The periodontal disease and gingival bleeding are highly prevalent in the adult population worldwide. The World Health Organization (WHO) data shows that 90–100% of the 34-year-old adults present gingival inflammation. Therefore, an investigation method is required to allow the assessment of the periodontal disease as well as the monitoring of the evolution of the gingival inflammation after periodontal treatments. Non-invasive and operator-independent methods for periodontal examination are necessary for diagnosing and monitoring the periodontal disease. The periodontal ultrasonography is a reliable technique for visualizing the anatomical elements which are necessary to diagnose the periodontal status. Using this imaging technique the dentino-enamel junction, the cortical bone, the radicular surface from the crown to the alveolar bone, the gingival tissue can be seen without interfering with those elements during the examination. Also, calculus visualization is possible before and after scaling in order to evaluate the quality of the treatment. Using 2D ultrasonography is not feasible in dental practice as it requires extensive experience and is also time consuming. The reproducibility of the 2D slices is very difficult in order to have the possibility to compare different investigations efficiently. 3D reconstructions of the periodontal tissue can be a very good alternative to eliminate the operator dependence. Ultrasonography allows the practitioner to visualize the anatomic elements involved in making a periodontal diagnosis. It also allows tracking of subsequent changes. This method is not commonly used for periodontal examination and further studies are required. Previous studies show that ultrasonography can be a reliable non-invasive method to diagnose and monitor the periodontal disease.

Brackets are metallic dental devices that are very often associated with acidic soft drinks such as cola and energy drinks. Acid erosion may affect the bonding between brackets and the enamel surface. The purpose of this study was to investigate the characteristics of brackets’ adhesion, in the presence of two different commercially available drinks. Sixty human teeth were divided into six groups and bonded with either resin-modified glass ionomer (RMGIC) or resin composite (CR). A shared bond test (SBS) was evaluated by comparing two control groups with four other categories, in which teeth were immersed in either Coca-ColaTM or Red BullTM energy drink. The debonding between the bracket and enamel was evaluated by SEM. The morphological aspect correlated with SBS results showed the best results for the samples exposed to artificial saliva. The best adhesion resistance to the acid erosion environment was observed in the group of teeth immersed in Red BullTM and with brackets bonded with RMGIC. The debonded structures were also exposed to Coca-ColaTM and Red BullTM to assess, by atomic force microscopy investigation (AFM), the erosive effect on the enamel surface after debonding and after polishing restoration. The results showed a significant increase in surface roughness due to acid erosion. Polishing restoration of the enamel surface significantly reduced the surface roughness that resulted after debonding, and inhibited acid erosion. The roughness values obtained from polished samples after exposure to Coca-ColaTM and Red BullTM were significantly lower in that case than for the debonded structures. Statistical results evaluating roughness showed that Red BullTM has a more erosive effect than Coca-Cola™. This result is supported by the large contact surface that resulted after debonding. In conclusion, the prolonged exposure of the brackets to acidic drinks affected the bonding strength due to erosion propagation into both the enamel–adhesive interface and the bonding layer. The best resistance to acid erosion was obtained by RMGIC.

Aim: To demonstrate the feasibility of the 3D ultrasound periodontal tissue reconstruction of the lateral area of a porcine mandible using standard 2D ultrasound equipment and spatial positioning reading sensors. Material and method: Periodontal 3D reconstructions were performed using a free-hand prototype based on a 2D US scanner and a spatial positioning reading sensor. For automated data processing, deep learning algorithms were implemented and trained using semi-automatically seg-mented images by highly specialized imaging professionals. Results: US probe movement analysis showed that non-parallel 2D frames were acquired during the scanning procedure. Comparing 3 different 3D periodontal reconstructions of the same porcine mandible, the accuracy ranged between 0.179 mm and 0.235 mm. Conclusion: The present study demonstrated the diagnostic potential of 3D reconstruction using a free-hand 2D US scanner with spatial positioning readings. The use of auto-mated data processing with deep learning algorithms makes the process practical in the clinical environment for assessment of periodontal soft tissues.

The primary aim of this study was to demonstrate that periodontal ultrasonography is a reliable method with which to identify and evaluate the attachment level of the gingival junctional epithelium. A secondary aim was to devise an automated computer-assisted method that allows the examiner to more easily identify the gingival sulcus contour on ultrasound images. Material and methods: This in vitro study was carried out on 36 sites on the lingual surface of eight pig mandibles. For each site, periodontal ultrasonography was performed by the same examiner, using DermaScan C Cortex Technology (Denmark) with a 20-MHz transducer. Subsequently, the mandibles were sectioned with a microtome and examined by direct microscopy. To facilitate identification of the gingival sulcus on ultrasound images, a computational method was adopted. Results: Computer processing of the ultrasound images slightly modified the contour of the gingival sulcus. The absolute mean differences in the linear measurements of the Dermascan-automated computer-generated values and the corresponding values of microscopy, which is the gold standard, varied between 0.06 and 1.75 mm. Statistical analysis showed that with respect to the gingival sulcus height, the correlation between the computer-processed ultrasound images and the direct microscopy images was stronger than the correlation between the non-processed ultrasound images and those from direct microscopy. Conclusions: Ultrasonographic examination of the periodontal tissues allows the examiner to localize the gingival epithelial attachment level and provides substantial data regarding the soft gingival tissues.

The aim of this study was to evaluate the usefulness of 40 MHz periodontal ultrasonography in the assessment of gingival inflammation, following professional teeth cleaning. Material and methods: The study was performed on 18 teeth without restorations having subgingival calculus (upper and lower premolars and frontal teeth). After the clinical exam the Gingival Index and the Sulcus Bleeding Index were calculated. Then a 40MHz transducer (ULTRASONIX SonoTouch device) was used to obtain longitudinal sections in the frontal plane. Three measurements were performed: alveolar crest -cementumenamel junction distance (ACJ), gingival height (GH), and gingival width (GW). Professional cleaning was performed by ultrasound scaling (SatelecP5 booster, France) and airflow (NSK, Japan). Two and seven days after the first evaluation, ultrasonographic and clinical examinations were repeated. Results: Two days after the treatment the median value of the ACJ, was 2.70 (2.38; 2.95) mm, whereas 7 days after treatment it was 2.55 (2.45; 3.01) mm. The intraclass correlation coefficient for ACJ measurement was 98.8 (p<0.001).The values obtained measuring GH [3.84(3.44; 4.27) mm vs. 3.52 (3.00; 3.76) mm] and GW [(1.81 (1.65; 1.95) mm vs.1.62 (1.40; 1.95) mm) had statistically significant differences between the 2nd and 7th day. Conclusions: Periodontal ultrasonography is a highly precise and reproducible imagistic method, with which bone resorption, gingival inflammation as well as the presence or absence of subgingival calculus can be assessed.