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Yu HC, Kripfgans OD, Rodriguez AB, Samal A, Quesada C, Webber LP, Mazzocco JP, Wang IC, Woo J, Chan HL. Ultrasonography-Derived Elasticity Estimation of Live Porcine Oral Mucosa. J Ultrasound Med 2024; 43:237-251. [PMID: 37846622 DOI: 10.1002/jum.16352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 10/18/2023]
Abstract
OBJECTIVES To investigate the biomechanical properties of porcine oral tissues with in vivo ultrasonography and to compare the difference between oral alveolar mucosa and gingival tissue concerning compressional and tensile mechanical strain. MATERIALS AND METHODS Sinclair minipigs (6 females and 4 males, 6 to 18 months of age) were anesthetized for ultrasonography. In vivo high-frequency tissue harmonic ultrasound (12/24 MHz) cine-loops were obtained while inducing mechanical tissue stress (0 to 1 N). Post-processing strain analysis was performed in a cardiac speckle tracking software (EchoInsight®). Region of interest (ROI) was placed for gingival and alveolar mucosa tissues for longitudinal (compressional) and tensile strain analyses. A calibrated gel pad was employed to determine the absolute force (pressure) for the measured tissue strain response function. The resulting elasticity data was statistically analyzed using custom Matlab scripts. RESULTS In total, 38 sonography cine-loops around the third premolars were included in the investigation. The longitudinal strain of alveolar mucosaε AM L was found to be significantly (P < .05) larger than that of gingivaε G L . Across the measured force range,ε AM L ~ 1.7 × ε G L . Significant differences between alveolar mucosa and gingiva tissues were found for all forces. The tensile strain of the alveolar mucosaε AM T was found to be ~2 × ε G T (on the epithelial surface of the gingiva). Both were statistically significantly different for forces exceeding ~0.08 N. At depth, that is, 500 and 1000 μm below the epithelial surface, the gingiva was found to have less ability to stretch contrary to the alveolar mucosa. Gingival tissue at 500 μm depth has significantly less tensile strain than at its surface and more than at 1000 μm depth. In contrast, the tensile strain of alveolar mucosa is largely independent of depth. CONCLUSION Ultrasonography can reveal significant differences in oral alveolar mucosal and gingival elastic properties, such as compressional and tensile strain. Under minute forces equivalent to 10 to 40 g, these differences can be observed. As dental ultrasound is a chairside, and noninvasive modality, obtaining real-time images might soon find clinical utility as a new diagnostic tool for the objective and quantitative assessment of periodontal and peri-implant soft tissues in clinical and research realms. As ultrasound is a safe modality with no known bioeffects, longitudinal monitoring of areas of concern would be particularly attractive.
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Affiliation(s)
- Hsi-Chien Yu
- Department of Radiology, School of Medicine, University of Michigan, Ann Arbor, MI, USA
- Department of Oral and Maxillofacial Surgery, Chi Mei Medical Center, Tainan, Taiwan
| | - Oliver D Kripfgans
- Department of Radiology, School of Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Amanda B Rodriguez
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Ankita Samal
- Department of Radiology, School of Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Carole Quesada
- Department of Radiology, School of Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Liana P Webber
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - John P Mazzocco
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - I-Ching Wang
- Department of Periodontics, College of Dentistry and Dental Clinics, University of Iowa, Iowa City, IA, USA
| | - Jaeman Woo
- Department of Dentistry, College of Medicine and Graduate School of Medicine, Jeju National University, Jeju, Republic of Korea
| | - Hsun-Liang Chan
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
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