Radiographic examination has been an essential part of the diagnostic workflow in periodontology and implant dentistry. However, radiographic examination unavoidably involves ionizing radiation and its associated risks. Clinicians and researchers have invested considerable efforts in assessing the feasibility and capability of utilizing nonionizing imaging modalities to replace traditional radiographic imaging. Two such modalities have been extensively evaluated in clinical settings, namely, ultrasonography (USG) and magnetic resonance imaging (MRI). Another modality, optical coherence tomography (OCT), has been under investigation more recently. This review aims to provide an overview of the literature and summarize the usage of USG, MRI, and OCT in evaluating health and pathology of periodontal and peri‐implant tissues. Clinical studies have shown that USG could accurately measure gingival height and crestal bone level, and classify furcation involvement. Due to physical constraints, USG may be more applicable to the buccal surfaces of the dentition even with an intra‐oral probe. Clinical studies have also shown that MRI could visualize the degree of soft‐tissue inflammation and osseous edema, the extent of bone loss at furcation involvement sites, and periodontal bone level. However, there was a lack of clinical studies on the evaluation of peri‐implant tissues by MRI. Moreover, an MRI machine is very expensive, occupies much space, and requires more time than cone‐beam computed tomography (CBCT) or intraoral radiographs to complete a scan. The feasibility of OCT to evaluate periodontal and peri‐implant tissues remains to be elucidated, as there are only preclinical studies at the moment. A major shortcoming of OCT is that it may not reach the bottom of the periodontal pocket, particularly for inflammatory conditions, due to the absorption of near‐infrared light by hemoglobin. Until future technological breakthroughs finally overcome the limitations of USG, MRI and OCT, the practical imaging modalities for routine diagnostics of periodontal and peri‐implant tissues remain to be plain radiographs and CBCTs.

中文翻译：

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用于可视化牙周和种植体周围组织的健康和病理的非电离诊断成像方式


射线照相检查已成为牙周病学和种植牙科诊断工作流程的重要组成部分。然而，射线照相检查不可避免地涉及电离辐射及其相关风险。临床医生和研究人员投入了大量精力来评估利用非电离成像方式取代传统放射线成像的可行性和能力。两种这样的模式已在临床环境中得到广泛评估，即超声检查（USG）和磁共振成像（MRI）。另一种模式，光学相干断层扫描（OCT），最近正在研究中。本综述旨在提供文献综述并总结 USG、MRI 和 OCT 在评估牙周和种植体周围组织的健康和病理学方面的应用。临床研究表明，USG可以准确测量牙龈高度和牙槽嵴骨水平，并对分叉受累进行分类。由于物理限制，即使使用口内探头，超声检查也可能更适用于牙列的颊面。临床研究还表明，MRI可以可视化软组织炎症和骨水肿的程度、分叉受累部位的骨丢失程度以及牙周骨水平。然而，缺乏利用 MRI 评估种植体周围组织的临床研究。此外，MRI 机器非常昂贵，占用空间大，并且比锥形束计算机断层扫描 (CBCT) 或口腔内 X 线摄影需要更多时间才能完成扫描。 OCT 评估牙周和种植体周围组织的可行性仍有待阐明，因为目前只有临床前研究。 OCT 的一个主要缺点是，由于血红蛋白吸收近红外光，它可能无法到达牙周袋的底部，特别是对于炎症情况。在未来的技术突破最终克服 USG、MRI 和 OCT 的局限性之前，牙周和种植体周围组织常规诊断的实用成像方式仍然是 X 线平片和 CBCT。