbio.2010.02.012] [Citation(s) in RCA: 319] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2009] [Revised: 02/03/2010] [Accepted: 02/22/2010] [Indexed: 05/05/2023]
Abstract
The characterization and calibration of ultrasound imaging systems requires tissue-mimicking phantoms with known acoustic properties, dimensions and internal features. Tissue phantoms are available commercially for a range of medical applications. However, commercial phantoms may not be suitable in ultrasound system design or for evaluation of novel imaging techniques. It is often desirable to have the ability to tailor acoustic properties and phantom configurations for specific applications. A multitude of tissue-mimicking materials and phantoms are described in the literature that have been created using a variety of materials and preparation techniques and that have modeled a range of biological systems. This paper reviews ultrasound tissue-mimicking materials and phantom fabrication techniques that have been developed over the past four decades, and describes the benefits and disadvantages of the processes. Both soft tissue and hard tissue substitutes are explored.
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Affiliation(s)
- Martin O Culjat
- Center for Advanced Surgical and Interventional Technology (CASIT), UCLA, Los Angeles, CA, USA.
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Scheven B, Shelton R, Cooper P, Walmsley A, Smith A. Therapeutic ultrasound for dental tissue repair. Med Hypotheses 2009; 73:591-3. [DOI: 10.1016/j.mehy.2009.05.032] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2009] [Revised: 05/22/2009] [Accepted: 05/27/2009] [Indexed: 01/26/2023]
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Hua J, Chen SK, Kim Y. Refining enamel thickness measurements from B-mode ultrasound images. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2009; 2009:440-443. [PMID: 19964934 DOI: 10.1109/iembs.2009.5334783] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Dental erosion has been growing increasingly prevalent with the rise in consumption of heavy starches, sugars, coffee, and acidic beverages. In addition, various disorders, such as Gastroenterological Reflux Disease (GERD), have symptoms of rapid rates of tooth erosion. The measurement of enamel thickness would be important for dentists to assess the progression of enamel loss from all forms of erosion, attrition, and abrasion. Characterizing enamel loss is currently done with various subjective indexes that can be interpreted in different ways by different dentists. Ultrasound has been utilized since the 1960s to determine internal tooth structure, but with mixed results. Via image processing and enhancement, we were able to refine B-mode dental ultrasound images for more accurate enamel thickness measurements. The mean difference between the measured thickness of the occlusal enamel from ultrasound images and corresponding gold standard CT images improved from 0.55 mm to 0.32 mm with image processing (p = 0.033). The difference also improved from 0.62 to 0.53 mm at the buccal/lingual enamel surfaces, but not significantly (p = 0.38).
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Affiliation(s)
- Jeremy Hua
- Department of Bioengineering, University of Washington, Seattle, WA 98195 USA. jhua27@ u.washington.edu
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Scheven BA, Man J, Millard JL, Cooper PR, Lea SC, Walmsley AD, Smith AJ. VEGF and odontoblast-like cells: stimulation by low frequency ultrasound. Arch Oral Biol 2008; 54:185-91. [PMID: 18980757 DOI: 10.1016/j.archoralbio.2008.09.008] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2008] [Revised: 08/22/2008] [Accepted: 09/21/2008] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Vascular endothelial growth factor (VEGF) has been implicated in the regulation of dental pulp and dentine repair. Therapeutic ultrasound was shown to be effective for fracture repair. We investigated whether low frequency ultrasound influences the production of VEGF by odontoblast-like cells. Moreover, we examined the direct effects of VEGF on odontoblast-like cell proliferation. DESIGN MDPC-23, an established odontoblast-like cell line, was exposed to increasing intensities of 30kHz ultrasound using an ultrasonic tip probe. RESULTS After 24h cell culture, WST-1 analysis of cell viability and number showed a dose-dependent decrease in the number of viable cells with increasing ultrasound power. However, the relative concentration of VEGF as analysed by ELISA and normalised to cell number was significantly increased in the culture supernatants indicating an ultrasound-induced stimulation of odontoblastic VEGF secretion. Analysis of VEGF gene expression by sqRT-PCR revealed the expression of the main VEGF isoforms in the MDPC-23 cells, i.e. VEGF(120) and VEGF(164) as well as to a minor extent VEGF(188). Low power ultrasound increased gene expression of all VEGF isoforms. Addition of recombinant VEGF to the cell cultures significantly stimulated cell proliferation. Gene expression of the VEGF receptors Flt1/VEGFR1 and KDR/VEGFR2 was detected in the MDPC-23, suggesting the possibility that VEGF may act on the odontoblast-like cells in an autocrine manner. CONCLUSIONS Our results indicate that ultrasound promoted VEGF expression and production by odontoblast-like cells and that VEGF may have autocrine effects on these cells. It is proposed that ultrasound may influence odontoblast activity and dentine repair by modulating production of endogenous growth factors in the dentine-pulp complex.
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Affiliation(s)
- B A Scheven
- University of Birmingham School of Dentistry, St Chad's Queensway, Birmingham B46NN, UK.
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