Ultrasound examination for the detection of simulated periapical bone lesions in bovine mandibles: an ex vivo study

Abstract

AimTo evaluate the accuracy of ultrasound examination (USE) for the detection of artificial bone defects in bovine mandibles in the absence of complete erosion of the cortical bone plate and to determine the minimum cortical thickness that constitutes a barrier for ultrasound waves.Methodology Sixty bovine mandibular anatomical blocks were harvested and uniformly distributed amongst six experimental groups. The negative control consisted of blocks with no intra‐bony defects, whereas the positive control consisted of blocks with an artificial lesion of 2 mm diameter that perforated the buccal cortical bone plate. Two experimental groups comprised blocks with small (2 mm) and large (5 mm) artificial defects created under a cortical plate thinned to varying thicknesses. Two additional groups had small (2 mm) and large (5 mm) artificial defects that did not involve the cortical plate. After USE, the scans were saved and submitted to three blinded examiners. Sensitivity, specificity, predictive values and receiver‐operating characteristics (ROC) were analysed. The significance of the findings (P < 0.05) was appraised using the chi‐square statistics with the Yates correction, whilst the intra‐ and inter‐examiner agreements were evaluated through Kappa statistics.ResultsUSE was associated with high sensitivity (97.3%) and negative predictive value (89%), and a perfect score for specificity and positive predictive value. The ROC curve analysis revealed an accuracy of 97.8%. The k‐values were 0.86 and 0.89 for the first and second examinations, respectively, demonstrating very high inter‐observer agreement. The intra‐observer agreement was also high (k‐value = 0.92). A significant correlation between the echographic diagnosis and the presence or absence of artificial intraosseous lesions in the anatomical blocks of bovine mandibles was observed (P < 0.0001).ConclusionsUSE was highly accurate and reliable for the detection of artificial lesions within bovine mandibles, regardless of the thickness or presence of the cortical plate.

Ultrasound Imaging versus Radiographs in Differentiating Periapical Lesions: A Systematic Review

“…This is an advantage for diagnosis in cases where a severe infection or a large lesion does not allow adequate mouth opening in the patient or when a patient is not cooperative and cannot follow instructions. The placement of radiographic films in the posterior regions of the mouth often presents a problem where the films cannot be placed due to a shallow sulcus, which can be eliminated by this method [ 55 , 56 , 57 ].…”

Ultrasound imaging for the differential diagnosis of periapical lesions of endodontic origin in comparison with histopathology – a systematic review and meta‐analysis

“…However, a recent animal study by Musu et al . (2020) reported that US imaging has the ability to assess even smaller (2mm) periapical lesions but this needs to be verified in future human clinical studies.…”

“…This is reflected in most of the articles included in this systematic review wherein 83% of periapical lesions included were from the anterior region (147 teeth) and only 17% were from the posterior region (31 teeth). However, a recent animal study by Musu et al (2020) reported that US imaging has the ability to assess even smaller (2mm) periapical lesions but this needs to be verified in future human clinical studies.…”

The usefulness of ultrasonography as a dynamic measurement system for visualizing root canal working length: an in vivo study

“…In another study that involved bovine mandibular bone, intraosseous lesions could be visualized with a high degree of accuracy and reliability regardless of cortical bone thickness. US demonstrated a remarkable sensitivity of 97.3% and a negative predictive value of 89% [ 29 ]. In addition, US could be used to detect intraosseous lesions by establishing a cortical thickness threshold of 1.1 mm for the examination of intrabony defects [ 30 ].…”