Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA.
Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Ann Arbor, MI, USA.
J Dent Res. 2022 Mar;101(3):278-285. doi: 10.1177/00220345211035684. Epub 2021 Sep 13.
Color flow ultrasonography has played a crucial role in medicine for its ability to assess dynamic tissue perfusion and blood flow variations as an indicator of a pathologic condition. While this feature of ultrasound is routinely employed in various medical fields, its intraoral application for the assessment of tissue perfusion at diseased versus healthy dental implants has never been explored. We tested the hypothesis that quantified tissue perfusion of power Doppler ultrasonography correlates with the clinically assessed inflammation of dental implants. Specifically, we designed a discordant-matched case-control study in which patients with nonadjacent dental implants with different clinical diagnoses (healthy, peri-implant mucositis, or peri-implantitis) were scanned and analyzed with real-time ultrasonography. Forty-two posterior implants in 21 patients were included. Ultrasound scans were obtained at the implant regions of midbuccal, mesial/distal (averaged as interproximal), and transverse to compute the velocity- and power-weighted color pixel density from color velocity (CV) and color power (CP), respectively. Linear mixed effect models were then used to assess the relationship between the clinical diagnoses and ultrasound CV and CP. Overall, the results strongly suggested that ultrasound's quantified CV and CP directly correlate with the clinical diagnosis of dental implants at health, peri-implant mucositis, and peri-implantitis. This study showed for the first time that ultrasound color flow can be applicable in the diagnosis of peri-implant disease and can act as a valuable tool for evaluating the degree of clinical inflammation at implant sites.
彩色血流超声在医学中发挥了关键作用，因为它能够评估动态组织灌注和血流变化，作为病理状况的指标。虽然这种超声特征在各种医学领域中常规应用，但它在口腔内用于评估患病和健康种植牙组织灌注的应用从未被探索过。我们检验了这样一个假设，即组织灌注的定量彩色多普勒超声与种植牙的临床评估炎症有关。具体来说，我们设计了一项不一致匹配的病例对照研究，其中患有不同临床诊断（健康、种植体周围黏膜炎或种植体周围炎）的非相邻种植牙患者接受实时超声扫描和分析。21 名患者的 42 个后牙种植体被纳入研究。在颊侧中份、近远中（平均为近中-远中）和横向部位的种植体区域获取超声扫描，以分别从彩色速度（CV）和彩色功率（CP）计算速度加权和功率加权彩色像素密度。然后使用线性混合效应模型评估临床诊断与超声 CV 和 CP 之间的关系。总的来说，结果强烈表明，超声的量化 CV 和 CP 与种植牙健康、种植体周围黏膜炎和种植体周围炎的临床诊断直接相关。这项研究首次表明，超声彩色血流可用于种植体周围疾病的诊断，并可作为评估种植部位临床炎症程度的有价值工具。
