||Periodontal Disease Assessed by High Frequency Ultrasonic Backscattered Signals and Statistical Parameter
||Institute of Computer Science and Information Engineering
ultrasonic quantitative parameters
牙周疾病是現在非常常見的疾病影響了全球90%的人口，並且有許多的嚴重疾病都與牙周病有關聯。現今最常用於偵測牙周病的臨床方法為口部X光影像與牙周探針，但是X光的游離輻射與牙周探針的侵入偵測而造成患者疼痛與傷害都是很擾人的議題。因此有必要發展一個不具游離輻射且不會造成患者疼痛的評估牙周病方法，所以這篇本研究主要是透過70MHz 的高頻超音波系統去偵測牙齦溝深度與牙齦組織的組織特性。透過將牙齒模型嵌入假體之中來驗證超音波系統，並且藉由綁線誘導大鼠牙齦發炎的方法得到動物的牙齦發炎模組。透過將編織尼龍縫線綁置於牙齒與牙齦的交界處來達到誘發牙齦發炎的目的，透過超音波探頭並使用C-Scan 的方式掃描假體和大鼠的牙齦組織。透過在每張連續的B-mode影像上做牙齦溝的判斷，牙齦溝的深度資訊就可以被計算出來，而牙周病的嚴重程度也可以透過計算超音波的定量參數Nakagami參數與逆散射訊號來做評估。自動偵測牙齦溝深度演算法的結果藉由與牙周探針來做比對後可以看出透過B-mode影像來做牙齦溝深度的計算是一個不錯的測量方式。在誘發大鼠牙齦發炎後的結果上可以看到牙齦的厚度、Nakagami參數、逆散射訊號都與控制組的結果有明顯的變化，並且可以從B-mode影像上看出牙齦腫脹前後會有明顯的差異。這篇研究將展示70MHz的高頻超音波系統有能力透過計算牙齦溝的深度與測量超音波定量參數來分析牙周疾病。
Periodontal diseases are very common and can affect up to 90% of the worldwide population. Some acute diseases have also been associated with periodontal diseases. Dental radiography and the periodontal probe are the most popular ways nowadays to diagnose periodontal disease, but the irradiation of radiography and the pain with examination of periodontal probe are annoying issues. It is necessary to develop a new diagnosis method with properties of non-ionization and painless examination to assess the periodontal disease. This study proposed a 70 MHz high-frequency ultrasound imaging system for measuring the depth of gingival sulcus and the tissue properties of gingiva. A plastic dental model was embedded in a tissue-mimicking phantom to be used to verify the ultrasound imaging system. Subsequently, the rat model for periodontal disease was achieved by ligature-induced. The phantom and gingival tissue were scanned by the ultrasonic transducer to acquire ultrasonic signals. By detecting every continuous B-mode image, the depth of gingival sulcus can be calculated. The degrees of periodontal disease were related to ultrasonic parameters. Integrated backscatter and Nakagami parameter were calculated from ultrasound image inside region of interest (ROI), respectively. The results of depth which were calculating by algorithm of automatically detecting gingival sulcus and periodontal probe show that calculating the depth of gingival sulcus by B-mode image is an feasible way to measurement. After ligature-induced gingivitis in rats, the results show that the thickness of gingival, Nakagami parameter and integrated backscatter were different from the control group. The difference between normal thickness of gingival and swelling thickness of gingival can also be seen on B-mode image. This study demonstrated that the 70 MHz high-frequency ultrasound imaging system which could be used to analyze the periodontal disease by measuring the depth of gingival sulcus and ultrasonic quantitative parameters.
List of Tables VII
List of Figures VIII
Chapter 1 Introduction 1
1.1 Ultrasound 1
1.2 Quantitative Ultrasound Parameters 2
1.4 Research background 4
1.4.1 Basic Periodontal Anatomy 4
1.4.2 Periodontal Disease & Dental Cavity Pathophysiology 5
1.5 Related Research 7
1.5.1 Periodontal Disease in Clinical Diagnosis 7
1.5.2 Application of Ultrasound in Periodontal 7
1.6 Motivation and Objectives 8
Chapter 2 Theoretical Background 9
2.1 Fundamentals of Ultrasound Wave Propagation 9
2.2 Reflection and Refraction 11
2.2.1 Ultrasonic Attenuation and Scattering 13
2.3 Statistical Models for Ultrasonic Backscattered Signals 18
2.4 Ultrasonic Transducers 21
Chapter 3 Materials and Methods 23
3.1 Experiments on A Plastic Dental Model 23
3.2 Simulate Periodontal Pocket by Phantoms 27
3.3 In vivo Rat Ligature-induced Periodontal Disease 31
3.4 Ultrasound Imaging System 37
Chapter 4 Results and Discussion 40
4.1 Plastic Dent Model 3D Reconstruction 40
4.2 Periodontal Pocket Depth Measurement 42
4.3 In vivo Animal Models of Gingivitis 46
Chapter 5 Conclusions and Future works 52
5.1 Conclusions 52
5.2 Suggestions for Future works 52
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