# Point of Care, High Resolution and 3-Dimensional Ultrasonography for Diagnosing Peri-Implant Bone Loss

> **NIH NIH R21** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2020 · $195,000

## Abstract

PROJECT SUMMARY
Peri-implant bone loss, mostly due to peri-implantitis after implants are in function, can cause implant loss if not
diagnosed and treated in a timely manner. It is estimated that peri-implantitis affects approximately 20% of
implants. Tissue loss and compromised function negatively impact the welfare of hundreds of thousands of
patients. Currently peri-implant bone loss is primarily assessed by 2-dimensional (2D) periapical radiographs.
The main limitation, i.e. only providing superimposed images, inevitably reduces its diagnostic value. Cone-
beam computed tomography provides useful cross-sectional imaging but is recommended not to be used for
periodic post-op assessment. Non-ionizing and point-of-care ultrasonography can also offer cross-sectional
images and holds great potential to complement radiographic uses. Our group, among others, has shown
accuracy of ultrasound to measure facial alveolar bone crest dimensions. Therefore, ultrasound can potentially
augment clinicians' ability to assess peri-implant bone level, especially on the facial and palatal/lingual sides.
Additionally, marginal bone thickness, another important clinical parameter for assessing long-term peri-
implant soft and hard tissue stability, can be measured with ultrasound. The primary aim of this proposal is to
validate the accuracy of 3D ultrasonography for measuring peri-implant marginal bone dimensions. Three
aims are proposed to achieve this objective:
Aim 1: Establish optimal imaging settings for the ultrasound system for peri-implant marginal bone
measurements. These settings include choice of transmit frequency, harmonic and compound use.
Hypothesis 1: Ultrasonic imaging can delineate oral hard tissue (bone) edges for use in diagnostic imaging
procedures (with <10% error, i.e. the same error as the current standard method 2D radiographs) and provide
dynamic range for differentiation of tissue types by relative contrast.
Aim 2: Establish intra- and inter-rater reliability by conducting a calibration exercise for ultrasound bone
measurements in humans. Hypothesis 2: Intra-class correlation coefficient (ICC) within and between
examiners can reach at least 0.85.
Aim 3: Compare ultrasound measurements to intraoperative direct and radiographic measurements in a cross-
sectional human investigation. Hypothesis 3: Mean ultrasonic bone level and thickness measures differ <0.5
mm and <0.3 mm, compared to the corresponding open bone intraoperative bone measurements, respectively.
Ultrasound measures would be non-significantly different from radiographic measures.
Successful completion of this proposal will validate non-invasive, real-time and high-resolution ultrasonography
for assessing peri-implant marginal bone dimensions. In future investigations we will test ultrasonography for
characterizing peri-implant bone loss and its progression. We will also measure treatment efficacy in larger
scale human studies using ultrasonography.

## Key facts

- **NIH application ID:** 9899974
- **Project number:** 5R21DE027765-02
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** Hsun-Liang Chan
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $195,000
- **Award type:** 5
- **Project period:** 2019-04-01 → 2023-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9899974

## Citation

> US National Institutes of Health, RePORTER application 9899974, Point of Care, High Resolution and 3-Dimensional Ultrasonography for Diagnosing Peri-Implant Bone Loss (5R21DE027765-02). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/9899974. Licensed CC0.

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