Ultrasonic Imaging of Bone Graft Healing in Extraction Sockets for Precise and Personalized Implant Therapy

拔牙槽中骨移植愈合的超声波成像，用于精确和个性化的种植治疗

• 批准号: 10698055
• 负责人: Hsun-Liang Chan
• 金额: $ 68.08万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-06 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10698055
• 关键词: 3-Dimensional; Adopted; Allografting; Anatomy; Assessment tool; Atrophic; Bacterial Infections; Blood; Blood flow; Bone Surface; Bone Transplantation; Chronic; Classification; Clinical; Clinical Research; Clinical Trials Design; Collaborations; Dental; Dental Care; Dental Implants; Dental caries; Diagnosis; Diagnostic; Dimensions; Disease; Elements; Evaluation; Exclusion; Face; Failure; Frequencies; Goals; Image; Imaging technology; Implant; Implantation procedure; Industry; Infection; Inferior; Inflammation; Investigation; Ionizing radiation; Lateral; Lesion; Longitudinal Studies; Machine Learning; Manufacturer; Measurement; Measures; Methods; Miniaturization; Monitor; Morphology; National Institute of Dental and Craniofacial Research; Operative Surgical Procedures; Oral; Oral cavity; Organ Transplantation; Outcome; Particulate; Pathology; Patients; Penetration; Physiological; Procedures; Process; Quality of life; Radiation; Readiness; Research; Resolution; Roentgen Rays; Severities; Site; Strategic Planning; Structure; Surface; System; Testing; Thick; Time; Time Study; Tissues; Tongue; Tooth Extraction; Transducers; Ultrasonography; United States; Visual; Visualization; Wait Time; Work; bone; bone healing; bone loss; bone quality; bone xenograft; care providers; clinical diagnostics; cone-beam computed tomography; dental structure; design; diagnostic value; disorder risk; experience; graft failure; graft healing; healing; health disparity; health equity; improved; manufacture; meter; oral care; point of care; prototype; soft tissue; targeted treatment; tool; two-dimensional; ultrasound

Abstract Socket augmentation after tooth extraction by placing either allograft or xenograft bone particulates in the socket is frequently applied to reduce the jawbone volume shrinkage for subsequent implant placement. Socket healing after augmentation varies largely, ranging from uneventful healing to infection, failure of bone graft integration and severe bone loss due to bacterial infection and/or local/systemic conditions. The healing duration, which dictates the timing of implant placement, is widely different as well. Currently, an arbitrary waiting time of 6 months after socket augmentation is adopted, when a 2-dimensional (2-D) or 3-D radiograph, along with a visual examination is performed to assess hard- and soft-tissue healing to determine the readiness and strategy for implant surgery. However, 3-D radiographs are not recommended for longitudinal use to monitor socket healing due to radiation concerns. They have low image resolution (250-500 µm), which limits their ability to evaluate bone surface healing, and have inferior soft-tissue contrast. A non-radiation and point-of-care method that can evaluate both hard- and soft-tissue longitudinally is much needed for a definitive, accurate, and timely diagnosis of socket healing pathologies. A high-frequency and miniature-sized intraoral ultrasound probe that can operate on an off-the-shelf scanner has been manufactured in collaboration with industry by our research team. Research conducted by our group demonstrated accuracy of this probe in measuring various oral and dental structures. The central hypothesis is to develop ultrasound-based imaging to characterize and grade socket healing lesions in determining their extent and severity. To test this hypothesis, two aims are proposed in this proposal. Aim 1. Evaluate the diagnostic value of ultrasound images for bone grafting procedures of dental extraction sockets in a longitudinal clinical study (from -2 months to +6 months of graft placement). We will compare other imaging and clinical diagnostic tools for assessing hard- and soft-tissue, anatomical and physiological status throughout the longitudinal study time- course. Aim 2. Develop a concave extended-view transducer array for acquiring large view-angle jawbone images and determine buccal to lingual tissue morphology. We will engage the manufacturer to create an extended aperture transducer for this specific dental application. Design goals will include the creation of an extended, large angle, field-of-view to visualize the buccal to lingual jawbone surface. We will also further our existing machine learning (ML) based measurement tools, including soft- and hard-tissue dimensions and crestal bone surface analysis to yield an ultrasound-based bone quality classification system. Successful execution of the proposed aims will result in a clinical tool for longitudinal socket augmentation evaluation that is based on ultrasound soft- and hard-tissue features and will allow the care provider to choose deviations from current clinical procedures where indicated. Those would be investigated subsequently in a specifically designed clinical trial.

抽象的 通过将同种异体移植或Xenographotic骨颗粒放置在拔牙后的插座插座 插座经常用于减少颚骨体积收缩以进行随后的植入物放置。 增强品种后的插座愈合很大程度 由于细菌感染和/或局部/全身状况，移植物的整合和严重的骨质流失。康复 持续时间决定了植入物放置的时机，也大不相同。目前是任意的 二维（2-D）或3-D射线照相时采用插座后6个月的等待时间， 还进行视觉检查以评估硬质和软组织愈合以确定 植入手术的准备和策略。但是，不建议纵向进行3-D X光片 用于监测由于辐射问题而引起的插座愈合。它们的图像分辨率低（250-500 µm）， 限制了他们评估骨表面愈合的能力，并具有较低的软组织对比度。非放射和 可以纵向评估硬性和软组织的即时保健方法对于确定的，非常需要 插座愈合病理的准确及时诊断。高频和微型大小 可以在现成的扫描仪上运行的超声探针已与 我们的研究团队的行业。我们小组进行的研究证明了此探针的准确性 测量各种口服和牙齿结构。中心假设是开发基于超声的成像 在确定其程度和严重性时表征和成绩插座愈合病变。测试这个 假设，该提议提出了两个目标。目标1。评估超声的诊断值 在纵向临床研究中，用于牙科提取插座的骨移植程序的图像（来自-2 几个月到+6个月的移植放置）。我们将比较其他成像和临床诊断工具 在整个纵向研究期间评估硬性和软组织，解剖和身体状况 - 课程。 AIM 2。开发一个凹进的视图换能器阵列，用于吸收大型视角 Jawbone图像并确定颊组织形态的颊。我们将吸引制造商 为此特定的牙科应用程序创建扩展的光圈传感器。设计目标将包括 创建一个扩展的，大角度的视野，以可视化颊到舌鼻孔表面。我们将 还进一步我们现有的基于机器学习（ML）的测量工具，包括软组织和硬组织 尺寸和Crestal骨表面分析，得出超声基于骨质的分类系统。 成功执行拟议的目标将导致纵向插座的临床工具 基于超声软组织功能的评估，并将允许护理人员选择 偏离当前指示的临床程序。这些将随后在 专门设计的临床试验。