Comparison of ultrasound imaging and cone-beam computed tomography for examination of the alveolar bone level: A systematic review

Kim-Cuong T Nguyen, Camila Pachêco-Pereira, Neelambar R Kaipatur, June Cheung, Paul W Major, Lawrence H Le, Kim-Cuong T Nguyen, Camila Pachêco-Pereira, Neelambar R Kaipatur, June Cheung, Paul W Major, Lawrence H Le

Abstract

Background and objective: The current methods to image alveolar bone in humans include intraoral 2D radiography and cone-beam computed tomography (CBCT). However, these methods expose the subject to ionizing radiation. Therefore, ultrasound imaging has been investigated as an alternative technique, as it is both non-invasive and free from ionizing radiation. In order to assess the validity and reliability of ultrasonography in visualizing alveolar bone, a systematic review was conducted comparing ultrasound imaging to CBCT for examination of the alveolar bone level.

Study design: Seven databases were searched. Studies addressing examination of alveolar bone level via CBCT and ultrasound were selected. Risk of bias under Cochrane guidelines was used as a methodological quality assessment tool.

Results: All the four included studies were ex vivo studies that used porcine or human cadaver samples. The alveolar bone level was measured by the distance from the alveolar bone crest to certain landmarks such as cemento-enamel junction or gingival margin. The risk of bias was found as low. The mean difference between ultrasound and CBCT measurements ranged from 0.07 mm to 0.68 mm, equivalent to 1.6% - 8.8%.

Conclusions: There is currently preliminary evidence to support the use of ultrasonography as compared to CBCT for the examination of alveolar bone level. Further studies comparing ultrasound to gold standard methods would be necessary to help validate the accuracy of ultrasonography as a diagnostic technique in periodontal imaging.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1. Modified PRISMA flow chart with…
Fig 1. Modified PRISMA flow chart with the database search and resultant screening process [32].
Fig 2. Risk of bias of the…
Fig 2. Risk of bias of the included studies.
Fig 3. Agreement between ultrasound and CBCT…
Fig 3. Agreement between ultrasound and CBCT in Chifor et al. (2011) and Chan et al. (2017b) using Bland-Altman plotting.

References

    1. Kumar G. Orban's oral histology & embryology: Elsevier Health Sciences; 2014.
    1. Chu T-MG, Liu SS-Y, Babler WJ. Craniofacial Biology, Orthodontics, and Implants Basic and Applied Bone Biology: Elsevier; 2014. p. 225–42.
    1. Jeffcoat MK. Bone loss in the oral cavity. J Bone Miner Res. 1993;8(S2):S467–73.
    1. Li X, Kolltveit KM, Tronstad L, Olsen I. Systemic diseases caused by oral infection. Clin Microbiol Rev. 2000;13(4):547–58.
    1. Agueda A, Echeverría A, Manau C. Association between periodontitis in pregnancy and preterm or low birth weight: Review of the literature. Med Oral Patol Oral Cir Bucal. 2008;13(9):609–15.
    1. Pinson M, Hoffman WH, Garnick JJ, Litaker MS. Periodontal disease and type diabetes mellitus in children and adolescents. J Clin Periodontol. 1995;22(2):118–23.
    1. Janket S-J, Baird AE, Chuang S-K, Jones JA. Meta-analysis of periodontal disease and risk of coronary heart disease and stroke. Oral Surg Oral Med Oral Pathol Oral Radiol. 2003;95(5):559–69.
    1. Nicolosi L, Lewin P, Rudzinski J, Pompeo M, Guanca F, Rodríguez P, et al. Relation between periodontal disease and arterial stiffness. J Periodontal Res. 2016.
    1. Kassebaum NJ, Bernabé E, Dahiya M, Bhandari B, Murray C, Marcenes W. Global Burden of Severe Periodontitis in 1990–2010 A Systematic Review and Meta-regression. J Dent Res. 2014: November; 93(11):1045–53. 10.1177/0022034514552491
    1. Agrawal P, Sanikop S, Patil S. New developments in tools for periodontal diagnosis. Int Dent J. 2012;62(2):57–64. 10.1111/j.1875-595X.2011.00099.x
    1. Listgarten M. Periodontal probing: what does it mean? J Clin Periodontol. 1980;7(3):165–76.
    1. Xiang X, Sowa MG, Iacopino AM, Maev RG, Hewko MD, Man A, et al. An update on novel non-invasive approaches for periodontal diagnosis. J Periodontol. 2010;81(2):186–98. 10.1902/jop.2009.090419
    1. Walter C, Dent PDM, Schmidt JC, Dula K. Cone beam computed tomography (CBCT) for diagnosis and treatment planning in periodontology: A systematic review. Quintessence Int (Berlin, Germany: 1985). 2015;47(1):25–37.
    1. Vasconcelos KD, Evangelista KM, Rodrigues CD, Estrela C, de Sousa TO, Silva MAG. Detection of periodontal bone loss using cone beam CT and intraoral radiography. Dentomaxillofac Rad. 2012;41(1):64–9.
    1. Sun L, Zhang L, Shen G, Wang B, Fang B. Accuracy of cone-beam computed tomography in detecting alveolar bone dehiscences and fenestrations. Am J Orthod Dentofacial Orthop. 2015;147(3):313–23. 10.1016/j.ajodo.2014.10.032
    1. Kook Y-A, Kim G, Kim Y. Comparison of alveolar bone loss around incisors in normal occlusion samples and surgical skeletal class III patients. The Angle Orthod. 2011;82(4):645–52. 10.2319/070111-424.1
    1. Haas LF, Zimmermann GS, De Luca Canto G, Flores-Mir C, Corrêa M. Precision of cone beam CT to assess periodontal bone defects: a systematic review and meta-analysis. Dentomaxillofac Rad. 2017; 47(2):20170084.
    1. Leung CC, Palomo L, Griffith R, Hans MG. Accuracy and reliability of cone-beam computed tomography for measuring alveolar bone height and detecting bony dehiscences and fenestrations. Am J Orthod Dentofacial Orthop. 2010;137(4):S109–S19.
    1. Grimard BA, Hoidal MJ, Mills MP, Mellonig JT, Nummikoski PV, Mealey BL. Comparison of clinical, periapical radiograph, and cone-beam volume tomography measurement techniques for assessing bone level changes following regenerative periodontal therapy. J Periodontol. 2009;80(1):48–55. 10.1902/jop.2009.080289
    1. Bushberg JT, Boone JM. The essential physics of medical imaging Lippincott Williams & Wilkins; 2011.
    1. Cootney RW. Ultrasound imaging: principles and applications in rodent research. Ilar Journal. 2001;42(3):233–47.
    1. Le LH, Gu YJ, Li YP, Zhang C. Probing long bones with ultrasonic body waves. Appl Phys Lett. 2010;96(11): 114102.
    1. Nguyen KCT, Le LH, Tran TNHT, Sacchi MD, Lou EHM. Excitation of ultrasonic Lamb waves using a phased array system with two array probes: Phantom and in vitro bone studies. Ultrasonics. 2014;54(5):1178–85. 10.1016/j.ultras.2013.08.004
    1. Degen K, Habor D, Radermacher K, Heger S, Kern JS, Wolfart S, et al. Assessment of cortical bone thickness using ultrasound. Clin Oral Implants Res. 2017;28(5):520–8. 10.1111/clr.12829
    1. Chen W, Lou EH, Zhang PQ, Le LH, Hill D. Reliability of assessing the coronal curvature of children with scoliosis by using ultrasound images. J Child Orthop. 2013;7(6):521–9. 10.1007/s11832-013-0539-y
    1. Marotti J, Heger S, Tinschert J, Tortamano P, Chuembou F, Radermacher K, et al. Recent advances of ultrasound imaging in dentistry–a review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013;115(6):819–32. 10.1016/j.oooo.2013.03.012
    1. Palou ME, McQuade MJ, Rossmann JA. The Use of Ultrasound for the Determination of Periodontal Bone Morphology. J Periodontol. 1987;58(4):262–5. 10.1902/jop.1987.58.4.262
    1. Salmon B, Le Denmat D. Intraoral ultrasonography: development of a specific high-frequency probe and clinical pilot study. Clin Oral Investig. 2012;16(2):643–9. 10.1007/s00784-011-0533-z
    1. Tsiolis FI, Needleman IG, Griffiths GS. Periodontal ultrasonography. J Clin Periodontol. 2003;30(10):849–54.
    1. Löst C, Irion KM, Nüssie W. Determination of the facial/oral alveolar crest using RF‐echograms. J Clin Periodontol. 1989;16(8):539–44.
    1. Needleman IG. A guide to systematic reviews. J Clin Periodontol. 2002;29(s3):6–9.
    1. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151(4):264–9.
    1. Higgins JP, Green S. Cochrane handbook for systematic reviews of interventions: John Wiley & Sons; 2011.
    1. Sawada K, Fujimasa T, Sunada I. Ultrasonography of the periodontal tissue. Nihon Shishubyo Gakkai kaishi. 1984;26(1):88
    1. Todescan JH, Todescan CG, editors. O uso do aparelho de ultra-som soluciona o problema periodontal. Congresso Paulista de Odontologia, 16; 1994: Artes Médicas.
    1. Hamano N, Hanaoka K, Ebihara K, Toyoda M, Teranaka T. Evaluation of adhesive defects using an ultrasonic pulse-reflection technique. Dent Mater J. 2003;22(1):66–79.
    1. Mazza D, Marini M, Tesei J, Primicerio P. Mandibular fracture caused by periodontal abscess: Radiological, US, CT and MRI findings. Minerva stomatologica. 2006;55(9):523–8.
    1. Klein M, Grötz K, Manefeld B, Kann P, Al-Nawas B. Ultrasound transmission velocity for noninvasive evaluation of jaw bone quality in vivo before dental implantation. Ultrasound Med Biol. 2008;34(12):1966–71. 10.1016/j.ultrasmedbio.2008.04.016
    1. Machtei EE, Zigdon H, Levin L, Peled M. Novel ultrasonic device to measure the distance from the bottom of the osteotome to various anatomic landmarks. J Periodontol. 2010;81(7):1051–5. 10.1902/jop.2010.090621
    1. Merheb J, Van Assche N, Coucke W, Jacobs R, Naert I, Quirynen M. Relationship between cortical bone thickness or computerized tomography‐derived bone density values and implant stability. Clin Oral Implants Res. 2010;21(6):612–7. 10.1111/j.1600-0501.2009.01880.x
    1. Kaneko T, Sakaue H, Okiji T, Suda H. Clinical management of dens invaginatus in a maxillary lateral incisor with the aid of cone‐beam computed tomography–a case report. Dent Traumatol. 2011;27(6):478–83. 10.1111/j.1600-9657.2011.01021.x
    1. Choi M, Culjat MO, Singh RS, White SN. Ultrasound imagery for dental implant diagnosis and treatment planning in a porcine model. J Prosthet Dent. 2012;108(6):344–53. 10.1016/S0022-3913(12)60190-5
    1. Szopinski KT, Regulski P. Visibility of dental pulp spaces in dental ultrasound. Dentomaxillofac Rad. 2013;43(1):20130289.
    1. Zigdon‐Giladi H, Saminsky M, Elimelech R, Machtei EE. Intraoperative Measurement of the Distance from the Bottom of Osteotomy to the Mandibular Canal Using a Novel Ultrasonic Device. Clin Implant Dent Relat Res. 2015;18(5):1034–1041. 10.1111/cid.12362
    1. Guo Y-J, Ge Z-p, Ma R-h, Hou J-x, Li G. A six-site method for the evaluation of periodontal bone loss in cone-beam CT images. Dentomaxillofac Rad. 2015;45(1):20150265.
    1. Chifor R, Badea ME, Hedesiu M, Chifor I. Identification of the anatomical elements used in periodontal diagnosis on 40 MHz periodontal ultrasonography. Rom J Morphol Embryol. 2015;56(1):149–53.
    1. Chifor R, Badea ME, Mitrea DA, Badea IC, Crisan M, Chifor I, et al. Computer-assisted identification of the gingival sulcus and periodontal epithelial junction on high-frequency ultrasound images. Med Ultrason. 2015;17(3):273–9. doi:
    1. Pascual A, Barallat L, Santos A, Levi JP, Vicario M, Nart J, et al. Comparison of Periodontal Biotypes Between Maxillary and Mandibular Anterior Teeth: A Clinical and Radiographic Study. Int J Periodontics Restorative Dent. 2017;37(4):533–9. doi:
    1. Chifor R, Hedesiu M, Bolfa P, Catoi C, Crisan M, Serbanescu A, et al. The evaluation of 20 MHz ultrasonography, computed tomography scans as compared to direct microscopy for periodontal system assessment. Med Ultrason. 2011;13(2):120–6.
    1. Nguyen K-CT, Le LH, Kaipatur NR, Zheng R, Lou EH, Major PW. High-Resolution Ultrasonic Imaging of Dento-Periodontal Tissues Using a Multi-Element Phased Array System. Ann Biomed Eng. 2016:1–13. 10.1007/s10439-015-1519-9
    1. Chan HL, Wang HL, Fowlkes JB, Giannobile WV, Kripfgans OD. Non-ionizing real-time ultrasonography in implant and oral surgery: A feasibility study. Clin Oral Implants Res. 2017;28(3):341–7. 10.1111/clr.12805 .
    1. Chan HL, Sinjab K, Chung M-P, Chiang Y-C, Wang HL, Giannobile WV, et al. Non-invasive evaluation of facial crestal bone with ultrasonography. PloS One. 2017;12(2):e0171237 10.1371/journal.pone.0171237
    1. Scarfe WC, Farman AG. What is cone-beam CT and how does it work? Dent Clin North Am. 2008;52(4):707–30. 10.1016/j.cden.2008.05.005
    1. Chan HL, Misch K, Wang HL. Dental imaging in implant treatment planning. Implant Dent. 2010;19(4):288–98. 10.1097/ID.0b013e3181e59ebd
    1. Baum G, Greenwood I, Slawski S, Smirnow R. Observation of internal structures of teeth by ultrasonography. Science. 1963;139(3554):495–6.
    1. Anter E, Zayet MK, El-Dessouky SH. Accuracy and precision of cone beam computed tomography in periodontal defects measurement (systematic review). J Indian Soc Periodontol. 2016;20(3):235–43. 10.4103/0972-124X.176389
    1. Culjat MO, Goldenberg D, Tewari P, Singh RS. A review of tissue substitutes for ultrasound imaging. Ultrasound Med Biol. 2010;36(6):861–73. 10.1016/j.ultrasmedbio.2010.02.012
    1. Mol A. Imaging methods in periodontology. Periodontol 2000. 2004;34(1):34–48.
    1. Brand JW, Gibbs SJ, Edwards M, Katz JO, Lurie AG, White SC, et al. Radiation Protection in Dentistry. Bethesda, MD: National Council on Radiation Protection & Measurements, 2003. 145.
    1. Theodorakou C, Walker A, Horner K, Pauwels R, Bogaerts R, Dds RJ, et al. Estimation of paediatric organ and effective doses from dental cone beam CT using anthropomorphic phantoms. Br J Radiol. 2012. February;85(1010):153–60 10.1259/bjr/19389412
    1. Ludlow J, Timothy R, Walker C, Hunter R, Benavides E, Samuelson D, et al. Effective dose of dental CBCT—a meta analysis of published data and additional data for nine CBCT units. Dentomaxillofac Rad. 2014;44(1):20140197.
    1. Evans CA, Scarfe WC, Ahmad M, Cevidanes LH, Ludlow JB, Palomo JM, et al. Clinical recommendations regarding use of cone beam computed tomography in orthodontics. Position statement by the American Academy of Oral and Maxillofacial Radiology. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013;116(2):238–57. 10.1016/j.oooo.2013.06.002
    1. Cotti E, Campisi G, Garau V, Puddu G. A new technique for the study of periapical bone lesions: ultrasound real time imaging. Int Endod J. 2002;35(2):148–52.
    1. Musu D, Rossi-Fedele G, Campisi G, Cotti E. Ultrasonography in the diagnosis of bone lesions of the jaws: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol. 2016;122(1):e19–e29. 10.1016/j.oooo.2016.03.022
    1. Lin C, Chen F, Hariri A, Chen C, Wilder-Smith P, Takesh T, et al. Photoacoustic Imaging for Noninvasive Periodontal Probing Depth Measurements. J Dent Res. 2017:0022034517729820.
    1. Rosner B. Fundamentals of biostatistics: Thomson-Brooks/Cole; 2006.

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