Application of radiopaque micro-particle fillers for 3-D imaging of periodontal pocket analogues using cone beam CT. Issue 4 (April 2018)

• Record Type: Journal Article
• Authors: Elashiry, M.; Meghil, M.M.; Kalathingal, S.; Buchanan, A.; Elrefai, R.; Looney, S.; Rajendran, M.; Ochieng, M.; Young, N.; Elawady, A.; Arce, R.M.; Sandhage, K.H.; Cutler, C.W
• Is Part Of: Dental materials. Volume 34:Issue 4(2018)
• Page Start: 619
• Page End: 628
• Publication Date: 2018-04
• Subjects: Dentistry -- Periodicals; Dental materials -- Periodicals; 617.695
• DOI: 10.1016/j.dental.2018.01.008
• Languages: English
• ISSNs: 0109-5641

Abstract

Highlights: 3-D images of artificial periodontal pockets could be obtained by CBCT after injection of the pockets with novel radiopaque fillers. This novel approach could provide a precise means of evaluating the depth, volumes, and 3-D shapes of periodontal pockets. This imaging technology could improve diagnosis and treatment planning of periodontal disease. Validation of the practicality of this new technology is needed in living animal models and in clinical trials in periodontitis patients. Abstract: Background: Periodontitis is an infectious/inflammatory disease most often diagnosed by deepening of the gingival sulcus, which leads to periodontal pockets (PPs) conventional manual periodontal probing does not provide detailed information on the three-dimensional (3-D) nature of PPs. Objectives: To determine whether accurate 3-D analyses of the depths and volumes of calibrated PP analogues (PPAs) can be obtained by conventional cone beam computed tomography (CBCT) coupled with novel radiopaque micro-particle fillers (described in the companion paper) injected into the PPAs. Methods: Two PPA models were employed: (1) a human skull model with artificial gingiva applied to teeth with alveolar bone loss and calibrated PPAs, and (2) a pig jaw model with alveolar bone loss and surgically-induced PPAs The PPAs were filled with controlled amounts of radiopaque micro-particle filler using volumetric pipetting Inter-method and intra-method agreement tests were then used to compare the PPA depths and volumes obtained from CBCT images with values obtained by masked examiners using calibrated manual methods. Results: Significant inter-method agreement (0.938–0.991) and intra-method agreement (0.94–0.99) were obtained when comparing analog manual data to digital CBCT measurements enabled by the radiopaque filler. Significance: CBCT imaging with radiopaque micro-particle fillers is a plausible means of visualizing and digitally assessing the depths, volumes, and 3-D shapes of PPs This approach could transform the diagnosis and treatment planning of periodontal disease, with particular initial utility in complex cases Efforts to confirm the clinical practicality of these fillers are currently in progress.