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Qi B, Khazeinezhad R, Hariri A, Yim W, Jin Z, Sasi L, Chen C, Jokerst JV. Three-dimensional mapping of the greater palatine artery location and physiology. Dentomaxillofac Radiol 2023; 52:20230066. [PMID: 37641889 DOI: 10.1259/dmfr.20230066] [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] [Indexed: 08/31/2023] Open
Abstract
OBJECTIVE To develop a novel technique for localizing and reconstructing the greater palatine artery (GPA) using three-dimensional (3D) technology. METHODS A miniaturized intraoral ultrasound transducer was used to imaging landmarks including the GPA, gingival margin (GM), and palatal masticatory mucosa (PMM). A 5-mm-thick solid hydrogel couplant was integrated to replace traditional ultrasound gel and avoid bubbles when moving the transducer. RESULTS A panorama image provided the relative localization of landmarks including the GPA, PMM, and hard palate. Short- and long-axis imaging of GPA was performed in five subjects including 3D mapping of GPA branches and surrounding tissues in a volume of 10 mm × 8 mm × 10 mm. Full-mouth Doppler imaging was also demonstrated on both the dorsal and ventral tongue as well as buccal mucosa and sublingual region on two subjects. CONCLUSIONS This study can measure the vertical distance from the GM to the GPA and depth from PMM to GPA and visualize the GPA localization in a 3D manner, which is critical to evaluate the available volume of palatal donor tissues and avoid sectioning of GPA during surgical harvesting of the tissues. Finally, the transducer's small size facilitates full-mouth Doppler imaging with the potential to improve the assessment, diagnosis, and management of oral mucosa.
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Affiliation(s)
- Baiyan Qi
- Materials Science and Engineering Program, University of California San Diego, La Jolla, California, United States
| | | | - Ali Hariri
- StyloSonic LLC, Lake Forest, California, United States
| | - Wonjun Yim
- Materials Science and Engineering Program, University of California San Diego, La Jolla, California, United States
| | - Zhicheng Jin
- Department of Nanoengineering, University of California San Diego, La Jolla, California, United States
| | - Lekshmi Sasi
- Department of Nanoengineering, University of California San Diego, La Jolla, California, United States
| | - Casey Chen
- Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, California, United States
| | - Jesse V Jokerst
- Materials Science and Engineering Program, University of California San Diego, La Jolla, California, United States
- Department of Nanoengineering, University of California San Diego, La Jolla, California, United States
- Department of Radiology, University of California San Diego, La Jolla, California, United States
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Koca-Ünsal RB, Ünsal G, Kasnak G, Fıratlı Y, Özcan İ, Orhan K, Fıratlı E. Ultrasonographic evaluation of the titanium-prepared platelet-rich fibrin effect in free gingival graft procedures. J Periodontol 2021; 93:187-194. [PMID: 34060090 DOI: 10.1002/jper.21-0076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 04/25/2021] [Accepted: 05/27/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND Complications after free gingival graft (FGG) operations are generally related to the donor site. The titanium-prepared, platelet-rich fibrin (T-PRF) placement in the donor site accelerate the wound healing and prevent postoperative complications such as pain and hemorrhage. We aim to evaluate the effect of T-PRF regarding vascularization and tissue thickness and to report the advantages of the ultrasonography (US) in FGG. METHODS Ten individuals were divided into two groups as T-PRF and control. While the T-PRF membrane was placed at the donor site in the T-PRF group, a gelatin sponge was placed in the control group. All patients underwent US examination in terms of vascularization and tissue thickness of left and right donor sites. The correlation between the right and left donor sites was analyzed with the Pearson correlation test. Tissue thicknesses and pulsatility index (PI) were analyzed with independent samples t-test. The results were evaluated statistically at the P <0.05 significance level. RESULTS The T-PRF group showed increased vascularity which can be interpreted to improve healing in soft tissue. However, not a difference, but a positively very high correlation was observed between the right and left tissue thicknesses (P = 0,00; r = +0902). CONCLUSIONS Evaluation of tissue thickness and vascularization density of donor sites with US not only increases clinical success rate but also reduces the risk of complications during surgery and postoperative pain in FGG. Studies evaluating T-PRF membrane as palatal dressing after FGG are only clinical, however, the efficiency of T-PRF was evaluated radiologically in this study for the first time.
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Affiliation(s)
- Revan Birke Koca-Ünsal
- Department of Periodontology, University of Kyrenia, Faculty of Dentistry, Kyrenia, Cyprus
| | - Gürkan Ünsal
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Near East University, Nicosia, Cyprus.,DESAM Institute, Near East University, Nicosia, Cyprus
| | - Gökhan Kasnak
- Department of Periodontology, Faculty of Dentistry, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Yiğit Fıratlı
- Department of Periodontology, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - İlknur Özcan
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Kaan Orhan
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey.,Medical Design Application and Research Center, Ankara University, Ankara, Turkey
| | - Erhan Fıratlı
- Department of Periodontology, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
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Asai S, Kaneko A, Matsuda T, Takanashi N, Doi M, Atsumi H, Ogura G, Nakamura N, Miyachi H. Sonographic appearance of syphilitic induration mimicking squamous cell carcinoma in the lower lip: a case report. J Med Case Rep 2020; 14:211. [PMID: 33143735 PMCID: PMC7641852 DOI: 10.1186/s13256-020-02547-x] [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: 11/04/2018] [Accepted: 10/02/2020] [Indexed: 11/14/2022] Open
Abstract
Background Syphilis is a sexually transmitted disease caused by the spirochete Treponema pallidum. Recently, its incidence has been increasing worldwide. We encountered a young woman who presented with induration mimicking squamous cell carcinoma in the lower lip, without major medical conditions. Case presentation A 25-year-old Japanese woman presented with a 1-month history of a painless induration in her lower lip. Because squamous cell carcinoma was suspected, a preoperation work up was performed, including laboratory tests, an ultrasonographic examination, and a biopsy. The ultrasonography findings showed an oval-shaped 17 × 11 × 12 mm tumor-like lesion with heterogeneous internal echo and an indistinct border. A pressure test and color Doppler sonography revealed that the lesion was soft with a very abundant blood flow. These findings suggested the possibility of underlying inflammatory causes rather than a neoplastic tumor. Serology tests for syphilis, including the anti-Treponema pallidum antibody and reactive rapid plasma reagin tests, were positive. The biopsy revealed no malignancy. Finally, she was diagnosed as having primary syphilis and treated with amoxicillin for 28 days. The rapid plasma reagin value gradually decreased and the initial induration in her lower lip disappeared. Conclusion This case highlights the need for prompt examinations for possible underlying infective causes, such as syphilis, when seeing a painless induration with ulcer in the lip. Ultrasonography was helpful in the differential diagnosis of a tumor-like lesion and should be included in addition to syphilis serology tests, such as anti-Treponema pallidum antibody and rapid plasma reagin tests.
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Affiliation(s)
- Satomi Asai
- Department of Laboratory Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan.
| | - Akihiro Kaneko
- Department of Dentistry Oral Surgery, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan
| | - Tsukumi Matsuda
- Clinical Laboratory Center, Tokai University Hospital, Isehara, Kanagawa, 259-1193, Japan
| | - Noboru Takanashi
- Clinical Laboratory Center, Tokai University Hospital, Isehara, Kanagawa, 259-1193, Japan
| | - Mika Doi
- Department of Laboratory Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
| | - Haruyo Atsumi
- Department of Laboratory Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
| | - Go Ogura
- Department of Pathology, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan
| | - Naoya Nakamura
- Department of Pathology, Tokai University School of Medicine, Isehara, Kanagawa, 259-1193, Japan
| | - Hayato Miyachi
- Department of Laboratory Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
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Liu Y, Zhu J, Guo H, Li W, Li J, Wang Y, Bilig A, Wang X. Buccal Mucosa Assessed by Ultrasonography in Healthy Adults: Methodology and Determination of Normal Appearance. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:1297-1305. [PMID: 30826154 DOI: 10.1016/j.ultrasmedbio.2019.01.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Revised: 01/10/2019] [Accepted: 01/15/2019] [Indexed: 06/09/2023]
Abstract
The aim of the work described here was to compare intra-oral and transcutaneous ultrasonography (US) scanning and to determine the normal values of buccal mucosa thickness and echogenicity. A total of 190 volunteers underwent US examination of the buccal mucosa. The thickness of the buccal epithelial layer was recorded in 19 subjects via both intra-oral and transcutaneous methods. Overall, 171 healthy adults were examined through intra-oral US. Buccal epithelial layer measurement was unreliable via the transcutaneous method (p = 0.001). The mean time required for visualizing the buccal mucosa was 75 and 171s with intra-oral and transcutaneous US, respectively (p < 0.001). The thickness of the buccal epithelial layers significantly differed with age and sex (p < 0.001), and was positively correlated with height, weight and body surface area. Intra-oral US was proposed as a conventional method for examination of the buccal mucosa. Normal buccal epithelial thickness in adults is associated with age, sex, height, weight and body surface area.
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Affiliation(s)
- Yiqun Liu
- Department of Ultrasound, Peking University People's Hospital, Beijing, China
| | - Jiaan Zhu
- Department of Ultrasound, Peking University People's Hospital, Beijing, China.
| | - Huijie Guo
- Department of Stomatology, Peking University People's Hospital, Beijing, China
| | - Wenxue Li
- Department of Ultrasound, Peking University People's Hospital, Beijing, China
| | - Jianguo Li
- Department of Ultrasound, Peking University People's Hospital, Beijing, China
| | - Yehong Wang
- Department of Ultrasound, Shuangyashan People's Hospital, Shuangyashan, Heilongjiang, China
| | - Ariun Bilig
- Department of Ultrasound, Peking University People's Hospital, Beijing, China
| | - Xiuming Wang
- Department of Ultrasound, Peking University People's Hospital, Beijing, China
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Ultrasonographic evaluation of submucosal thickness in oral submucous fibrosis patients: a cross-sectional study. Pol J Radiol 2018; 83:e280-e288. [PMID: 30627248 PMCID: PMC6323594 DOI: 10.5114/pjr.2018.76795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 04/04/2018] [Indexed: 11/17/2022] Open
Abstract
Purpose To evaluate the role of ultrasonography in oral submucous fibrosis (OSMF) patients. Material and methods A total of 150 subjects were divided equally into six groups (Group I: 25 healthy subjects; Group II: 25 healthy subjects with habit; Group III: 25 OSMF stage I; Group IV: 25 OSMF stage II; Group V: 25 OSMF stage III; and Group VI: 25 stage OSMF IVA). The grading of OSMF were done according the clinical classification given by Khanna and Andrade (2005). After fulfilling inclusion and exclusion criteria each subject underwent extraoral ultrasonographic evaluation of submucosal thickness and vascularity in terms of peak systolic velocity (PSV), bilaterally on buccal and labial mucosa. Furthermore, statistical comparison of each group was done, and sensitivity and specificity of USG measurements was obtained in comparison with clinical diagnosis. The statistical analysis was performed using SPSS ver. 20.0. Results A statistically significant increase in mean submucosal thickness was shown, and a decrease in PSV with the advancement of severity of the OSMF. In ultrasonographic diagnosis of OSMF, the reported submucosal thickness had a sensitivity, specificity, PPV, NPV, and accuracy was 80%, 100%, 100%, 71.4%, and 87%, respectively, but PSV failed to classify the lesion. Conclusions Because the severity of the disease showed a direct relationship with submucosal thickness and an inverse relationship with PSV, habit-induced mucosal alteration in submucosal thickness can be seen on USG, which cannot be appreciated on clinical examination. Hence, USG can be a promising tool for early diagnosis, assessment of the severity, and evaluation of prognosis of OSMF.
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Izzetti R, Fantoni G, Gelli F, Faggioni L, Vitali S, Gabriele M, Caramella D. Feasibility of intraoral ultrasonography in the diagnosis of oral soft tissue lesions: a preclinical assessment on an ex vivo specimen. Radiol Med 2017; 123:135-142. [PMID: 28948476 DOI: 10.1007/s11547-017-0817-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 09/14/2017] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The early detection of oral soft tissue lesions is an important prognostic factor, and the possibility of using ultrasonography (US) as a diagnostic tool may improve the diagnosis and characterization of tissue alterations at an early stage. This study aims to evaluate the feasibility of intraoral US by performing a preclinical assessment of an ex vivo specimen in which focal lesions were simulated. MATERIALS AND METHODS Fourteen lesions were simulated on a freshly extracted calf tongue, by introducing in the tongue different materials mimicking the appearance of various focal lesions. The specimen was scanned with a 8 MHz US probe and computed tomography (CT) was performed to compare the two imaging techniques. Later, the specimen was dissected to set a benchmark for size assessment. RESULTS US was able to identify all the simulated lesions within the tongue, resulting in one case more accurate than CT. Statistical analysis demonstrated high correlation between the measurements of the simulated lesions performed on the US images and the real size of the materials introduced in the tongue (p < 0.05). CONCLUSIONS This preclinical study proves that US performs well in the detection and characterization of simulated lesions of the tongue. These findings suggest that US could be effectively used in clinical applications. However, further research is mandatory to assess the reliability of in vivo US in the detection and characterization of tongue lesions as well as of other oral soft tissue alterations.
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Affiliation(s)
- Rossana Izzetti
- Department of Translational Research on New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
| | - Gualtiero Fantoni
- Department of Civil and Industrial Engineering, University of Pisa, Pisa, Italy
| | | | - Lorenzo Faggioni
- Diagnostic and Interventional Radiology, University of Pisa, Via Paradisa 2, 56100, Pisa, Italy
| | - Saverio Vitali
- Diagnostic and Interventional Radiology, University of Pisa, Via Paradisa 2, 56100, Pisa, Italy
| | - Mario Gabriele
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Davide Caramella
- Diagnostic and Interventional Radiology, University of Pisa, Via Paradisa 2, 56100, Pisa, Italy
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