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Rodriguez Betancourt A, Samal A, Chan HL, Kripfgans OD. Overview of Ultrasound in Dentistry for Advancing Research Methodology and Patient Care Quality with Emphasis on Periodontal/Peri-implant Applications. Z Med Phys 2023; 33:336-386. [PMID: 36922293 PMCID: PMC10517409 DOI: 10.1016/j.zemedi.2023.01.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 12/20/2022] [Accepted: 01/11/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND Ultrasound is a non-invasive, cross-sectional imaging technique emerging in dentistry. It is an adjunct tool for diagnosing pathologies in the oral cavity that overcomes some limitations of current methodologies, including direct clinical examination, 2D radiographs, and cone beam computerized tomography. Increasing demand for soft tissue imaging has led to continuous improvements on transducer miniaturization and spatial resolution. The aims of this study are (1) to create a comprehensive overview of the current literature of ultrasonic imaging relating to dentistry, and (2) to provide a view onto investigations with immediate, intermediate, and long-term impact in periodontology and implantology. METHODS A rapid literature review was performed using two broad searches conducted in the PubMed database, yielding 576 and 757 citations, respectively. A rating was established within a citation software (EndNote) using a 5-star classification. The broad search with 757 citations allowed for high sensitivity whereas the subsequent rating added specificity. RESULTS A critical review of the clinical applications of ultrasound in dentistry was provided with a focus on applications in periodontology and implantology. The role of ultrasound as a developing dental diagnostic tool was reviewed. Specific uses such as soft and hard tissue imaging, longitudinal monitoring, as well as anatomic and physiological evaluation were discussed. CONCLUSIONS Future efforts should be directed towards the transition of ultrasonography from a research tool to a clinical tool. Moreover, a dedicated effort is needed to introduce ultrasonic imaging to dental education and the dental community to ultimately improve the quality of patient care.
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Affiliation(s)
| | - Ankita Samal
- Department of Radiology, Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Hsun-Liang Chan
- Department of Periodontology and Oral Medicine, Dental School, University of Michigan, Ann Arbor, MI, USA
| | - Oliver D Kripfgans
- Department of Radiology, Medical School, University of Michigan, Ann Arbor, MI, USA
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Kim D, Ko HS, Park SY, Ryu SY, Park SH. The effects of gingival blood flow on pulpal blood flow detection using ultrasound Doppler flowmetry: animal study. Restor Dent Endod 2023; 48:e9. [PMID: 36875807 PMCID: PMC9982237 DOI: 10.5395/rde.2023.48.e9] [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: 10/04/2022] [Revised: 10/27/2022] [Accepted: 10/27/2022] [Indexed: 02/10/2023] Open
Abstract
Objectives This study evaluated the effect of adjacent gingival blood flow on detection of pulpal blood flow (PBF) using ultrasound Doppler flowmetry (UDF) through animal study. Materials and Methods The study included 36 right and left maxillary the third incisors and canines in 9 experimental dogs. The study included 2 main steps: In the first step, the pulse sound level (PSL) was recorded on the cervical part of each tooth without flap elevation (Group 1), with flap elevation (Group 2), and after it was repositioned in place (Group 3). In the second step, the PSL was recorded on the cervical part of each tooth (Group 4), after pulpotomy (Group 5), after partial pulp extirpation (Group 6), after complete extirpation (Group 7), and after canal filling (Group 8). In Groups 5-8, the study was performed with and without flap elevation in the left and right teeth, respectively. The PSL was graded as follows: 0, inaudible; 1, heard faintly; and 2, heard well. The difference between each group was analyzed using Friedman's test with Wilcoxon signed-rank tests (α = 0.05). Results In step 1, the PSL results were Group 1 > 2 and 3. In step 2, there was no significant difference between the groups when the flap was not elevated, while PSL results were Group 4 > 5 ≥ 6 and 7 ≥ 8 when the flap was elevated. Conclusions PBF is affected by gingival blood flow when measured with UDF. UDF measurements require isolation of gingiva from the tooth.
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Affiliation(s)
- Dohyun Kim
- Department of Conservative Dentistry, Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea
| | - Hyoung-Seok Ko
- Department of Conservative Dentistry, Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea
| | - Soo-Yeon Park
- Department of Conservative Dentistry, Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea
| | - Seung-Yeon Ryu
- Department of Conservative Dentistry, Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea
| | - Sung-Ho Park
- Department of Conservative Dentistry, Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea
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Wu C, Liu X, Zhang H, Zhang Q, Ding S, Jin S, Zheng X, Fu C, Han Q, Shen J, Xu J, Ye N, Jiang F, Wu T. Response of human periodontal ligament to orthodontic force using superb microvascular imaging. Am J Orthod Dentofacial Orthop 2022; 162:e257-e266. [PMID: 36089442 DOI: 10.1016/j.ajodo.2022.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 08/01/2022] [Accepted: 08/01/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Remodeling of the periodontal ligament (PDL) during orthodontic tooth movement is closely related to the vascularity of the PDL, which has not been thoroughly investigated in humans. This study aimed to measure the width and vascular parameters of human PDL using superb microvascular imaging for the first time. METHODS Patients aged 18-25 years were selected for participation. The intervention was randomly allocated from the maxillary canines to the first molars on both sides using 50 g or 150 g of force. The width and vascular parameters of the PDL were measured using superb microvascular imaging at different time intervals (baseline, 30 minutes, and 1, 3, 7, and 14 days). RESULTS Before the intervention, the width of the PDL ranged from 0.14 to 0.25 mm, and the vascular index ranged from 9.40% to 13.54%. After applying orthodontic forces, the cervical and middle PDL widths increased. The vascular index decreased slightly in 30 minutes, decreased to a minimum value after 1 day, increased to the maximum in 3-7 days, and returned to baseline values in 14 days. The values of other vascular parameters showed similar trends. CONCLUSIONS The width and vascular parameters of the PDL changed slightly after force application, underwent changes in the period of reconstruction for 3-7 days, and eventually returned to baseline in 14 days.
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Affiliation(s)
- Chuan Wu
- Department of Orthodontics, School and Hospital of Stomatology, Anhui Medical University, Anhui Provincial Key Laboratory of Oral Diseases, Hefei, Anhui, China
| | - Xiaoyu Liu
- Department of Orthodontics, School and Hospital of Stomatology, Anhui Medical University, Anhui Provincial Key Laboratory of Oral Diseases, Hefei, Anhui, China
| | - Huan Zhang
- Department of Medical Ultrasound, the Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Qunyan Zhang
- Department of Orthodontics, School and Hospital of Stomatology, Anhui Medical University, Anhui Provincial Key Laboratory of Oral Diseases, Hefei, Anhui, China
| | - Siqi Ding
- Department of Orthodontics, School and Hospital of Stomatology, Anhui Medical University, Anhui Provincial Key Laboratory of Oral Diseases, Hefei, Anhui, China
| | - Shiyu Jin
- Department of Orthodontics, School and Hospital of Stomatology, Anhui Medical University, Anhui Provincial Key Laboratory of Oral Diseases, Hefei, Anhui, China
| | - Xiuyun Zheng
- Department of Orthodontics, School and Hospital of Stomatology, Anhui Medical University, Anhui Provincial Key Laboratory of Oral Diseases, Hefei, Anhui, China
| | - Chunfeng Fu
- Department of Orthodontics, School and Hospital of Stomatology, Anhui Medical University, Anhui Provincial Key Laboratory of Oral Diseases, Hefei, Anhui, China
| | - Quancheng Han
- Department of Orthodontics, School and Hospital of Stomatology, Anhui Medical University, Anhui Provincial Key Laboratory of Oral Diseases, Hefei, Anhui, China
| | - Jun Shen
- Department of Orthodontics, School and Hospital of Stomatology, Anhui Medical University, Anhui Provincial Key Laboratory of Oral Diseases, Hefei, Anhui, China
| | - Jianguang Xu
- Department of Orthodontics, School and Hospital of Stomatology, Anhui Medical University, Anhui Provincial Key Laboratory of Oral Diseases, Hefei, Anhui, China
| | | | - Fan Jiang
- Department of Medical Ultrasound, the Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
| | - Tingting Wu
- Department of Orthodontics, School and Hospital of Stomatology, Anhui Medical University, Anhui Provincial Key Laboratory of Oral Diseases, Hefei, Anhui, China.
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Liang X, Xie L, Zhang Q, Wang G, Zhang S, Jiang M, Zhang R, Yang T, Hu X, Yang Z, Tian W. Gelatin methacryloyl-alginate core-shell microcapsules as efficient delivery platforms for prevascularized microtissues in endodontic regeneration. Acta Biomater 2022; 144:242-257. [PMID: 35364321 DOI: 10.1016/j.actbio.2022.03.045] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 03/17/2022] [Accepted: 03/24/2022] [Indexed: 02/06/2023]
Abstract
Combined injectable cell-laden microspheres and angiogenesis approaches are promising for functional vascularized endodontic regeneration. However, advanced microsphere designs and production techniques that benefit practical applications are rarely developed. Herein, gelatin methacryloyl (GelMA)-alginate core-shell microcapsules were fabricated to co-encapsulate human dental pulp stem cells (hDPSCs) and human umbilical vein endothelial cells (HUVECs) based on a coaxial electrostatic microdroplet technique. This technique enables high-throughput production, convenient collection, and minimal material waste. The average diameter of core-shell microcapsules was ∼359 µm, and that of GelMA cores was ∼278 µm. There were higher proliferation rates for hDPSCs and HUVECs co-encapsulated in the GelMA cores than for hDPSCs or HUVECs monoculture group. HUVECs assembled to form 3D capillary-like networks in co-culture microcapsules. Moreover, HUVECs promoted the osteo/odontogenic differentiation of hDPSCs in microcapsules. After 14 days of cultivation, prevascularized microtissues formed in microcapsules that contained abundant deposited extracellular matrix (ECM); no microcapsule aggregation occurred. In vivo studies confirmed that better microvessel formation and pulp-like tissue regeneration occurred in the co-culture group than in hDPSCs group. Thus, an effective platform for prevascularization microtissue preparation was proposed and showed great promise in endodontic regeneration and tissue engineering applications. STATEMENT OF SIGNIFICANCE: Cell-laden microspheres combined with the proangiogenesis approach are promising in endodontic regeneration. We proposed GelMA-alginate core-shell microcapsules generated via the coaxial electrostatic microdroplet (CEM) method, which utilizes a double-lumen needle to allow for core-shell structures to form. The microcapsules were used for co-culturing hDPSCs and HUVECs to harvest large amounts of prevascularized microtissues, which further showed improved vascularization and pulp-like tissue regeneration in vivo. This CEM method and the microcapsule system have advantages of high-throughput generation, convenient collection, and avoid aggregation during long-term culturing. We proposed a high-effective platform for mass production of prevascularized microtissues, which exhibit great promise in the clinical transformation of endodontic regeneration and other applications in regenerative medicine.
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Affiliation(s)
- Xi Liang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China; Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Li Xie
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
| | - Qingyuan Zhang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China; Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Ge Wang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China; Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Siyuan Zhang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Mingyan Jiang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China; Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Ruitao Zhang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China; Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Ting Yang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China; Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Xingyu Hu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China; Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Ziyang Yang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China; Department of Stomatology, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China
| | - Weidong Tian
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China; Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.
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