Identifying alveolar bone defects using ultrasonography

Objective: To evaluate high frequency ultrasound imaging as a diagnostic tool for detecting buccal alveolar bone dehiscences and fenestrations in an animal model.

Methods: Alveolar bone defects were created to mimic natural dehiscences (d) and fenestrations (f) using round surgical burs of 2mm (narrow) and 5mm (wide) diameters in four disarticulated pig mandibles. An ultrasound unit (HDI 5000 SonoCT with a CL 15-7 probe,Philips Medical Systems, The Netherlands) was used to scan the buccal gingiva of the premolar and molar segments to determine the location, morphology and size of the defects. The width and height of the mucosal and gingival tissues of each jaw were scanned by examiners who were blind to the surgical procedures (JJ, GM). Defects were classified based on the ultrasound images according to their presence (yes/no), morphology (d/f) and size (narrow/wide).

Results: Twenty four of 27 lesions were identified as being present by ultrasonography – sensitivity 88.9% [95% CIs: 0.71-0.98]. The specificity of the method was 75% [95% CIs: 0.48-0.93]. The correct dimensions (narrow/wide) of the lesions were identified in 91.6% of cases [95% CIs: 0.73-0.99] and the correct morphology was identified in 100% of cases [95% CIs: 0.86-1.00]. In 70.4% (19/27) instances the lesions were identified correctly as being present and of the correct morphology and size [95% CIs: 0.50-0.86]. Ultrasonography produced 4 false positive and 3 false negative outcomes.

Conclusion: Based on this in vitro model, high frequency ultrasonography is a sensitive method for identifying the presence, morphology and dimensions of dehiscences and fenestrations of alveolar bone. The method should be further evaluated in the clinical situation in which there may be considerable merit in identifying these types of bony lesions in patients who may be at risk from developing localized gingival recession.

Supported by Philips Oral Healthcare, Inc.