BackgroundBone 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.MethodsA 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.ResultsHydroxyapatite 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.ConclusionPreliminary 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.

中文翻译：

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基于超声的牙槽嵴保留后颚骨表面质量评估


背景通常在拔牙和牙槽嵴保留 （ARP） 后 3 至 6 个月的任意时间，通过 2 维 X 光片和锥形束计算机断层扫描上的骨质量/密度来评估种植体植入的骨骼准备情况。本研究的目的是调查高频超声 （US） 是否可以对人类的骨骼准备情况进行分类，使用显微 CT 作为参考标准来获得人类接受 ARP 的愈合窝的骨矿物质密度 （BMD） 和骨体积分数 （BVTV）。方法在种植体手术中，从 24 例既往接受过 ARP 拔除的患者身上共采集 27 个骨芯。在植入手术前立即在与组织活检采集位置共同注册的部位拍摄 US 图像，使用专门设计的导板进行拍摄，然后使用 B 型图像标准 （1） 有利，（2） 可疑，（3） 不利。骨密度 （羟基磷灰石） 和 BVTV 以显微 CT 为金标准。结果羟基磷灰石和 BVTV 在预测的 US 切片平面内进行评估，阈值为有利（>2200 mg/cm3;>0.45 mm3/mm3）、可疑（1500-2200 mg/cm3;0.4-0.45 mm3/mm3）和不利（<1500 mg/cm3;<0.4 mm3/mm3）。目前的 US B 型分类与 BMD 成反比。回归分析显示 US 分类与 BMD 以及 BVTV 之间存在显著关系。T 检验分析表明，美国读者评分与黄金标准之间存在显著相关性。当将第 1 层与第 2 层和第 3 层的组合进行比较时，美国相对于平均 BMD 实现了显着的组别差异 （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%，敏感性 66.7%，受试者操作特征曲线下面积 0.86）。在 US 衍生的层级和 BVTV 之间发现了类似的结果。结论初步数据表明，US 可以对与 BMD/BVTV 相关的颚骨表面质量进行分类，并作为 ARP 后基于 US 的牙槽愈合评估的未来发展基础。