Ultrasonic Imaging for Evaluating Peri-Implant Diseases

2021 
Peri-implant diseases and conditions are prevalent, accounting for approximately 40% of implants. According to the most updated disease classification by the joint effort between the American Academy of Periodontology (AAP) and the European Federation of Periodontology (EFP) in 2017, four categories have been proposed, namely implant health, peri-implant mucositis, peri-implantitis, and soft- and hard-tissue deficiencies. Clinical parameters to differentiate these four diseases and conditions are bleeding upon probing (BOP), radiographic bone loss, probing depth, hard- and soft-tissue dimension, and presence of pus/suppuration. Current methods to measure these clinical parameters have their own limitations and disadvantages, which will be highlighted in this chapter. High-frequency ultrasonography has advantages of being non-ionizing, point-of-care, and cross-sectional; therefore, it can be a first-line tool to evaluate peri-implant tissue health during implant maintenance phase. Recent research efforts by our group suggests ultrasound B-mode is accurate in delineating soft tissue thickness around implants, marginal bone level, and thickness. Additionally, it can also be used to measure peri-implant papilla height, mid-facial soft tissue height, bony fenestration, etc. Besides B-mode imaging, functional ultrasound modes, e.g. color flow and power flow, can estimate blood velocity and volume, currently in 2-dimension. These quantitative ultrasound markers may be related to the degree of inflammation around implants and are under active investigation. Once validated, these functional modes can become objective markers to estimate peri-implant inflammation. This chapter will demonstrate the potential of ultrasound to diagnose peri-implant diseases and conditions by presenting ultrasound images of clinical cases.
    • Correction
    • Source
    • Cite
    • Save
    • Machine Reading By IdeaReader
    35
    References
    0
    Citations
    NaN
    KQI
    []