Computer-assisted detection of cemento-enamel junction in intraoral ultrasonographs

The cemento-enamel junction (CEJ) is an important reference point for various clinical measurements in oral health assessment. Identifying CEJ in ultrasound images is a challenging task for dentists. In this study, a computer-assisted detection method is proposed to identify the CEJ in ultrasound images, based on the curvature change of the junction outlining the upper edge of the enamel and cementum at the cementum–enamel intersection. The technique consists of image preprocessing steps for image enhancement, segmentation, and edge detection to locate the boundary of the enamel and cementum. The effects of the image preprocessing and the sizes of the bounding boxes enclosing the CEJ were studied. For validation, the algorithm was applied to 120 images acquired from human volunteers. The mean difference of the best performance between the proposed method and the two raters’ measurements was an average of 0.25 mm with reliability ≥ 0.98. The proposed method has the potential to assist dental professionals in CEJ identification on ultrasonographs to provide better patient care

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

BACKGROUND AND OBJECTIVE:The 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 DESIGN:Seven 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. RESULTS:All 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%. CONCLUSIONS:There 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