ArticleBMC oral health2026
Ultrasound-based assessment of peri-implant mucosal thickness: an ex vivo comparative study with artificial intelligence-assisted image analysis.
Article in BMC oral health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundMucosal thickness (MT) is a key factor influencing peri-implant soft-tissue response and outcomes in dental implantology. This ex vivo study evaluated the agreement of peri-implant MT measurements obtained using ultrasound (US) standardized with a custom probe holder, compared with transgingival probing (TP) and cone-beam computed tomography (CBCT).
methodsPorcine hemimandibles (n = 18) underwent guided implant placement. MT was measured at five standardized points using four approaches: (1) US with expert annotation, (2) US with artificial intelligence (AI)-based image segmentation, (3) CBCT, and (4) TP. US images (18 MHz) were independently annotated by two trained specialists; a deep-learning-based method was used to derive automated MT measurements. Method differences were analyzed using a linear mixed-effects model; agreement was assessed using intraclass correlation coefficients (ICCs) and Bland-Altman analysis.
resultsThe overall method effect was not significant (p = 0.105). Pairwise comparisons showed no significant difference between expert-annotated US and TP (p = 0.328), whereas CBCT yielded higher MT values than TP (p = 0.035). Agreement was moderate for expert-annotated US versus TP (ICC = 0.58; 95% confidence interval (CI): 0.42-0.70) and for expert-annotated US versus AI-segmented US (ICC = 0.67; 95% CI: 0.53-0.77), but poor for expert-annotated US versus CBCT (ICC = 0.14; 95% CI: -0.05-0.33). Bland-Altman analysis showed mean differences (95% limits of agreement) of 0.08 mm (- 0.96 mm to + 1.13 mm) for expert-annotated US - TP, - 0.01 mm (- 0.68 mm to + 0.67 mm) for expert-annotated US-AI-segmented US, and - 0.30 mm (- 2.29 mm to + 1.68 mm) for expert-annotated US-CBCT.
conclusionsUnder controlled ex vivo conditions, expert-annotated US standardized with a custom probe holder showed moderate comparative agreement with TP, while AI-segmented measurements showed moderate agreement with expert annotation. CBCT showed limited agreement with US. This integrated approach represents a proof-of-concept requiring further in vivo validation.
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