title: Non-ionizing real-time ultrasonography in implant and oral surgery: A feasibility study.
abstract: OBJECTIVE
  Ultrasound imaging has potential to complement radiographic imaging modalities in implant and oral surgery given that it is non-ionizing and provides instantaneous images of anatomical structures. For application in oral and dental imaging, its qualities are dependent on its ability to accurately capture these complex structures. Therefore, the aim of this feasibility study was to investigate ultrasound to image soft tissue, hard tissue surface topography and specific vital structures.
  
  
  METHODS
  A clinical ultrasound scanner, paired with two 14-MHz transducers of different sizes (one for extraoral and the other for intraoral scans), was used to scan the following structures on a fresh cadaver: (i) the facial bone surface and soft tissue of maxillary anterior teeth, (ii) the greater palatine foramen; (iii) the mental foramen and (iv) the lingual nerve. Multiple measurements relevant to these structures were made on the ultrasound images and compared to those on cone-beam computed tomography (CBCT) scans and/or direct measurements.
  
  
  RESULTS
  Ultrasound imaging could delineate hard tissue surfaces, including enamel, root dentin and bone as well as soft tissue with high resolution (110 μm wavelength). The greater palatine foramen, mental foramen and lingual nerve were clearly shown in ultrasound images. Merging ultrasound and CBCT images demonstrated overall spatial accuracy of ultrasound images, which was corroborated by data gathered from direct measurements.
  
  
  CONCLUSIONS
  For the first time, this study provides proof-of-concept evidence that ultrasound can be a real-time and non-invasive alternative for the evaluation of oral and dental anatomical structures relevant for implant and oral surgery.
authors.affiliation: Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.
authors.forename: Hsun-Liang
authors.initials: HL
authors.lastname: Chan
authors.affiliation: Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.
authors.forename: Hom-Lay
authors.initials: HL
authors.lastname: Wang
authors.affiliation: Department of Radiology, University of Michigan Medical School, Ann Arbor, MI, USA.|Department of Biomedical Engineering, College of Engineering, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Jeffery Brian
authors.initials: JB
authors.lastname: Fowlkes
authors.affiliation: Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.|Department of Biomedical Engineering, College of Engineering, University of Michigan, Ann Arbor, MI, USA.
authors.forename: William V
authors.initials: WV
authors.lastname: Giannobile
authors.affiliation: Department of Radiology, University of Michigan Medical School, Ann Arbor, MI, USA.
authors.forename: Oliver D
authors.initials: OD
authors.lastname: Kripfgans
mesh_terms: D000369:Aged, 80 and over; D002102:Cadaver; D005240:Feasibility Studies; D006801:Humans; D007568:Jaw / Q000000981:diagnostic imaging; D008297:Male; D014070:Tooth / Q000000981:diagnostic imaging*; D014463:Ultrasonography / Q000379:methods
keywords: alveolar ridge; anatomy; bone regeneration; cone-beam computed tomography; dental implants; ultrasonography