Use of ultrasonography in assessing peri-implant osseous defects: An in vitro study

The purpose of this study is to investigate the feasibility and diagnostic accuracy of ultrasonography in peri-implant defect identification and evaluation, and to compare ultrasonography (USG) with cone-beam computed tomography (CBCT) in defect identification and evaluation in an in vitro model.

Seventy-two implants were placed in fresh porcine rib bone models with different types of artificially created defects (including buccal dehiscence, circumferential defect, circumferential defect with buccal dehiscence), and in control sites with no defect. Both USG and CBCT were used to assess the presence, type, and linear measurements (height and depth) of the defects. Diagnostic performance metrics, including the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of USG and CBCT in characterizing different types of defects, were examined. Linear measurement results obtained by using USG and CBCT were compared with the direct measurement as the gold standard, with the computation of the intraclass correlation coefficient (ICC).

USG demonstrated satisfactory diagnostic accuracy (> 95%) in defect type detection across all types. Its sensitivity in detecting circumferential defects (83.3%) and its positive predictive value for no-defect sites (87.0%) were lower. CBCT showed perfect diagnostic accuracy (100%) for defect detection. USG illustrated high agreement with direct measurements for defect depth (ICC = 0.934, p < 0.001) but poor agreement for defect height (ICC = 0.349, p < 0.001), underlining its limitations compared with CBCT.

USG is a reliable, non-ionizing diagnostic tool for characterizing peri-implant defect types with performance comparable to CBCT. However, it underestimates defect height measurements in defects with infrabony components, where CBCT remains superior.