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.
Bibliographical noteFunding Information:
The authors would like to thank Dr. Erika Benavides, DDS, PhD, Clinical Associate Professor, University of Michigan School of Dentistry, for providing CBCT services, and Ms. Alicia Baker, Clinic Coordinator and Cynthia Miller and Veronica Slayton, Dental Assistants, for assisting with this project. The study was supported by grants from the University of Michigan, Michigan Institute for Clinical and Health Research (MICHR) (UL1TR000433), Ann Arbor, Michigan; the Delta Dental Foundation (AWD004687), Okemos, Michigan; the Osteology Foundation (AWD003900), Lucerne, Switzerland; AAP Sunstar Innovation Award (AWD007224), Chicago, Illinois; Department of Periodontics and Oral Medicine Clinical Research Supplemental Research Grant, Ann Arbor, Michigan; and School of Dentistry Research Collaborative Award, Ann Arbor, Michigan. The authors report no conflicts of interest related to this study.
- alveolar ridge, bone
- cone-beam computed tomography, dental implants, periodontium, ultrasonography
PubMed: MeSH publication types
- Journal Article
- Research Support, N.I.H., Extramural
- Research Support, Non-U.S. Gov't