This pilot study evaluated the accuracy and correlation of ultrasound (US) imaging in measuring periodontal structures, compared to direct clinical measurements and cone-beam computed tomography (CBCT). 20 participants scheduled for single implant surgery had their papilla height, crestal bone level, soft tissue height, and mucosal thickness measured using US, direct probing, and CBCT. Strong correlations were found between US and direct measurements. US also showed fair to good agreement with CBCT. The study demonstrates US may be a valuable tool for real-time, cross-sectional evaluation of periodontal tissues without radiation. Further research is needed to evaluate US for differentiating healthy from diseased periodontal status.
Radiology in orthodontics dr.kavitha /certified fixed orthodontic courses by ...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Radiology in orthodontics dr.kavitha /certified fixed orthodontic courses by ...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Current literature on dental radiology was reviewed in order to seek justification for radiological protection of patients in dental radiography, to explore the different factors affecting patient dose and to derive practical guidance on how to achieve radiological protection of patients in dentistry. Individual doses incurred in dental radiology are in general relatively low, however it is generally accepted that there is no safe level of radiation dose and that no matter how low the doses received are, there is a mathematical probability of an effect. Hence appropriate patient protection measures must be instituted to keep the exposures as low as reasonably achievable (ALARA). The literature review demonstrated that there is considerable scope for significant dose reductions in dental radiology using the techniques of optimization of protection.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Current literature on dental radiology was reviewed in order to seek justification for radiological protection of patients in dental radiography, to explore the different factors affecting patient dose and to derive practical guidance on how to achieve radiological protection of patients in dentistry. Individual doses incurred in dental radiology are in general relatively low, however it is generally accepted that there is no safe level of radiation dose and that no matter how low the doses received are, there is a mathematical probability of an effect. Hence appropriate patient protection measures must be instituted to keep the exposures as low as reasonably achievable (ALARA). The literature review demonstrated that there is considerable scope for significant dose reductions in dental radiology using the techniques of optimization of protection.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
This one is my Physics Investigatory Project done on the topic 'Physics Principle In Medicine'. You and I both of us know, without physics advancement in biology especially in the medical field is impossible. So, in this project we are gonna investigate through the various principles of physics which are used in the medical field ( like X ray machines, CT scanners, MRI and other advancements like SPECTS scan).
Both for class 11th & 12th.
Especially for class 12th.
Thank You... Hope you find it useful...
A 4 part seminar on 3D cbct technology for seminar presentations. with added technical details and considerations with differences between a CT technology.
Also it features the technical parameters ,uses and how it is considered useful in each departments of medicine and dentistry.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
2. Ultrasonography For
Chairside Evaluation Of
Periodontal Structures:
A Pilot Study
P R E S E N T E D BY : - D R K . A B H I L A S H A
M O D E R AT E D BY : - D R R U PA M A L I N I
D E PA R T M E N T O F P E R I O D O N T I C S
3. PRESENTATION LAYOUT
• INTRODUCTION
• RADIOGRAPHIC DIAGNOSTIC AIDS
• CONE BEAM COMPUTED TOMOGRAPHY (CBCT)
• ULTRASONOGRAPHY
– HISTORY
– MECHANISM
– INTERACTION WITH TISSUES
– APPLICATION IN DENTISTRY
• ARTICLE
– INTRODUCTION
– MATERIALS AND METHODS
– RESULTS
– DISCUSSION
– CONCLUSION
• REFRENCES
3
5. • Diagnostic testing has been a great challenge in
Periodontology.
• It is primarily derived from information obtained from the
patient’s medical and dental histories combined with findings
from thorough oral examination.
• The entire constellation of signs and symptoms associated with
disease and the additional information provided by
radiographic imaging is taken into consideration before
arriving a diagnosis.
• A better understanding of the periodontal disease process
challenged usefulness of traditional clinical and radiographic
methods for diagnosis and prompted revision of outdated
diagnostic aids.
5
7. • Dental Radiographs are traditional method to assess destruction
of alveolar bone.
• Primary criterion for bone loss is the distance from CEJ to the
alveolar crest and distance more than 2 mm is considered as the
bone loss.
CONVENTIONAL
ADVANCED
7
9. • More than 30% of bone mass at alveolar crest must be lost to
be recognized on radiographs
• Radiographs provide a 2-dimensional view of a 3- dimensional
situation.
• Provides only information about inter proximal bone level.
• Radiographs do not demonstrate soft tissue - to – hard tissue
relationship hence no information about depth of soft tissue
pocket
LIMITATIONS OF RADIOGRAPHS
* Conventional Radiographs Are Specific But Lack Sensitivi
9
11. CONE BEAM COMPUTED TOMOGRAPHY
• Developed in 1982 for
angiography
• In recent years, this technology
for acquiring 3D images of oral
structures is now available to the
dental clinics and hospitals.
• PRINCIPLE- A thin fan beam of
X-Rays rotates around the patient
to generate in one resolution
around thin axial slice of the area
of interest.
• Utilizes cone shaped source of
ionizing radiation & 2D area
detector fixed on a rotating
gantry . 11
12. Rotates 360° around the head
Scan time typically < 1 minute
12
13. • Image acquisition involves a Rotational scan of a x ray source
and reciprocating area detector moving synchronously around
patients head.
• Many exposures are made at fixed intervals to form basic
images.
• Software programs are used to reconstruct 3D images.
13
15. Poor Soft Tissue contrast- due to scattering based radiations
and presence of panel detector based artifacts.
Image noise is due to large volume being irradiated during
CBCT scanning resulting in heavy interactions with tissues
producing scattered radiation.
CBCT is not applicable for evaluating peri-implant structures
due to beam hardening and scattering artifacts (Gonzalez-
Martin et al. 2015; Kuhl et al. 2015).
Exposure to ionizing radiations.
Steep financial costs.
LIMITATIONS OF CBCT
Although CBCT has made a speedy ingress into the field of dentistry,
currently it is not devoid of drawbacks,
15
16. Nevertheless, The Terms Ultrasound
And Ultrasonic When Used In
Dentistry Refer Almost Always To
The Kilohertz-frequency Vibrating
Tips Used For Scaling Teeth And Not
To Diagnostic Imaging
(Ultrasonography) As In Medical
Diagnostics And Industrial
Inspection.
16
18. INTRODUCTION
• Sound has been used clinically as an alternative to light in the
diagnostic evaluation of variety of conditions.
• Advantage of sound over light is it can pass through opaque
tissue.
• An important tool in terms of diagnosis and management.
• Sonography–technique based on sound waves that acquire
images in real time without the use of ionizing radiation‘‘Ultra’’
means
beyond or in
excess
‘‘Sound’’ means
audible sound
energy
ULTRASOUND
18
19. • The human ear can respond to an audible
frequency range, roughly 20 Hz - 20 kHz.
• Ultrasound Waves are acoustic waves with frequencies at or
above 20 kHz
19
20. HISTORY
• In the year 1926, Paul Langevin was the first to report the
biological effects of ultrasound.
• In1942 Dussik K .T & Friederick reported the first successful
application of ultrasound to medical diagnosis
• The first use of diagnostic ultrasound in dentistry appears to
have been by Baum et al. In 1958.
• In 1971 Dalyand Wheeler carried out ultrasound imaging of
dental soft tissues to find out the use of ultrasonic
measurement in clinical evaluation of oral soft tissues.
20
21. MECHANISM
Scanners used for sonography generate electrical impulses that
are converted into ultra-high-frequency sound waves by a
transducer
Sound waves travel into body and hit the tissues and organs
Some of them are partially reflected from the interface between
different tissues and returns to the transducer
Transducer calculates the distance from it to the
tissues and transmits the echoes electrically onto a
monitor.
21
22. ULTRASOUND PROBE (TRANSDUCER)
Device which converts one form of energy to other
In US, it converts electrical energy to ultrasonic
energy {PULSE} & vice- versa {ECHO}
Transducer is both a transmitter & a receiver
1. Piezoelectric
crystals
2. Two electrodes
3. Backing layer
4. Matching layer
5.Acoustic insulator
6. Plastic housing
24. • Reflection occurs when the ultrasound wave is deflected
towards the transducer.
• The major factors affecting the amount of reflection are:-
REFLECTION
1. Angle of incidence
2. Width of Tissue Boundary
3. Acoustic Impedence Mismatch
4. Angle of Tissue Boundary
24
25. • Scattering occurs when the width or lateral dimension of the
tissue boundary is less than one wavelength
• If a large number of small tissue boundaries occurs, the
scattering can radiate in all directions.
• The signal that reaches the transducer is a much weaker signal
than the transmitted signal and is typically 100-1000 times (40 -
60 dB) less than the transmitted signal.
SCATTERING
25
26. • Refraction occurs when the ultrasound signal is deflected from a
straight path and the angle of deflection is away from the
transducer.
• Ultrasound waves are only refracted at a different medium
interface of different acoustic impedance
• Refraction allows enhanced image quality by using acoustic
lenses.
• Refraction can result in ultrasound double-image artifacts.
REFRACTION
26
27. • Attenuation is the result of an ultrasound wave losing energy.
• As the ultrasound wave travels through a medium, the medium
absorbs some of the energy of the ultrasound wave.
• The amount of energy absorption, or acoustic impedance , is
determined by the product of the density of the medium and
the propagation velocity of the ultrasound wave
ATTENUATION
27
28. APPLICATION IN DENTISTRY
28
Alok A, Singh S, Kishore M, Shukla AK. Ultrasonography–A boon in dentistry.
SRM Journal of Research in Dental Sciences. 2019 Apr 1;10(2):98.
29. 29
Alok A, Singh S, Kishore M, Shukla AK. Ultrasonography–A boon in dentistry.
SRM Journal of Research in Dental Sciences. 2019 Apr 1;10(2):98.
35. AIM OF THE STUDY
To Evaluate The Correlation And
Accuracy Of Ultrasound (US)
In Measuring Periodontal
Dimensions, Compared To
Direct Clinical And Cone-beam
Computed
Tomography (CBCT) Methods.
35
39. MATERIALS AND METHODS
• This study was approved by the University of Michigan
Institutional Review Board and was conducted in accordance
with the Helsinki Declaration of 1975, as revised in 2013.
• All patients signed an informed written consent to participate in
the study.
• A sample of 20 participants scheduled for a Single Implant
Surgery, at the University of Michigan School of Dentistry,
Department of Periodontics and Oral Medicine, were recruited
for this pilot study.
RECRUITMENT
39
40. • The participants were deemed eligible if they had a Maxillary Or
Mandibular Single Edentulous Area At The Anterior Or Premolar
Site With Two Immediately Adjacent Teeth On Both Sides
Available.
• The sites of interest in each individual patient were the Mesial
And Distal Tooth, in addition To The Edentulous Site for an
implant placement.
40
41. • Following 6 parameters were measured:-
QUANTITATIVE DATA ACQUISITION
1. PH
2. CBL
3. STHt
4. MTt
Interdental papilla height (PH): the vertical distance
from the tip of the facial papilla to the crestal bone
on the mesial and distal papillae of a given tooth.
The crestal bone level (CBL) at teeth: the vertical
distance between the alveolar crest and the cemento-
enamel junction (CEJ) or the restoration margin on the
midfacial
site of the imaged tooth.
Mid-facial soft tissue height at teeth (STHt): the
vertical distance from the free gingival margin to the
crestal bone at the mid-facial site of a given tooth.
Soft tissue height at the edentulous ridge (STHe): the
vertical distance from the external border of the cortical
bone to the most superficial level of the crestal soft tissue
in the center of the gap.
Mucosal thickness at the edentulous ridge (MTe): the
horizontal distance between the mucosal surface to the
underlying bone surface, measured at 3 and 6 mm from
the mucosal margin at mid-facial and mid-palatal sites.
5. STHe
6. MTe
Mucosal thickness at teeth (MTt): the horizontal distance
between the mucosal surface to the underlying bone or root
surface measured at 2 and 5 mm from the gingival margin at
mid-facial sites
41
42. CBCT scans were acquired for participants who did
not have a clinically ordered scan for the planned
implant surgeries.
Scans were used to acquire crestal bone levels
and soft tissue-related parameters as an
additional reference for comparison to US
readings
All scans, were obtained using a CBCT device with
scanning parameters of 120 kVp, 18.66 mAs, scan
time of 20 seconds, and resolution of 250 μm.
CBCT SCANS
42
43. ULTRASOUND (US) SCAN
• The US scan was a separate visit usually within 2 weeks before
the implant surgery date.
• Ultrasound scan was performed using a US image probe
prototype
• US IMAGE PROBE PROTOTYPE
The 24 MHz imaging probe prototype dimension is comparable to
that of a toothbrush and its cable runs perpendicular to the
aperture, allowing for cross-sectional scans to the 2nd molars. The
maximal transducer thickness, width and length is 15, 16.2 and 30
mm. Its axial and lateral image resolution is 64 and 192 µm,
respectively, with an optimal penetration depth of 15 mm, and in
real-time image acquisition.
43
44. • Acoustic coupling was achieved with mounting a gel-based
stand-off-pad to the probe aperture and applying US gel
between the pad and the oral structures.
• The mesial and distal teeth adjacent to the edentulous gap in
each participant were scanned at the mesial and distal papillae
and midfacial surface with the transducer placed approximately
in line with the long axis of the particular tooth.
• The included edentulous gaps were scanned at the mid-facial
and mid-lingual surfaces.
• The participants wore a customized acrylic reference guide
during the US scans.
• The same guide was used during the CBCT scan and direct
measurements to minimize measurement site variability among
the three methods.
44
46. • At the implant placement visit, PRIOR to elevating a full thickness
flap, the papilla and mucosal height of teeth and mucosal thickness
at the dentate and edentulous sites were measured.
• Interdental papilla height and facial mucosal height around teeth
were measured with a calibrated periodontal probe to the closest
0.5 mm.
• AFTER facial flap elevation, the remaining measurements (i.e. the
mucosal height at the edentulous gap and crestal bone level) were
made with the same periodontal probe.
• To clinically measure mucosal thickness, a #25 endodontic file was
used.
• The file was inserted perpendicular to the mucosal surface. The
distance between the tip of the file to the rubber stop (i.e. the
mucosal thickness) was measured using a metric digital caliper,
precision to 0.01 mm
DIRECT MEASUREMENTS
46
47. • The inter-rater correlation coefficients (ICC), root mean square
error (RMSE) and maximum differences were calculated to
evaluate the strength of agreement between US measurements
from both readers.
• The pairwise agreement between the direct, US and CBCT
measurements were also assessed by ICC.
• Bonferroni corrections were used to adjust the significance level
as 0.0083 (=0.05/6).
• F-tests were employed to examine if the p-values of the ICC
were significantly greater than 0.
DATA ANALYSIS
47
48. • The ICC ranges from -1 to 1, where an estimate of 1 indicates
perfect agreement and 0 means random agreement. Negative ICCs
indicate a systematic disagreement.
• Commonly-cited cut-offs are
– POOR for ICC values less than 0.40,
– FAIR for values between 0.40 and 0.59,
– GOOD for values between 0.60 and 0.74, and
– EXCELLENT for values between 0.75 and 1.0
• Bland-Altman plots were also created to evaluate the differences
between US, direct measurements, and CBCT readings and clinical
significance.
48
49. RESULTS
• A total of 20 participants (15 male and 5 female), with a mean
age of 61.2 ± 13.4 years.
• The study sample accounted for 40 teeth (anterior teeth (27)
and posterior teeth (13) sites) and 20 edentulous ridges
(anterior (16) and premolar (4)).
• Of these sites, 51 sites were in the maxilla (34 tooth sites and 17
edentulous sites), while 9 were in the mandible (6 tooth sites
and 3 edentulous sites).
DESCRIPTIVE ANALYSIS
49
61. With encouraging 1st time human data
displaying satisfactory measurements of
periodontal soft and hard tissue
dimensions, US imaging could become a
valuable tool for real-time, cross-
sectional evaluation of the periodontia
without concerns of ionizing radiation
and metallic artifacts. Future research
should focus on the ability of US to
differentiate periodontal disease from
healthy status.
61
63. • Principles and Practice of Oral Medicine, Stephan S Sonis, Fazio,
Fang
• Chifor R, Badea ME, Vesa ŞC, Chifor I. The utility of 40 MHz
periodontal ultrasonography in the assessment of gingival
inflammation evolution following professional teeth cleaning.
Medical ultrasonography. 2015 Mar 1;17(1):34-8.
• Nguyen KC, Pacheco-Pereira C, Kaipatur NR, Cheung J, Major
PW, Le LH. Comparison of ultrasound imaging and cone-beam
computed tomography for examination of the alveolar bone
level: A systematic review. PloS one. 2018;13(10).
• Tsiolis FI, Needleman IG, Griffiths GS. Periodontal
ultrasonography. Journal of clinical periodontology. 2003
Oct;30(10):849-54.
• Sainu R, Madhumala R, Thouseef MA, Ravi S, Sayeeganesh N,
Jayachandran D. Imaging techniques in periodontics: a review
article. Journal of Bioscience And Technology. 2016;7(2):739-47.63
64. • Chan HL, Wang HL, Fowlkes JB, Giannobile WV, Kripfgans OD.
Non-ionizing real-time ultrasonography in implant and oral
surgery: A feasibility study. Clin Oral Implants Res 2017;28:341-
347
• e-EchoCardiography- An Echocardiographic interactive Course
and Resource (Webpage by American Society of Radiologic
Technologists (ASRT))
• Ghorayeb SR, Bertoncini CA, Hinders MK. Ultrasonography in
dentistry. IEEE transactions on ultrasonics, ferroelectrics, and
frequency control. 2008 Jun 3;55(6):1256-66.
• Chan HL, Wang HL, Fowlkes JB, Giannobile WV, Kripfgans OD.
Non‐ionizing real‐time ultrasonography in implant and oral
surgery: A feasibility study. Clinical oral implants research. 2017
Mar;28(3):341-7.
• Kumar S B ,Mahabob N Ultrasound in dentistry–a review
JIADS2014;1:44-45
64