In vivo periodontal ultrasound imaging via a hockey-stick transducer and comparison to periodontal probing: a proof-of-concept study.

OBJECTIVE

The objective of this study is to evaluate a compact ultrasound transducer to image anatomical biomarkers for periodontal diagnosis of teeth, including difficult-to-reach posterior teeth.

MATERIALS AND METHODS

A 9-MHz hockey-stick transducer was used to image 53 premolars, 30 molars, and 79 incisors and canines from 13 subjects. The alveolar bone crest (ABC), cementoenamel junction (CEJ), and gingival margin (GM) were identified by ultrasound imaging. The image-based distances between these anatomic landmarks were measured for iABC (ABC to CEJ), iGR (GM to CEJ) and iGH (ABC to GM). The measurements were compared to corresponding parameters obtained from clinical examination. The measurements were also used to assess periodontal health and were compared with clinical diagnosis.

RESULTS

The average iGR measurements were - 1.12 mm (i.e., 1.12 mm above the CEJ) for gingivitis and Stage I periodontitis, and - 0.56 mm for Stage III periodontitis, demonstrating a significant increase in gingival recession in patients with severe periodontitis (Student t-test, unpaired, two-tailed, p < 0.0001). The iGH measurements distinguished gingivitis, Stage I periodontitis group, and the Stage III periodontitis group (unpaired, two-tailed t-test, p < 0.05 for PPD, and p = 0.05 for iGH).

CONCLUSION

Non-invasive periodontal ultrasound imaging can be used to stratify subjects with differing periodontal disease severity. The clinical parameters obtained from ultrasound imaging with the hockey-stick transducer are reproducible.

CLINICAL RELEVANCE

The compact ultrasound transducer can be used as a screening tool for patients affected by periodontitis for clinical examination and treatment.