Refining enamel thickness measurements from B-mode ultrasound images

Dental erosion has been growing increasingly prevalent with the rise in consumption of heavy starches, sugars, coffee, and acidic beverages. In addition, various disorders, such as Gastroenterological Reflux Disease (GERD), have symptoms of rapid rates of tooth erosion. The measurement of enamel thickness would be important for dentists to assess the progression of enamel loss from all forms of erosion, attrition, and abrasion. Characterizing enamel loss is currently done with various subjective indexes that can be interpreted in different ways by different dentists. Ultrasound has been utilized since the 1960s to determine internal tooth structure, but with mixed results. Via image processing and enhancement, we were able to refine B-mode dental ultrasound images for more accurate enamel thickness measurements. The mean difference between the measured thickness of the occlusal enamel from ultrasound images and corresponding gold standard CT images improved from 0.55 mm to 0.32 mm with image processing (p = 0.033). The difference also improved from 0.62 to 0.53 mm at the buccal/lingual enamel surfaces, but not significantly (p = 0.38).