Comparison of ultrasound imaging and cone-beam computed tomography for examination of the alveolar bone level: A systematic review

Background and objectiveThe current methods to image alveolar bone in humans include intraoral 2D radiography and cone-beam computed tomography (CBCT). However, these methods expose the subject to ionizing radiation. Therefore, ultrasound imaging has been investigated as an alternative technique, as it is both non-invasive and free from ionizing radiation. In order to assess the validity and reliability of ultrasonography in visualizing alveolar bone, a systematic review was conducted comparing ultrasound imaging to CBCT for examination of the alveolar bone level.Study designSeven databases were searched. Studies addressing examination of alveolar bone level via CBCT and ultrasound were selected. Risk of bias under Cochrane guidelines was used as a methodological quality assessment tool.ResultsAll the four included studies were ex vivo studies that used porcine or human cadaver samples. The alveolar bone level was measured by the distance from the alveolar bone crest to certain landmarks such as cemento-enamel junction or gingival margin. The risk of bias was found as low. The mean difference between ultrasound and CBCT measurements ranged from 0.07 mm to 0.68 mm, equivalent to 1.6% - 8.8%.ConclusionsThere is currently preliminary evidence to support the use of ultrasonography as compared to CBCT for the examination of alveolar bone level. Further studies comparing ultrasound to gold standard methods would be necessary to help validate the accuracy of ultrasonography as a diagnostic technique in periodontal imaging.

研究背景与目的：当前用于人类牙槽骨成像的方法包括口内二维放射摄影与锥形束计算机断层扫描（cone-beam computed tomography, CBCT），但此类方法会使受试者暴露于电离辐射中。因此，超声成像作为一种替代技术被广泛研究，因其兼具无创性与无电离辐射的优势。为评估超声成像可视化牙槽骨的有效性与可靠性，本研究开展了一项系统综述，对比超声成像与CBCT在牙槽骨水平检查中的应用效果。

研究设计：本研究检索了7个数据库，筛选出通过CBCT与超声检查牙槽骨水平的相关研究，并采用Cochrane偏倚风险指南作为方法学质量评估工具。

研究结果：纳入的4项研究均为离体研究，使用猪源或人类尸体样本。牙槽骨水平以牙槽嵴至特定标志点（如牙骨质-牙釉质界或牙龈缘）的距离进行量化测量。偏倚风险评估结果为低风险。超声成像与CBCT测量值的平均差值范围为0.07 mm至0.68 mm，相当于1.6%~8.8%。

研究结论：目前已有初步证据支持超声成像相较于CBCT用于牙槽骨水平检查的应用价值。未来仍需开展将超声与金标准方法对比的相关研究，以进一步验证超声作为牙周成像诊断技术的准确性。