Overview of Ultrasound in Dentistry for Advancing Research Methodology and Patient Care Quality with Emphasis on Periodontal/Peri-implant Applications

Betancourt, Amanda Rodriguez; Samal, Ankita; Chan, Hsun‐Liang; Kripfgans, Oliver D.

doi:10.1016/j.zemedi.2023.01.005

Cited by 11 publications

(22 citation statements)

References 392 publications

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“…Clinical wound healing indices are not only used to assess the current condition but also serve as a means to inform treatment prognosis. Through the integration of biomechanical, aesthetic, patient-centered, and pathophysiological parameters, it may be possible to gain more useful healing information by monitoring the clinical representations of these critical healing events and evaluating the degree of stability by both visual and functional examinations [ 1 , 4 , 5 , 7 , 14 , 23 , 31 ]. The evaluation categories should be distinct without overlapping criteria so the examiners can score a given wound with confidence.…”

Section: Discussionmentioning

confidence: 99%

“…Considering the heterogeneity of the parameters assessed and the timing of the evaluation, a thoroughly wound healing index is deemed necessary. Some key points to include are primary and secondary treatment outcomes, follow-up duration, time of assessment, a criterion for defining success and failure, defect size, clinical measurement [ 7 , 11 , 27 , 31 , 40 ], and the possible use of non-invasive, point-of-care tools to quantify healing i.e., ultrasound, and laser speckle contrast imaging [ 1 , 24 – 26 , 32 , 38 , 39 ]. This study comprehensively reviewed the currently availvble indices and highlighted the unmet needs that can serve as the framework for future research directions enabling evidence-based wound healing evaluation and outcome assessment [ 1 , 5 , 7 , 14 , 22 , 23 , 25 , 27 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

“…Surgical healing is a complex process of repair or regeneration of treated tissue which occurs in four main phases: hemostasis, inflammation, proliferation, and remodeling [ 1 ]. Hemostasis occurs immediately upon injury, starting with vasoconstriction and platelet activation [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

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A systematic review of oral wound healing indices

Rodriguez,

Alhachache,

Velasquez

et al. 2024

PLoS ONE

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Wound healing monitoring for abnormality identification and intervention is crucial to securing a successful surgical outcome. Indices have been used to summarize the degree of healing. Given the increasing frequency of regenerative procedures which preserve dentition and implant stability, and the higher esthetic demands, an appraisal of the available indices is needed to identify the current knowledge gap. This study aimed to systematically review published oral wound healing indices and scores. Materials and Methods: A complete literature electronic search in 5 databases was conducted by two reviewers. A combination of keywords related to oral wound healing was used. Results: A total of 11 articles were included in the evaluation of various procedures (conventional periodontal procedures, guided tissue regeneration, soft tissue reconstruction procedures, and tooth extractions), at different time points (1 day to 12 weeks), with a focus on diverse clinical signs and symptoms. Frequently evaluated parameters included wound dehiscence/epithelialization (91%), tissue color (redness) (73%), suppuration (55%), swelling/edema (55%), and hemostasis (55%). Other less commonly used parameters include esthetics-related and patient-centered outcomes. Conclusion: The available indices evaluate a diverse group of subjective clinical signs and symptoms to estimate the underlying biological healing events and assess the degree of clinical success. The majority of the included indices are not validated. Quantitative and objective subclinical parameters including blood perfusion, biomaterial stability, and completeness of epithelialization, are needed for customized wound healing care and better outcome prediction.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A systematic review of oral wound healing indices

Rodriguez,

Alhachache,

Velasquez

et al. 2024

PLoS ONE

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“…Preclinical studies have shown that measurements conducted in US images have high accuracy when compared to micro‐CT estimations 29,30 . More recently, human study results have indicated that intraoral US has relevant diagnostic capability in the periodontium 31–35 . Studies have also used the color flow/power function in US to evaluate blood flow in periodontal structures 36 …”

Section: Introductionmentioning

confidence: 99%

“…Previous studies have reviewed some of the applications of US in periodontium imaging 23,35 . A recent systematic review has been published investigating the accuracy of probing, US, and CBCT in assessing the buccal alveolar bone around implants and found that US needs further scientific validation 37 .…”

Section: Introductionmentioning

confidence: 99%

Use of ultrasound imaging for assessment of the periodontium: A systematic review

Figueredo,

Catunda,

Gibson

et al. 2023

J of Periodontal Research

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The objective of this study was to systematically review the literature regarding diagnostic applications of ultrasound imaging for evaluation of the periodontium in humans. The search was conducted on Medline, EMBASE, Web of Science, Scopus, Cochrane, and PubMed up to April 3, 2023. The studies included were exclusively human studies that assessed the periodontium with ultrasound (US) imaging (b‐mode). Outcomes measured included alveolar bone level, alveolar bone thickness, gingival thickness, and blood flow quantification. References were imported to Covidence. Two reviewers conducted phases 1 and 2. The JBI risk assessment tool for cross‐sectional studies was used. Extracted data included the transducer and measurements used and the study's outcomes. The search yielded 4892 studies after removing duplicates. From these, 25 studies were included and selected for extraction. Included studies retrieved outcomes from US examinations of the periodontal tissues. From the selected studies, 15 used US on natural teeth, 4 used US on implants, 2 used US on edentulous ridges, and 4 used color flow/power in US to evaluate the blood flow. The results of the present systematic review suggest that US might be a feasible and valuable diagnostic tool for the periodontium, with the potential to complement shortfalls of current radiographic technologies.

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Ultrasound‐based jawbone surface quality evaluation after alveolar ridge preservation

Rodriguez,

Kripfgans,

Kozloff

et al. 2024

Journal of Periodontology

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BackgroundBone readiness for implant placement is typically evaluated by bone quality/density on 2‐dimensional radiographs and cone beam computed tomography at an arbitrary time between 3 and 6 months after tooth extraction and alveolar ridge preservation (ARP). The aim of this study is to investigate if high‐frequency ultrasound (US) can classify bone readiness in humans, using micro‐CT as a reference standard to obtain bone mineral density (BMD) and bone volume fraction (BVTV) of healed sockets receiving ARP in humans.MethodsA total of 27 bone cores were harvested during the implant surgery from 24 patients who received prior extraction with ARP. US images were taken immediately before the implant surgery at a site co‐registered with the tissue biopsy collection location, made possible with a specially designed guide, and then classified into 3 tiers using B‐mode image criteria (1) favorable, (2) questionable, and (3) unfavorable. Bone mineral density (hydroxyapatite) and BVTV were obtained from micro‐CT as the gold standard.ResultsHydroxyapatite and BVTV were evaluated within the projected US slice plane and thresholded to favorable (>2200 mg/cm3; >0.45 mm3/mm3), questionable (1500–2200 mg/cm3; 0.4–0.45 mm3/mm3), and unfavorable (<1500 mg/cm3; <0.4 mm3/mm3). The present US B‐mode classification inversely scales with BMD. Regression analysis showed a significant relation between US classification and BMD as well as BVTV. T‐test analysis demonstrated a significant correlation between US reader scores and the gold standard. When comparing Tier 1 with the combination of Tier 2 and 3, US achieved a significant group differentiation relative to mean BMD (p = 0.004, true positive 66.7%, false positive 0%, true negative 100%, false negative 33.3%, specificity 100%, sensitivity 66.7%, receiver operating characteristics area under the curve 0.86). Similar results were found between US‐derived tiers and BVTV.ConclusionPreliminary data suggest US could classify jawbone surface quality that correlates with BMD/BVTV and serve as the basis for future development of US‐based socket healing evaluation after ARP.

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Overview of Ultrasound in Dentistry for Advancing Research Methodology and Patient Care Quality with Emphasis on Periodontal/Peri-implant Applications

Cited by 11 publications

References 392 publications

A systematic review of oral wound healing indices

A systematic review of oral wound healing indices

Use of ultrasound imaging for assessment of the periodontium: A systematic review

Ultrasound‐based jawbone surface quality evaluation after alveolar ridge preservation

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