Periodontal evaluation using a non-invasive imaging method (ultrasonography)

Abstract

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.

A miniaturized ultrasound transducer for monitoring full-mouth oral health: a preliminary study

“…(7) Compared with laser Doppler flowmetry, Doppler ultrasound measurement offers real-time diagnosis as well as high reproducibility that allows monitoring oral microcirculation changes over time; metal constructions and/or implants do not limit studies of blood flow in the gingiva or tooth pulp. (8) Previously, we and others (9)(10)(11)(12)(13)(14) have reported that ultrasound imaging has major value in oral health and can improve the limitations of conventional methods. (15,16) Ultrasound offers visualization of anatomical features including the alveolar bone (AB), alveolar bone crest (ABC), cementoenamel junction (CEJ), gingival margin (GM), gingival thickness, etc.…”

Three-dimensional periodontal investigations using a prototype handheld ultrasound scanner with spatial positioning reading sensor

“…Noninvasive techniques to image gingival soft tissues are not currently available in dentistry. Bi-dimensional ultrasound (2D US) imaging has already shown great potential for evaluating periodontal soft-tissue structures [2][3][4][5]. Lin et al demonstrated that periodontal probing depths could be measured with photoacoustic imaging [6].…”

High-Frequency Ultrasound Assessment of Skin and Oral Mucosa in Metabolic Syndrome Patients—A Cross-Sectional Study

“…It is known that patients diagnosed with MS have a disrupted dermis, due to alteration of collagen fiber structure, that can be assessed using ultrasound examination; diffuse and impaired collagen matrix is responsible for skin frailty and low mechanical strength [ 9 ]. Ultrasound applications in the maxillofacial area include investigation of lymph nodes, salivary glands, and benign and malignant tumors and monitoring of soft tissue healing, inflammation and degenerative processes, and anatomy and physiology of dento-periodontal dynamics [ 10 , 11 ]. HFU finds its applications in the diagnosis of pigmented lesions, autoimmune and degenerative diseases, and benign and malignant tumors [ 12 ], but also in the monitoring and controlling of the aging process [ 13 ], tissue healing, and regenerative processes [ 14 , 15 , 16 ].…”