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: 10586344
• 负责人: Hsun-Liang Chan
• 金额: $ 68.93万
• 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/10586344
• 关键词: 3-Dimensional; Adopted; Allografting; Anatomy; 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; Face; Failure; Frequencies; Goals; Gold; Image; Imaging technology; Implant; Implantation procedure; Industry; Infection; Inferior; Inflammation; Investigation; Ionizing radiation; Lateral; Lesion; Longitudinal Studies; Machine Learning; Manufacturer Name; 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; Perfusion; 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; Wait Time; Work; base; bone; bone healing; bone loss; bone quality; bone xenograft; care providers; clinical diagnostics; cone-beam computed tomography; dental structure; design; diagnostic tool; diagnostic value; disorder risk; experience; graft failure; graft healing; healing; health disparity; health equity; improved; 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.

摘要 拔牙后通过将同种异体骨或异种骨颗粒植入牙槽窝 通常应用窝腔来减少颌骨体积收缩，以便于随后的种植体放置。 增强后的牙槽愈合差异很大，从顺利愈合到感染、骨失败 移植物整合和由于细菌感染和/或局部/全身状况导致的严重骨丢失。愈合 决定植入物放置时间的持续时间也有很大的不同。目前，任意 接受接受牙槽嵴提升后6个月的等待时间，当二维（2-D）或三维X线片， 进行沿着目视检查，以评估硬组织和软组织愈合情况， 种植手术的准备和策略。但是，不建议使用3D X线片进行纵向检查。 用于监测由于辐射问题导致的插座愈合。图像分辨率低（250-500 µm）， 限制了它们评估骨表面愈合的能力，并且具有较差的软组织对比度。无辐射， 非常需要能够纵向评估硬组织和软组织的现场护理方法， 准确、及时地诊断牙槽愈合病理。一种高频微型口内 可以在现成的扫描仪上操作的超声探头已经与 我们的研究团队。我们小组进行的研究证明了这种探针在 测量各种口腔和牙齿结构。核心假设是开发基于超声的成像技术 对牙槽愈合病变进行表征和分级，以确定其范围和严重程度。为了验证这一 假设，在这个建议中提出了两个目标。目标1。评价超声的诊断价值 在一项纵向临床研究中，拔牙窝骨移植手术的图像（从-2 移植物放置的3个月至+6个月）。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组织和软组织、解剖学和生理学状态- 当然了目标2.一种用于大视角采集的凹面扩展视角换能器阵列的研制 颌骨图像，并确定颊舌组织形态。我们会让制造商 为这种特殊的牙科应用创造一个扩展孔径换能器。设计目标将包括 创建扩展的大角度视场，以可视化颊侧到舌侧的颌骨表面。我们将 此外，我们还进一步发展了现有的基于机器学习（ML）的测量工具，包括软组织和硬组织 尺寸和嵴骨表面分析，以产生基于超声的骨质量分类系统。 成功实现所提出的目标将为纵向牙槽骨增强提供一种临床工具 基于超声软组织和硬组织特征的评估，并允许护理提供者选择 与当前临床程序的偏离（如适用）。随后将对这些案件进行调查， 专门设计的临床试验。