Longitudinal Monitoring of Periodontal Inflammation by Quantitative Ultrasound: Attenuation and Backscatter Intensity Signature

Abstract

In the USA, periodontal diseases, a spectrum of inflammatory conditions, affect 4 out of 10 adults (>=30 years). Current standards of care in clinical assessment of these diseases are invasive, subjective, only semi-quantitative, and primarily detecting later stages. Applications of ultrasonography in periodontology has been emerging in recent years. Despite such growing interest, Quantitative ultrasound (QUS) approaches remain largely unexplored and their utility for longitudinal characterization of oral inflammation has yet to be established. Here, we present one of the early investigations into the potential of QUS techniques for inflammation monitoring. In a staggered study involving a pig cohort (N=8), interdental gingival tissues at three interproximal oral sites from four quadrants were enrolled. The study involved baseline and five inflammation timepoints. Inflammation was induced using two complementary approaches at each site. Two QUS parameters of attenuation coefficient slope (ACS) and backscatter intensity (BSI) were investigated. Sex and oral sites were also used to stratify the longitudinal QUS estimates with inflammation. Results showed that both ACS and BSI were statistically significant from the healthy baseline across all oral sites at week 2 and|or 4 (combined sexes). Overall, inflammation inoculation was associated with a decrease in ACS and an increase in BSI. For BSI, week4 and/or week 2 remained statistically significant across males and females at all oral sites. ACS variations were spread across oral sites and sexes, with PM4-Dis as overall non-significant. The 2D classification (baseline from week 2) accuracy, were 92%, 82%, and 74.2% for M1-Dis, PM4-Dis, and PM3-Dis, respectively This study is among early implementation of QUS approaches for periodontal inflammation characterization.