Ultrasonography for Chairside Evaluation of Periodontal Structures: A Pilot Study

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 (US) in measuring periodontal dimensions, compared to direct clinical and cone‐beam computed tomography (CBCT) methods.

Methods

A 24‐MHz US 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 US images were interpreted by 2 calibrated examiners. Inter‐rater agreement was calculated by using inter‐rater correlation coefficient (ICC). US readings were compared to 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 US and direct readings ranged from 0.667 to 0.957. The mean difference in mucosal thickness (tooth) between the US and direct readings was −0.015 mm (95% CI: −0.655 to 0.624 mm) without statistical significance. ICC between US and CBCT ranged from 0.654 to 0.849 among the measured parameters. The mean differences between US 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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https://aap.onlinelibrary.wiley.com/doi/abs/10.1002/JPER.19-0342?af=R