Point of Care, High Resolution and 3-Dimensional Ultrasonography for Diagnosing Peri-Implant Bone Loss

项目总结 种植体周围骨丢失，主要是由于种植体功能正常后的种植体周围炎所致，否则会导致种植体丢失。 及时诊断和治疗。据估计，种植体周围炎影响到大约20%的 植入物。组织丢失和功能受损对数十万人的福利产生了负面影响 病人。目前，种植体周围骨丢失主要通过2维(2D)根尖周围X线片进行评估。 主要的局限性，即只提供重叠图像，不可避免地降低了它的诊断价值。圆锥体- 束流计算机断层扫描可提供有用的横断面成像，但建议不要用于 定期进行术后评估。非电离和护理点超声检查也可以提供横断面 图像和具有巨大的潜力，以补充射线照相用途。我们的团队和其他人一样，已经展示了 超声测量面部牙槽骨冠尺寸的准确性。因此，超声波有可能 增强临床医生评估种植体周围骨水平的能力，特别是面部和腭部/舌侧的骨量。 此外，骨缘厚度是评估长期牙周状况的另一项重要临床参数。 种植体软硬组织稳定性，可用超声波测量。这项建议的主要目的是 验证三维超声测量种植体周缘骨大小的准确性。三 为实现这一目标提出了目标： 目的1：建立种植体周缘骨超声系统的最佳成像条件 测量。这些设置包括发射频率、谐波和复合使用的选择。 假设1：超声成像可以勾勒出口腔硬组织(骨)的边缘，用于诊断成像 程序(误差为10%，即与当前标准方法2D X光片相同的误差)，并提供 通过相对对比区分组织类型的动态范围。 目标2：通过对超声骨进行校准练习来建立评价者内部和评价者之间的可靠性 在人体上进行测量。假设2：组内和组间相关系数(ICC) 主考员至少可以达到0.85分。 目的3：将超声测量与术中直接测量和放射学测量进行比较。 分区人类调查。假设3：平均超声骨水平和厚度测量不同&0.5 Mm和0.3 mm，分别与相应的术中开放骨测量结果进行比较。 超声测量与放射测量没有显著不同。 成功完成这项提案将验证非侵入性、实时和高分辨率超声检查 用于评估种植体周缘骨的大小。在未来的调查中，我们将测试超声波检查 种植体周围骨丢失及其进展的特征。我们还将在更大范围内测量治疗效果 使用超声仪进行人体研究。

PROJECT SUMMARY Peri-implant bone loss, mostly due to peri-implantitis after implants are in function, can cause implant loss if not diagnosed and treated in a timely manner. It is estimated that peri-implantitis affects approximately 20% of implants. Tissue loss and compromised function negatively impact the welfare of hundreds of thousands of patients. Currently peri-implant bone loss is primarily assessed by 2-dimensional (2D) periapical radiographs. The main limitation, i.e. only providing superimposed images, inevitably reduces its diagnostic value. Cone- beam computed tomography provides useful cross-sectional imaging but is recommended not to be used for periodic post-op assessment. Non-ionizing and point-of-care ultrasonography can also offer cross-sectional images and holds great potential to complement radiographic uses. Our group, among others, has shown accuracy of ultrasound to measure facial alveolar bone crest dimensions. Therefore, ultrasound can potentially augment clinicians' ability to assess peri-implant bone level, especially on the facial and palatal/lingual sides. Additionally, marginal bone thickness, another important clinical parameter for assessing long-term peri- implant soft and hard tissue stability, can be measured with ultrasound. The primary aim of this proposal is to validate the accuracy of 3D ultrasonography for measuring peri-implant marginal bone dimensions. Three aims are proposed to achieve this objective: Aim 1: Establish optimal imaging settings for the ultrasound system for peri-implant marginal bone measurements. These settings include choice of transmit frequency, harmonic and compound use. Hypothesis 1: Ultrasonic imaging can delineate oral hard tissue (bone) edges for use in diagnostic imaging procedures (with <10% error, i.e. the same error as the current standard method 2D radiographs) and provide dynamic range for differentiation of tissue types by relative contrast. Aim 2: Establish intra- and inter-rater reliability by conducting a calibration exercise for ultrasound bone measurements in humans. Hypothesis 2: Intra-class correlation coefficient (ICC) within and between examiners can reach at least 0.85. Aim 3: Compare ultrasound measurements to intraoperative direct and radiographic measurements in a cross- sectional human investigation. Hypothesis 3: Mean ultrasonic bone level and thickness measures differ <0.5 mm and <0.3 mm, compared to the corresponding open bone intraoperative bone measurements, respectively. Ultrasound measures would be non-significantly different from radiographic measures. Successful completion of this proposal will validate non-invasive, real-time and high-resolution ultrasonography for assessing peri-implant marginal bone dimensions. In future investigations we will test ultrasonography for characterizing peri-implant bone loss and its progression. We will also measure treatment efficacy in larger scale human studies using ultrasonography.