title: Ultrasound transmission velocity for noninvasive evaluation of jaw bone quality in vivo before dental implantation.
abstract: For the insertion of dental implants, mechanical bone properties at the implantation site have great impact both for therapeutic regimes as well as for the overall long-term success, making a reliable method for the preoperative assessment of the bone quality desirable. Ultrasound transmission velocity (UTV) has been introduced as a noninvasive method to analyze mechanical properties of bone. The aim of this study was the first intra-oral in vivo assessment of alveolar crest UTV values of edentulous jaws. Partly or fully edentulous patients (n = 108) were enrolled in this study, taking into account possible influence factors that affect bone quality (osteoporosis, radiation therapy). Six intra-oral measurement points were used: left side region, right side region and frontal region, for upper and lower jaw, respectively. Ultrasound transmission velocity values were measured bicortically (in bucco-oral direction) and correlated to sex, age, measurement site and history of osteoporosis or radiation therapy. We found a minimum mouth opening of 30 mm, as well as a residual alveolar ridge height of 8 mm as thresholds for a reliable intra-oral placement of the device. Xerostomia was no contraindication. Assessment of intra-oral UTV showed significantly higher values both for mandibular side regions (female 1713 +/- 153 m/s, male 1734 +/- 221 m/s) and the maxillary frontal region (female 1665 +/- 189 m/s, male 1648 +/- 82 m/s) than for maxillary side regions (female 1538 +/- 177 m/s, male 1583 +/- 90 m/s). These data were even more clarified by intra-individual correlation of upper and lower jaw side region UTV values. We found no correlation between assessed UTV values and the variables sex, age, osteoporosis or radiation therapy. The use of a small UTV device in this study allowed the recording of intra-oral UTV values in a large and heterogeneous patient collective for the first time. Assessment of alveolar-ridge UTV might offer the possibility to identify critical bone quality before implantation or to monitor bone healing (mineralization) after augmentation procedures.
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Hospital Mainz, Augustusplatz, Mainz, Germany. klein@mkg.klinik.uni-mainz.de
authors.forename: M O
authors.initials: MO
authors.lastname: Klein
authors.forename: K A
authors.initials: KA
authors.lastname: Grötz
authors.forename: B
authors.initials: B
authors.lastname: Manefeld
authors.forename: P H
authors.initials: PH
authors.lastname: Kann
authors.forename: B
authors.initials: B
authors.lastname: Al-Nawas
mesh_terms: D000539:Alveolar Process / Q000000981:diagnostic imaging / Q000502:physiology / Q000528:radiation effects; D015519:Bone Density; D003757:Dental Implantation; D005260:Female; D006801:Humans; D007568:Jaw / Q000000981:diagnostic imaging* / Q000502:physiology / Q000528:radiation effects; D007575:Jaw, Edentulous / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008334:Mandible / Q000502:physiology / Q000601:surgery; D008437:Maxilla / Q000000981:diagnostic imaging / Q000502:physiology; D008875:Middle Aged; D056948:Orthognathic Surgical Procedures; D010024:Osteoporosis / Q000503:physiopathology; D011300:Preoperative Care / Q000379:methods; D012737:Sex Factors; D014463:Ultrasonography / Q000295:instrumentation