A Miniaturized Tool for Ultrasound Quantification of Periodontal Disease

项目总结 该方案目标是一种非侵入性测量牙袋的小型(墨水笔大小)工具 使用超声波对牙床进行深度检查和评估。我们的动机是研究表明，牙科 疼痛大大降低了生活质量，但近50%的美国人患有某种形式的牙周炎。 我们的科学前提是，目前测量口袋深度的方法是痛苦和不精确的 变异系数高达40%。这导致患者依从性差，诊断洞察力差 最终导致依恋丧失。因此，不那么痛苦和更准确的诊断工具可以 改善牙齿健康，从而提高整体生活质量。我们的初步数据(J.Dent.Res.，2017)使用了口头 基于食品级鱿鱼墨水中的黑色素纳米颗粒的漂洗，以绘制和测量 利用新颖的光声成像技术建立猪模型的整个牙周袋。我们注意到了良好的相关性 这些基于图像的测量与通过Bland-Bland的非盲法常规探头深度测量相比， 奥特曼分析。然而，电流传感器的大小为~20 cm×5 cm，并且只能在 人类。这项研究的目标是建立一个更小的原型，适合于口腔内超声成像。 下面的目标描述了我们将如何构建和验证该设备。 AIM 1号将制造该设备。我们将把单个元件换能器和发光二极管组合成一个 紧凑的笔状设计。这将利用乔克斯特博士在声学方面的专业知识和霍尔博士在电学方面的专业知识 工程学。目标2将使用标准参考材料来表征设备的性能 (成像幻影)。我们将测量光的均匀性，轴向分辨率，横向分辨率，深度 穿透、帧速率和扫描时间。目标3将验证该设备测量口袋的能力 在体外的猪模型中的深度。我们会用食品级造影剂(鱿鱼墨水)冲洗口袋 黑色素纳米颗粒)，并对口袋和周围的牙龈进行成像。我们将比较创造的价值 通过成像到Koka博士收集的黄金标准探测器深度。我们将评估成像数据以 两种方法的偏倚和重复性，我们假设成像的深度将与 盲化常规牙周探头数据(R2&GT；0.90)。这项工作是创新的，因为它将很快(2 分钟)，并且以低方差非侵入性地绘制整个牙袋的轮廓。我们的预赛 数据和研究团队在工程、成像和牙周学方面的专业知识强调了 这些想法的可行性。临床影响将是一种更可靠、侵入性更小的监测工具 依恋丧失-这将增加患者的依从性，并有助于更全面地估计 减少附着，最终降低牙周炎发病率。从长远来看，这种口腔成像工具将有 许多其他应用于口腔软组织的表征，包括种植体周围炎和异常生物膜。

PROJECT SUMMARY The objective of this proposal is a small (ink pen-sized) tool that non-invasively measures dental pocket depths and assesses gingival health using ultrasound. We are motivated by studies showing that dental pain dramatically decreases quality of life but that nearly 50% of Americans have some form of periodontitis. Our scientific premise is that the current approach to measuring pocket depths is painful and imprecise with coefficients of variation as high as 40%. This results in poor patient compliance and poor diagnostic insight ultimately leading to attachment loss. Therefore, less painful and more accurate diagnostic tools could improve dental health and thus overall quality of life. Our preliminary data (J. Dent. Res., 2017) used an oral rinse based on the melanin nanoparticles from food-grade squid ink to map and measure the contours of the entire periodontal pocket in swine models with novel photoacoustic imaging. We noted good correlation of these image-based measurements to non-blinded conventional probe depth measurements via Bland- Altman analysis. However, the current transducer is ~20 cm by 5 cm and can only access the incisors in humans. The goal of this research is to build a smaller prototype suitable for intraoral ultrasound imaging. The aims below describe how we will build and validate this device. Aim 1 will build the device. We will combine a single element transducer and light emitting diodes into a compact pen-like design. This will use the expertise of Dr. Jokerst in acoustics and Dr. Hall in electrical engineering. Aim 2 will characterize the performance of the device using standard reference materials (imaging phantoms). We will measure the light homogeneity, axial resolution, lateral resolution, depth of penetration, frame rate, and scan time. Aim 3 will validate the ability of this device to measure the pocket depths in an ex vivo swine model. We will irrigate the pockets with a food-grade contrast agent (squid ink melanin nanoparticles) and image the pocket and surrounding gingiva. We will compare the values created by imaging to the gold-standard probe depths collected by Dr. Koka. We will evaluate the imaging data for bias and reproducibility with both methods, and we hypothesize that depths from imaging will correlate to blinded conventional periodontal probe data (R2>0.90). This work is innovative because it will quickly (2 minutes) and non-invasively map the contours of the entire dental pocket with low variance. Our preliminary data and the expertise of the research team in engineering, imaging, and periodontology underscore the feasibility of these ideas. The clinical impact will be a more reliable and less invasive tool to monitor attachment loss—this will increase patient compliance and facilitate more comprehensive estimates of attachment loss to ultimately decrease periodontitis rates. Long-term, this oral imaging tool would have many other applications in characterizing oral soft tissue including peri-implantitis and aberrant biofilms.