Table 1.
Listing and summary of included publications
| Author (year) | Study design | Objective | Ultrasound device (make & frequency) | Sample size | Methods | Results | Conclusions |
| Soft tissue evaluation | |||||||
| Traxler et al | Pre-clinical | Analyse the soft tissue covering the upper jaw and to compare the findings with mechanical methods | ATL, Ultramark 8 (10 MHz) | 8 cadaver heads/20 sites | The distance between the mucosal surface to bone was measured by ultrasound and directly and compared | Minimal deviations of 0.2 mm between ultrasound and direct measures | Sonographic imaging corresponds well to direct measurements |
| Culjat et al | Pre-clinical | Demonstrate a specialized ultrasound system in measuring the soft tissue thickness over implants | Prototype (16.1 MHz) | Two implants on one porcine model | Implants submerged in porcine ribs were measured by ultrasound by measuring the thickness of overlying soft tissue | Implants were located to an accuracy of 0.2 mm and soft tissue thickness was with a 0.5 mm error | The system was capable of measuring soft tissue thickness over bone and implants as well as locating implants |
| Culjat et al | Pre-clinical | Test an ultrasound system to measure the soft tissue thickness covering submerged implants | SP 7.5, Interson Corp (24 MHz) | Two implants on one porcine model | Implants placed in porcine bone samples were measured by three examiners recorded four ultrasound measurements | Ultrasound soft tissue measures were within 0.3 mm error | Ultrasound can be used to accurately detect dental implant fixtures and measure soft tissue |
| De Bryuckere et al | Pre-clinical | Use ultrasound to monitor soft tissue graft stability | EPOCH 600, Olympus, Aartselaar, Belgium (5MHz) | 37 subjects | Facial soft tissue thickness was measured before surgery, 2 week, 3 months and 1 year | Changes of 0.1 mm after 1 year | Grafted tissue stays stable at 1 year |
| Eghball et al | Pre-clinical | Assess validity and reproducibility of ultrasound for measuring mucosal thickness | EPOCH 600, Olympus, Aartselaar, Belgium (5MHz) | 4 human cadaver maxilla/100 sites | Mucosal thickness at 100 sites were measured with ultrasound and compared to micro-CT | Soft tissue thickness recorded with ultrasound and micro-CT had high correlation (r = 0.89) | The ultrasonic device can be non-invasive and reproducible to evaluate mucosal thickness |
| Hard tissue evaluation | |||||||
| Traxler et al | Clinical human | Compare residual ridge dimensions measured with ultrasound and open measurement | ATL, Ultramark 8 (10 MHz) | 4 patients/11 sites | Ridge width measured by ultrasound was compared with direct measurements | Ultrasound measures corresponds well to direct ridge mapping | Ultrasound for bone morphology evaluation is a valuable initial screening tool for implant treatment planning |
| Bertram et al | Clinical human | Assess reproducibility and validity of ultrasound peri-implant buccal bone loss | Sonoace Pico (12.5 MHz) | 25 patients/29 buccal bone defects | The distance between the upper thread of the implant to the most apical marginal bone was evaluated sonographically and compared to direct measures | Bone loss measurements made at moderate bone loss levels (3–6 mm) was most reliable | Ultrasound may be a reliable and valid method for assessing marginal bone loss and is defect depth dependent |
| Klein et al | Clinical human | (1) Assess alveolar crest UTV values (2) to compare UTV of osteoporosis and H/N radiation patients to health patients | DBMSonic 1200 instrument, IGEA (1.2 MHz) | 87 patients/204 sites | UTV values were measured and compared among different anatomical sites and patient groups | Significantly higher UTV in the max ant & mand post regions UTV corresponds clinically and histologically. UTV in osteoporotic patients were generally lower than in healthy patients |
UTV might identify critical bone quality before or to monitor bone healing after augmentation procedures |
| Salmon and Le Denmat | Clinical human | Present intraoral sonographic images generated by a novel ultrasound system | Prototype (25 MHz) | 3 patients/162 sites | All teeth of three subjects were evaluated on buccal and lingual sides by two examiners with ultrasound | Crestal bone and the marginal gingival levels were detectable at least 90% of the sites | This promising device requires large-scale clinical studies to determine whether it should remain a research tool or be used as a diagnostic tool for daily dental practice |
| Krammerer et al | Pre-clinical | Collerate UTV to histomorphometry and 3D-radiology | Modified DBMSonic 1200 instrument (1.2-MHz) | Six porcine rib samples (cortical, cancellous and mixed bone types) | Clinical cortical, cancellous, and mixed bone was measured with ultrasound, CBCT, micro-CT, and histomorphometry and compared | Statistically significant correlation (p < 0.001) was found between UTV, histomorphometry and radiogrpahic measures of bone parameters | UTV is able to discriminate between different bone types ex vivo |
| Degen et al | Pre-clinical | Analyse ultrasound for measuring the cortical bone thickness | Combination of low (5 MHz) and high (50 MHz) ultrasound system | 10 bovine rib blocks/ 10 implants (3.8 mm by 11 mm) | Dental implants were investigated using ultrasound, CBCT, and stereomicroscopy to measure the cortical bone thickness | The median deviation of ultrasound was 0.23 mm. CBCT method was slightly more accurate (median percent deviation of 9.2%) than the ultrasound method (10.3%) |
Ultrasound showed a high potential to supplement CBCT for measurements of the cortical bone thickness |
| Chan et al | Pre-clinical | Evaluate ultrasound to measure facial crestal bone level and thickness | Zonare ZS 3 (14 MHz) | 6 cadaver head/ 139 teeth | Crestal bone level/thickness of midfacial site were measured with ultrasound | Ultrasound bone level/thickness correlated well (0.8–0.9) with CBCT and direct measures | Ultrasound holds promise for evaluating crestal bone level/thickness |
| Vital structure evaluation | |||||||
| Lustig et al | Clinical human | Characterize lingual foramen artery using an ultrasound system | A.T.L. HD 3000 (10 MHz) | 20 patients | Blood vessel to the lingual foreman was identified and characterized by ultrasound | The diameter of the artery was 0.18–1.8 mm and the blood flow from 0.7 to 3.7 ml min-1 | Ultrasound is a reliable tool to visualize and measure the blood supply to the bony chin |
| Machtei et al | Clinical human | Identify IAC/maxillary sinus floor using an ultrasound device | JetGuide prototype | 14 patients; 21 implants (11 mandibular, 10 maxillary) | IAC and maxillary sinus was measured with ultrasound and compared to panoramic radiograph | A very strong positive correlation was observed between the two measurements in mandibles (r = 0.967; p = 0.0001). The correlation with respect to the floor of the sinus were weak |
The results support the value of this ultrasonic system in measuring the residual osseous depth |
| Rosenberg et al | Pre-clinical/clinical human | Measure hard tissue boundaries with ultrasound | JetGuide prototype (5 MHz) | (1) A cubic phantom (2) fresh porcine femora (3) nine patients | Bone boundaries of the three models were measured with ultrasound and compared to radiographic and direct measures | Ultrasound could differentiate the cortical bone from cancellous bone in both pre-clinical and clinical evaluations | Ultrasound technology can be employed as a useful tool to monitor intraosseous drilling |
| Zigdon- Giladi et al | Clinical human | Identify IAC with ultrasound | JetGuide prototype | 10 patients; 18 implant in mand | The distance between the bottom of the osteotome to the IAC was assessed using the ultrasound device and compared with standard panoramic radiographs | The mean difference by ultrasound and PAN was 0.18 mm (r = 0.61). That between ultrasound and CBCT was 0.21 mm |
The tested ultrasound device identifies the IAC |
| Chan et al | Pre-clinical | Evaluate ultrasound in measuring facial crestal bone level and thickness on different tooth types | Zonare ZS3 (14 MHz) | 6 cadaver heads, 10 sites in each head | (1)Greater palatine foramen, (2) lingual nerve (3) mental foramen were assessed with ultrasound. The images from ultrasound was compared to those obtained from CBT and /or direct measurements | The correlations were between 0.78 and 0.88. The mean absolute differences in crestal bone height and thickness were 0.09 mm | Proof-of-concept evidence that ultrasound can be a real time and non-invasive alternative |
| Implant stability evaluation | |||||||
| Veltri et al | Pre-clinical | Correlate amplitude-dependent speed of sound (ad-SOS) to implant insertion torque | DBMSonic 1200, IGEA (1.2 MHz) | 16 rabbits/2 anatomical sites, 32 implants/28 sites | Amplitude-dependent speed of sound (ad- SOS) of diaphysis (Group 1) and epiphyses (Group 2) of rabbit femurs and the insertion torque was measured and correlated | A negative correlation between insertion torque and ad-SOS (r = −0.7) | Ultrasound could convey potentially useful information on bone mechanical characteristics |
| Mathieu et al | Pre-clinical/ simulation | Study propagation of ultrasonic waves in cylinder implant prototypes and the sensitivity of these waves to the surrounding bone biomechanical properties | V129SM, Panametrics (10 MHz) | 40 rabbit femurs/4 conditions | Specific geometric configuration in four groups with a controlled amount of implant-bone contact were tested with ultrasound | A change of 1 mm of bone in contact with the implant, 1.1 mm of cortical bone thickness or 12% of trabecular bone mass density could be detectable by ultrasound | The ultrasound quantitative parameter extracted from the radiofrequency signals is sensitive to implant stability |
| Mathieu et al | Pre-clinical | Test ultrasound to measure the amount of bone in contact with implants | V129SM, Panametrics (10 MHz) | 10 implants in rabbit femurs | Four distinct clinical conditions corresponding to the amount of bone around the implant were tested with ultrasound | The Indicator I was significantly associated with the amount of bone in contact with the implants | The first step towards successful use of ultrasound to monitor dental implant stability |
| Ossi et al | Pre-clinical | Investigate the feasibility of monitoring implant primary stability using ultrasound | PAC Micro-80D AE sensor (0.1–1 MHz) | 40 implants (2 conditions) on 10 bovine ribs | Tight- and loose- fitting implants were measured by ultrasound and compared | Implants with good primary stability had a higher acoustic emission energy than shorter narrower implants | A simple transmission test, properly calibrated, should be able to assess the quality of bone-implant contact in the clinical situation |
| Kumar et al | Pre-clinical | Compare UTV bone quality measurements and correlate to RFA and POT | Modified DBMSonic 1200, IGEA (1.2 MHz) | Three porcine bone block types/nine implants | Porcine three bone types (1) cortical, (2) cancellous, (3) mix of cortical and cancellous bone were measured using UTV. RFA and POT were measured and compared to UTV | Higher values of RFA and POT were seen with higher UTV values (corresponding to higher bone quality) | A high correlation between UTV values and primary implant stability in ex vivo bone samples |
| Ossi et al | Pre-clinical | Assess ultrasound on various dental materials and bovine rib bones with various degrees of hydration | PAC Micro-80D AE sensor (0.1–1 MHz) | Materials used: bovine bone, GIC, Plaster of Paris, acrylic orthodontic resin, Type 4 dental stone | Fresh bovine rib, Plaster of Paris, acrylic orthodontic resin, GIC and Type 4 dental stones were used to study the axial surface transmission of AE | Ultrasound transmission through GIC is closest to the bone. AE energy through bone was found to be dependent on its degree of hydration |
These findings may have implications not only for AE transmission testing of bone- implant interfaces but also for passive AE monitoring of implants |
| Vayron et al | Pre-clinical | Use ultrasound system to study the response of an implant embedded in TSBC subjected to fatigue stresses | V129SM, Panametrics (10 MHz) | Seven implants in TSBC | Implants were embedded in TSBC. Indicator I, based on the temporal variation of the signal amplitude, was derived and its variation as a function of fatigue time was determined | No significant variation of indicator I as a function of time without mechanical solicitation. The indicator significantly increases as a function of fatigue time |
Ultrasound has the potential to emerge as a diagnostic tool to investigate the material properties around dental implants and help assess implant stability |
| Vayron et al | Pre-clinical | Use ultrasound to detect the amount of bone in contact with implants | Sonaxis, Besancon (10 MHz) | 10 implants placed in bovine humeral bone | Indicator I was determined for (1) implant hung in air was first measured, (2) after implantation and (3) after unscrewing the implant to reduce the contact area | Implant stability was measured by indicator I, calculated based on the amplitude of ultrasound signal after each turn. A significant association was found betweenIand the bone implant contact | The results indicates the feasibility of quantitative ultrasound techniques to assess implant primary stability in vitro |
| Vayron et al | Pre-clinical | Investigate the sensitivity of ultrasound response to bone healing around implants in vivo | V129SM, Panametrics (10 MHz) | 21 implants placed in femur of 7 rabbits | Indicator I was measured at insertion and at 2, 6 and 11 week healing and correlated to histological bone-implant contact ratio | Indicator I as a function of the healing time was between 7 and 40%. A statistically significant correlation between indicator I and BIC | Pave the way for the development of a new QUS method in dental implant therapy |
| Vayron et al | Simulation | Provide a model of ultrasound wave propagation through prototype titanium cylindrical implants | V129SM, Panametrics (10 MHz) | None (numerical analysis) | Different geometrical configurations were modelled to project various bone–implant interface situations and indicator I were measured | The implant ultrasonic response changes significantly when there is a liquid layer at implant surface | There is a potential of QUS techniques to study dental implant stability |
| Vayron et al | Simulation | Provide understanding of the ultrasound wave propagation in commercial dental implants | V129SM, Panametrics (10 MHz) | None (numerical analysis) | Three-dimensional finite element model was used to compute different geometrical configurations and related to indicator I | Indicator I decrease when bone quality increases, consistent with the experimental results | There is a potential of QUS techniques to study dental implant stability |
ad-SOS , amplitude-dependent speed of sound; AE, acoustic emission; BIC, bone-implant contact; CBCT, cone beam CT; GIC, glass-ionomer cement; H/N, Head & Neck; IAC, inferior alveolar canal; Mand, Mandibular; Max, Maxillary; POT, push-out test; QUS, quantitative ultrasound; RFA, radio frequency analysis; TSBC, tricalcium silicate-basedcement; UTV, ultrasound velocity.