Abstract
Background and objectiveThe 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 designSeven 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.ResultsAll 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%.ConclusionsThere 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.
Highlights
The periodontium is a complex tooth-supporting structure consisting of four main components: the alveolar bone, cementum, gingiva, and periodontal ligament [1]
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
There is currently preliminary evidence to support the use of ultrasonography as compared to cone-beam computed tomography (CBCT) for the examination of alveolar bone level
Summary
The periodontium is a complex tooth-supporting structure consisting of four main components: the alveolar bone, cementum, gingiva, and periodontal ligament [1]. Bone loss due to bacterial infection of teeth (dental caries), which if left untreated will result in pulpitis extending towards tooth’s apex. In this situation, a periapical abscess may form in the alveolar bone adjacent to the apex leading to bone loss [2]. Bacterial infection resulting in inflammation of the periodontium (periodontitis) may result in bone loss and subsequent loss of teeth, if left untreated. The current methods to image alveolar bone in humans include intraoral 2D radiography and cone-beam computed tomography (CBCT). These methods expose the subject to 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
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