High-Frequency Ultrasonography for Ex Vivo Periodontal Tissue Measurement: Accuracy and Reproducibility Compared to Cone Beam Computed Tomography

OBJECTIVE: The aim of this study was to assess the accuracy and reproducibility of periodontal tissue measurements obtained through ultrasonographic imaging, by comparing them ex vivo to reference measurements acquired via cone beam computed tomography (CBCT). METHODS: A total of 12 hemi-jaws were included in the study. CBCT acquisition was realised, and then ultrasound measurements of periodontal structures were performed. Ultrasound imaging was performed with a linear array 20 MHz probe (field of view 14.1 × 6.4 mm; penetration depth ≈ 4.9 mm; axial/lateral resolution 80/120 µm). The ultrasound images were analysed using ImageJ software. Reference points were made allowing the measurement of the different tissues. A Kolmogorov-Smirnov test and Lin's concordance test were performed for each of the samples due to the size of their population (>50). RESULTS: A total of 348 manual probing measurements were performed. Lin's concordance correlation coefficients were: gingival thickness: 0.479 (95% CI [0.393-0.558]); distance from the alveolar crest to the CEJ: 0.872 (95% CI [0.842-0.897]); distance from the alveolar crest to the gingival margin: 0.794 (95% CI [0.749-0.832]); alveolar bone thickness: -0.0165 (95% CI [-0.0512 to 0.0183]). CONCLUSION: High-frequency ultrasonography demonstrates high accuracy and reproducibility for measuring periodontal structures ex vivo, particularly for the distance from the alveolar crest to the CEJ, but further clinical studies are needed to validate its use in vivo. CLINICAL RELEVANCE: This non-ionising technique offers a safe alternative to CBCT for periodontal assessment, with potential to enhance early diagnosis and monitoring in clinical practice while minimising radiation exposure.