Non-invasive evaluation of facial crestal bone with ultrasonography

PURPOSE Facial crestal bone level and dimension determine function and esthetics of dentition and dental implants. We have previously demonstrated that ultrasound can identify bony and soft tissue structures in the oral cavity. The aim of this study is to evaluate the accuracy of using ultrasound to measure facial crestal bone level and thickness. MATERIALS AND METHODS A commercially available medical ultrasound scanner, paired with a 14 MHz imaging probe was used to scan dental and periodontal tissues at the mid-facial site of each tooth on 6 fresh cadavers. The alveolar crest level in relation to the cemento-enamel junction and its thickness on ultrasound images were measured and compared to those on cone-beam computed tomography (CBCT) scans and/or direct measurements on a total of 144 teeth. RESULTS The mean crestal bone level measured by means of ultrasound, CBCT and direct measures was 2.66 ± 0.86 mm, 2.51 ± 0.82 mm, and 2.71 ± 1.04 mm, respectively. The mean crestal bone thickness was 0.71 ± 0.44 mm and 0.74 ± 0.34 mm, measured by means of ultrasound and CBCT, respectively. The correlations of the ultrasound readings to the other two methods were between 0.78 and 0.88. The mean absolute differences in crestal bone height and thickness between ultrasound and CBCT were 0.09 mm (-1.20 to 1.00 mm, p = 0.06) and 0.03 mm (-0.48 to 0.54 mm, p = 0.03), respectively. CONCLUSION Ultrasound was as accurate in determining alveolar bone level and its thickness as CBCT and direct measurements. Clinical trials will be required to further validate this non-ionizing and non-invasive method for determining facial crestal bone position and dimension.