Ultrasonographic characterization of lingual structures pertinent to oral, periodontal, and implant surgery

Abstract

Objectives Increased applications of ridge augmentation in the lingual posterior mandible call for an urgent need to study its anatomy. Therefore, our first aim was to validate ultrasound in measuring the mandibular lingual structures in human cadavers. Secondarily, to test its feasibility in imaging the lingual nerve in live humans. Materials and methods Nine fresh un‐embalmed fully/partially edentulous cadaver heads were utilized for aim 1. Three areas in the lingual mandible were imaged (mandibular premolar, molar, and retromolar). Immediately after, biopsies were harvested from each site. The thickness of the mucosa, mylohyoid muscle, and lingual nerve diameter was measured via ultrasound and statistically compared to histology. Similarly, the lingual nerve in live humans was also imaged. Results None of the differences between the ultrasound and histology measurements reached statistical significance (p > .05). The mean mucosal thickness via ultrasound and histology was 1.45 ± 0.49 and 1.39 ± 0.50 mm, 5 mm lingual to the mylohyoid muscle attachment. At 10 mm beyond the attachment, the ultrasound and histologic values were 1.54 ± 0.48 and 1.37 ± 0.49, respectively. The mean muscle thickness measured via ultrasound and histology was 2.31 ± 0.56 and 2.25 ± 0.47 mm, at the 5 mm distance. At the 10 mm distance, the measurements were 2.46 ± 0.56 and 2.36 ± 0.5 mm, respectively. The mean ultrasonic lingual nerve diameter was 2.38 ± 0.44 mm, versus 2.43 ± 0.42 mm, with histology. The lingual nerve diameter on 19 live humans averaged to 2.01 ± 0.35 mm (1.4–3.1 mm). Conclusions Within its limitations, ultrasound accurately measured mandibular lingual soft tissue structures on cadavers, and the lingual nerve on live humans.

The peri‐implant phenotype and implant esthetic complications. Contemporary overview

“…Ultrasonography has shown to be a non-invasive and reliable tool for assessing peri-implant soft and hard tissues in real-time. [72][73][74] Unlike natural teeth, the STH reflects the fact that the supracrestal connective tissue is not attached to the implant abutment surface; hence, STH should not be used interchangeably with the term "supracrestal tissue attachment" around natural teeth, which has recently been proposed to replace the classical term "biologic width". 17 The principle of "biologic width" had comprised the junctional epithelium and the supracrestal connective tissue 75 to be associated with the physiologic establishment of the peri-implant biologic space to protect the bone level.…”

Acellular dermal matrix for root coverage procedures: 9‐year assessment of treated isolated gingival recessions and their adjacent untreated sites

“…In addition, it would have been beneficial had we had information on GT at baseline for the adjacent untreated sites for further assessment of the effect of GT on the progression of recessions and its role in stability. The method for assessing GT may also have some limitations, including the possibility in needle bending and patient discomfort, which can be reduced with the use of contemporary non‐invasive and more accurate technologies 51 . Lastly, it should be noted that although no changes in RECd at the untreated sites were noticed at the 1‐year recall, originally some of the vertical releasing incisions had been performed close to the gingival margin of the untreated sites which could have induced a local trauma.…”

Ultrasonographic tissue perfusion analysis at implant and palatal donor sites following soft tissue augmentation: A clinical pilot study

“…The ultrasound equipment setup and the scanning procedures were performed by two experienced operators with expertise in the field of ultrasonography (H.C. and O.K.) (Chan, Sinjab, et al, 2017; Chan, Wang, et al, 2017; Tattan et al, 2019; Barootchi, Chan, et al, 2020; Chan & Kripfgans, 2020b). The scans were taken at baseline (prior to the initiation of the surgical procedure), and at 1‐week, 1‐month, 6‐month and 12‐month follow‐up appointments at both the implant recipient and palatal donor sites.…”

“…Over the past decade, technological advancements have had major impact in dentistry by changing the way that oral health care is delivered. Non‐ionizing, cross‐sectional and real‐time ultrasonography (US) is a promising imaging modality that serves as a valuable tool for evaluation of vital anatomical structures, and soft and hard tissue dimensions (Chan, Sinjab, et al, 2017; Bhaskar et al, 2018; Barootchi, Chan, et al, 2020; Chan & Kripfgans, 2020b). Recently, studies have validated the accuracy of US compared to histology or cone‐beam computed tomography (Chan, Sinjab, et al, 2017; Chan et al, 2018; Tattan et al, 2019; Barootchi, Chan, et al, 2020).…”