牙槽嵴保留术后基于超声波的颌骨表面质量评估

IF 4.2 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Journal of periodontology Pub Date : 2024-05-14 DOI:10.1002/JPER.23-0370
Amanda B Rodriguez, Oliver D Kripfgans, Kenneth M Kozloff, Ankita Samal, Jae-Man Woo, Mostafa Shehabeldin, Hsun-Liang Chan
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引用次数: 0

摘要

背景:通常在拔牙和牙槽嵴保留(ARP)后 3 到 6 个月之间的任意时间,通过二维射线照片和锥形束计算机断层扫描检查骨质/骨密度来评估种植体植入的骨准备情况。本研究旨在探讨高频超声波(US)是否能对人类的骨准备情况进行分类,并以显微计算机断层扫描(Micro-CT)作为参考标准,获得接受 ARP 治疗的愈合牙槽窝的骨矿密度(BMD)和骨体积分数(BVTV):方法:在种植手术过程中,从 24 名曾接受过 ARP 拔牙的患者身上共采集了 27 个骨核。种植手术前立即在与组织活检采集位置共同登记的部位拍摄 US 图像(使用专门设计的导板),然后根据 B 型图像标准将其分为 3 级:(1) 有利;(2) 有疑问;(3) 不利。作为金标准,骨矿密度(羟基磷灰石)和 BVTV 是通过显微 CT 获得的:在投射的 US 切片平面内对羟磷灰石和 BVTV 进行评估,并将阈值分为有利(>2200 mg/cm3;>0.45 mm3/mm3)、可疑(1500-2200 mg/cm3;0.4-0.45 mm3/mm3)和不利(3;3/mm3)。目前的 US B 型分类与 BMD 成反比。回归分析表明,US 分级与 BMD 和 BVTV 之间存在显著关系。T检验分析表明,US读者评分与金标准之间存在明显的相关性。在比较第一级与第二级和第三级的组合时,相对于平均 BMD,US 实现了显著的组别区分(p = 0.004,真阳性 66.7%,假阳性 0%,真阴性 100%,假阴性 33.3%,特异性 100%,灵敏度 66.7%,曲线下接收者操作特征面积 0.86)。结论:初步数据表明,US 可以对与 BMD/BVTV 相关的颌骨表面质量进行分级,并为将来开发基于 US 的 ARP 后牙槽骨愈合评估奠定基础。
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Ultrasound-based jawbone surface quality evaluation after alveolar ridge preservation.

Background: Bone readiness for implant placement is typically evaluated by bone quality/density on 2-dimensional radiographs and cone beam computed tomography at an arbitrary time between 3 and 6 months after tooth extraction and alveolar ridge preservation (ARP). The aim of this study is to investigate if high-frequency ultrasound (US) can classify bone readiness in humans, using micro-CT as a reference standard to obtain bone mineral density (BMD) and bone volume fraction (BVTV) of healed sockets receiving ARP in humans.

Methods: A total of 27 bone cores were harvested during the implant surgery from 24 patients who received prior extraction with ARP. US images were taken immediately before the implant surgery at a site co-registered with the tissue biopsy collection location, made possible with a specially designed guide, and then classified into 3 tiers using B-mode image criteria (1) favorable, (2) questionable, and (3) unfavorable. Bone mineral density (hydroxyapatite) and BVTV were obtained from micro-CT as the gold standard.

Results: Hydroxyapatite and BVTV were evaluated within the projected US slice plane and thresholded to favorable (>2200 mg/cm3; >0.45 mm3/mm3), questionable (1500-2200 mg/cm3; 0.4-0.45 mm3/mm3), and unfavorable (<1500 mg/cm3; <0.4 mm3/mm3). The present US B-mode classification inversely scales with BMD. Regression analysis showed a significant relation between US classification and BMD as well as BVTV. T-test analysis demonstrated a significant correlation between US reader scores and the gold standard. When comparing Tier 1 with the combination of Tier 2 and 3, US achieved a significant group differentiation relative to mean BMD (p = 0.004, true positive 66.7%, false positive 0%, true negative 100%, false negative 33.3%, specificity 100%, sensitivity 66.7%, receiver operating characteristics area under the curve 0.86). Similar results were found between US-derived tiers and BVTV.

Conclusion: Preliminary data suggest US could classify jawbone surface quality that correlates with BMD/BVTV and serve as the basis for future development of US-based socket healing evaluation after ARP.

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来源期刊
Journal of periodontology
Journal of periodontology 医学-牙科与口腔外科
CiteScore
9.10
自引率
7.00%
发文量
290
审稿时长
3-8 weeks
期刊介绍: The Journal of Periodontology publishes articles relevant to the science and practice of periodontics and related areas.
期刊最新文献
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