title: Ultrasonic Assessment of Mucosal Thickness around Implants: Validity, Reproducibility, and Stability of Connective Tissue Grafts at the Buccal Aspect.
abstract: OBJECTIVE
  (1) To assess validity and reproducibility of mucosal thickness (MT) registration by means of an ultrasonic device and (2) to determine the MT stability of connective tissue grafts (CTGs) when applied at the buccal aspect of single implants demonstrating alveolar process deficiency.
  
  
  METHODS
  For the validity assessment, four human cadaver edentulous maxillae were used to determine MT at 100 different sites. Soft tissue thickness as recorded with the ultrasonic device was compared with MT as registered with Micro-CT (UGent, Ghent, Belgium), taking the latter as gold standard. For the reproducibility assessment, 50 duplicate ultrasonic registrations were used. For the clinical part, 10 non-smoking patients with a single implant were included. All demonstrated alveolar process deficiency and had been provided with a provisional screw-retained crown at the time of inclusion. Following an intrasulcular incision at the buccal aspect, a CTG was inserted to thicken soft tissues. MT was assessed at t0 (before CTG), t1 (immediately after CTG), t2 (suture removal), t3 (permanent crown installation), and t4 (9 months after CTG).
  
  
  RESULTS
  There was a strong correlation between ultrasonic and Micro-CT measurements (r = 0.89, p < .001). However, the former significantly underrated MT by 0.13 mm (p = .030). There was a strong correlation between duplicate ultrasonic recordings (r = 0.99, p < .001). Seven females and three males were included in the clinical study with a mean age of 52. MT significantly increased by 0.92 mm between t0 and t1 (p = .005). Between t3 and t4, there was a slight, yet significant decrease of 0.15 mm (p = .047).
  
  
  CONCLUSIONS
  The ultrasonic device can be used as a non-invasive, reliable, and reproducible method to evaluate MT. Using this technology around single implants demonstrated that CTG may substantially thicken the peri-implant mucosa with acceptable stability over a 9-month period.
authors.affiliation: Faculty of Medicine and Health Sciences, Dental School, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium.
authors.forename: Aryan
authors.initials: A
authors.lastname: Eghbali
authors.affiliation: Faculty of Medicine and Health Sciences, Dental School, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium.
authors.forename: Hugo
authors.initials: H
authors.lastname: De Bruyn
authors.affiliation: Faculty of Medicine and Health Sciences, Dental School, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium.|Faculty of Medicine and Pharmacy, Dental Medicine, Free University of Brussels (VUB), Brussels, Belgium.
authors.forename: Jan
authors.initials: J
authors.lastname: Cosyn
authors.affiliation: Faculty of Medicine and Medical Sciences, Department of Anatomy, Embryology, Histology, and Medical Physics, Ghent University, Ghent, Belgium.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Kerckaert
authors.affiliation: Faculty of Medicine and Medical Sciences, Department of Anatomy, Embryology, Histology, and Medical Physics, Ghent University, Ghent, Belgium.
authors.forename: Tom
authors.initials: T
authors.lastname: Van Hoof
mesh_terms: D002102:Cadaver; D003238:Connective Tissue / Q000637:transplantation*; D003442:Crowns; D019250:Dental Implants, Single-Tooth; D019094:Dental Prosthesis, Implant-Supported; D005260:Female; D006801:Humans; D057893:Immediate Dental Implant Loading; D008297:Male; D008437:Maxilla / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D009061:Mouth Mucosa / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D018579:Patient Selection; D015203:Reproducibility of Results; D014465:Ultrasonics / Q000295:instrumentation*; D055114:X-Ray Microtomography
keywords: connective tissue graft; dental implant; mucosal thickness; single tooth; ultrasonic thickness determination; validity and reproducibility