Dental and Medical Problems
2018, vol. 55, nr 3, July-September, p. 281–288
Publication type: original article
The repeatability and reproducibility of gingival thickness measurement with an ultrasonic device
Powtarzalność i odtwarzalność pomiaru grubości dziąsła biometrem ultrasonograficznym
1 Specialist Outpatient Medical Clinic MEDIDENT in Gorlice, Poland
2 Department of Periodontology, Faculty of Dentistry, Wroclaw Medical University, Poland
Background. Successful periodontal and implant surgery as well as orthodontic treatment often depends on gingival and mucosal thickness. So far there has been no generally accepted protocol of measuring the thickness of gingiva by non-invasive methods.
Objectives. The aim of the study was to evaluate the repeatability and reproducibility (%R&R) of the 20 MHz A-Scan ultrasonic device in measuring gingival thickness (GT) in the mucogingival complex.
Material and Methods. A 2-stage study utilizing non-invasive ultrasonic methods was conducted. In the 1st stage, 3 operators got calibrated by measuring previously established GT in porcine cadaver jaws. In the 2nd stage, 1 periodontally healthy subject was recruited in the study. Three operators performed the measurements of GT in maxillary left central and lateral incisors and canines, using the 20 MHz A-Scan ultrasonic device with a probe of 1.7 mm in diameter. The thickness was measured in 4 standardized points located in the free gingiva (FGT), supracrestal gingiva (SGT), crestal gingiva (CGT) and the mucosa (MGT).
Results. The analysis of variance (ANOVA) method was used to quantify %R&R. The repeatability and reproducibility of the measurements was 8.4%. Interobserver reproducibility varied from 0.8% to 13.4%. The average intraobserver coefficient of variation (CV) was 6.6% (1.9–13.6%). The median of the reproducibility of all measurements was 8.1 %. Nevertheless, the median of CV was variable to the observer, i.e. 5.4%, 6.5%, 6.4%.
Conclusion. The obtained results in %R&R prove the good recognition of methodology as well as the usefulness of the device. Non-invasive ultrasonic biometer GT measurements are crucial in periodontology as well as in other fields of dentistry.
gingiva, periodontium, anatomy and histology, ultrasonography, reproducibility of results
dziąsło, przyzębie, anatomia i histologia, ultrasonografia, odtwarzalność wynikówi
- Baum G, Greenwood I, Slawski S, Smirnow R. Observation of internal structures of teeth by ultrasonography. Science. 1963;139(3554):495–496.
- Ślak B, Ambroziak A, Strumban E, Maev RG. Enamel thickness measurement with a high frequency ultrasonic transducer-based hand-held probe for potential application in the dental veneer placing procedure. Acta Bioeng Biomech. 2011;13(1):65–70.
- Culjat MO, Singh RS, Brown ER, Neurgaonkar RR, Yoon DC, White SN. Ultrasound crack detection in a simulated human tooth. Dentomaxillofac Radiol. 2005;34(2):80–85.
- Matalon S, Feuerstein O, Calderon S, Mittleman A, Kaffe I. Detection of cavitated carious lesions in approximal tooth surfaces by ultrasonic caries detector. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;103(1):109–113.
- Maity I, Kumari A, Shukla AK, Usha HL, Naveen DN. Monitoring of healing by ultrasound with color power doppler after root canal treatment of maxillary anterior teeth with periapical lesions. J Conserv Dent. 2011;14(3):252–257.
- Adeyemo WL, Akadiri OA. A systematic review of the diagnostic role of ultrasonography in maxillofacial fractures. Int J Oral Maxillofac Surg. 2011;40(7):655–661.
- Cakir-Ozkan N, Sarikaya B, Erkorkmaz U, Aktürk Y. Ultrasonographic evaluation of disc displacement of the temporomandibular joint compared with magnetic resonance imaging. J Oral Maxillofac Surg. 2010;68(5):1075–1080.
- Eger T, Müller HP, Heinecke A. Ultrasonic determination of gingival thickness. Subject variation and influence of tooth type and clinical features. J Clin Periodontol. 1996;23(9):839–845.
- Müller HP, Schaller N, Eger T, Heinecke A. Thickness of masticatory mucosa. J Clin Periodontol. 2000;27(9):431–436.
- Bednarz W, Zielińska A. Ultrasonic biometer and its usage in an assessment of periodontal soft tissue thickness and comparison of its measurement accuracy with a bone sounding method. Dent Med Probl. 2011;48(4):481–489.
- Marotti J, Heger S, Tinschert J, et al. Recent advances of ultrasound imaging in dentistry – a review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013;115(6):815–832.
- Puzio M, Błaszczyszyn A, Hadzik J, Dominiak M. Ultrasound assessment of soft tissue augmentation around implants in the aesthetic zone using a connective tissue graft and xenogeneic collagen matrix – 1-year randomised follow-up. Ann Anat. 2018;217:129–141.
- Lodder WL, Teertstra HJ, Tan IB, et al. Tumour thickness in oral cancer using an intra-oral ultrasound probe. Eur Radiol. 2011;21(1):98–106.
- Salmon B, Le Denmat D. Intraoral ultrasonography: Development of a specific high-frequency probe and clinical pilot study. Clin Oral Investig. 2011;16(2):643–649.
- Hwang D, Wang HL. Flap thickness as a predictor of root coverage: A systematic review. J Periodontol. 2006;77(10):1625–1634.
- Yared KF, Zenobio EG, Pacheco W. Periodontal status of mandibular central incisors after orthodontic proclination in adults. Am J Orthod Dentofacial Orthop. 2006;130(1):6.e1–8.
- Eghbali A, De Bruyn H, Cosyn J, Kerckaert I, Van Hoof T. Ultrasonic assessment of mucosal thickness around implants: Validity, reproducibility, and stability of connective tissue grafts at the buccal aspect. Clin Implant Dent Relat Res. 2014;18(1):51–61.
- Matys J, Świder K, Flieger R. Laser instant implant impression method: A case presentation. Dent Med Probl. 2017;54(1):101–106.
- Akcalı A, Trullenque‐Eriksson A, Sun C, Petrie A, Nibali L, Donos N. What is the effect of soft tissue thickness on crestal bone loss around dental implants? A systematic review. Clin Oral Implants Res. 2016;28(9):1046–1053.
- Suárez‐López Del Amo F, Lin GH, Monje A, Galindo‐Moreno P, Wang HL. Influence of soft tissue thickness on peri‐implant marginal bone loss: A systematic review and meta‐analysis. J Periodontol. 2016;87(6):690–699.
- Vervaeke S, Dierens M, Besseler J, De Bruyn H. The influence of initial soft tissue thickness on peri‐implant bone remodeling. Clin Implant Dent Relat Res. 2016;16(2):238–247.
- Ronay V, Sahrmann P, Bindl A, Attin T, Schmidlin PR. Current status and perspectives of mucogingival soft tissue measurement methods. J Esthet Restor Dent. 2011;23(3):146–157.
- Egreja AM, Kahn S, Barceleiro M, Bittencourt S. Relationship between the width of the zone of keratinized tissue and thickness of gingival tissue in the anterior maxilla. Int J Periodontics Restorative Dent. 2012;32(5):573–579.
- Barriviera M, Duarte WR, Januário AL, Faber J, Bezerra AC. A new method to assess and measure palatal masticatory mucosa by cone-beam computerized tomography. J Clin Periodontol. 2009;36(7):564–568.
- Ueno D, Sato J, Igarashi C, et al. Accuracy of oral mucosal thickness measurements using spiral computed tomography. J Periodontol. 2011;82(6):829–836.
- Slak B, Daabous A, Bednarz W, Strumban E, Maev RG. Assessment of gingival thickness using an ultrasonic dental system prototype: A comparison to traditional methods. Ann Anat. 2015;199:98–103.
- Larsen GA. Measurement system analysis in a production environment with multiple test parameters. Qual Eng. 2003;16(2):297–306.
- Bednarz W. New possibilities of periodontal tissue diagnostics by using ultrasound biometry. e-Dentico. 2016;1(59):48–63.
- Müller HP, Barrieshi-Nusair KM, Könönen E. Repeatability of ultrasonic determination of gingival thickness. Clin Oral Investig. 2007;11(4):439–442.
- Müller HP, Könönen E. Variance components of gingival thickness. J Periodontal Res. 2005;40(3):239–244.