**12. Ultrasonography**

Ultrasound imaging is easy to use for the detection of noninvasive and soft tissue related diseases. Ultrasonography utilizes sound waves for image production. The first major attempt at a practical application was made in search for the sunken Titanic in the North Atlantic in 1912. A few early attempts at applying US in medical diagnosis. Successful medical application began shortly after the war in the late 1940s and early 1950s. The vital ingredients are transducer, ultrasonic beam, a cathode ray tube or television monitor. The evolution of sonic imaging began slowly from a static one dimensional base (A-mode or amplitude mode), improved somewhat when a component of motion was added (TM-mode), made a giant leap forward with two dimensional imaging (B mode or brightness mode) and reached its current zenith with gray scale imaging. The phenomenon sound which are perceived is the result of changes which are periodic in the pressure of air against the eardrum. The periodicity of these changes ranging from 1500 to 20,000 cycles per second (hertz [Hz]). By definition, ultrasound has a periodicity >20 kHz. Thus it is distinguished from other waveforms which are mechanical simply by having a vibratory frequency more than the human audible range. Diagnostic ultrasonography (sonography), uses vibratory frequencies in the range of 1–20 MHz. Scanners which are used for sonography generate impulses which is electrical that are converted into sound waves which is of high frequency help of a transducer.

Transducer is a device that transform one form of energy into another-in this case, electrical energy can be converted into sonic energy. The most important part of the transducer is a thin piezoelectric crystal or material which is made up of a great number of dipoles arranged in a pattern of geometric. A dipole may be thought of as a distorted molecule which has two ends that appears to have a positive charge on one end and a negative charge on the other.

Applications of ultrasound in periodontics:


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**13. Conclusions**

*Role of Radiographic Evolution: An Aid to Diagnose Periodontal Disease*

has features of subgingival calculus detection.

lesions as this possess an action of lavage.

lus is needed.

removal or detoxification.

curettage done by hand instruments.

3.Detection of subgingival calculus: there are large number of subgingival calculus detection systems available found that dental surfaces may be determined separately by the tip oscillations analysis of an ultrasonic instrument, which

4.Complete removal of dental plaque or the biofilm: removal of the bacterial plaque by means of the acoustic micro-streaming and cavitation effects of ultrasound. Many studies have shown that there is no statistically significant difference in the effectiveness of plaque removal using hand or motor driven instruments. It can also used for scaling in cases of necrotizing ulcerative

5.Removal of supra and subgingival calculus: cavitation effect liberates energy that can be able to remove the deposits. It is effective on the both supra and subgingival calculus, a direct contact between the vibrating tip and the calcu-

6.Clearance of endotoxin and detoxification: the endotoxins are known to be fragments of bacterial cells and toxic products of bacteria and can be found in the root cementum or dentine, saliva and gingival crevicular fluid. Endotoxins are cytotoxic substances and can affect the immune system of the host. It is suggested that, for the successful treatment outcome, the infected dentine and altered cementum have to be removed. Recent studies have shown that endotoxin is superficially associated with the cementum and calculus. They can be easily removed by rinsing, brushing, lightly scaling, or polishing the root surface. Heat generated from magnetostrictive units may helpful in endotoxin

7.Curettage: ultrasound is effective for the debridement of the epithelial lining of periodontal pockets. A Morse scaler-shaped or rod-shaped ultrasonic instrument can be used. Ultrasonic instruments are found to be as effective as

8.Osseous surgery: ultrasonic bone cutting surgery has been recently introduced as an alternative to the conventional techniques. Piezosurgery® is a new and innovative method that uses piezoelectric ultrasonic vibrations to do precise and safe osteotomies. Piezoelectric surgery uses a specifically engineered surgical instrument characterized by a surgical power that is three-times higher than normal ultrasonic instruments. The unique feature of this technique is that the cutting action occurs when tool is employed on the mineralized tissue, but stops when soft tissue is encountered. This technique can be used for preprosthetic surgery, sinus elevation procedure, implant placement as well as alveolar crest expansion.

Periapical radiographic examination should be part of each patient's periodontal

evaluation and should be coupled with a detailed recording of pocket depths, gingival margin location, and bleeding on probing. Radiographic evaluation should be updated every 2 years. Periapical radiographs often underestimate the amount of periodontal bone loss, and early changes are usually not detected. Significant interdental bone loss can occur and may not be detectable on periapical radiographs

*DOI: http://dx.doi.org/10.5772/intechopen.88035*

### *Role of Radiographic Evolution: An Aid to Diagnose Periodontal Disease DOI: http://dx.doi.org/10.5772/intechopen.88035*

*Periodontal Disease - Diagnostic and Adjunctive Non-surgical Considerations*

• Recognition of fractures and structural maxillofacial deformities;

Ultrasound imaging is easy to use for the detection of noninvasive and soft tissue related diseases. Ultrasonography utilizes sound waves for image production. The first major attempt at a practical application was made in search for the sunken Titanic in the North Atlantic in 1912. A few early attempts at applying US in medical diagnosis. Successful medical application began shortly after the war in the late 1940s and early 1950s. The vital ingredients are transducer, ultrasonic beam, a cathode ray tube or television monitor. The evolution of sonic imaging began slowly from a static one dimensional base (A-mode or amplitude mode), improved somewhat when a component of motion was added (TM-mode), made a giant leap forward with two dimensional imaging (B mode or brightness mode) and reached its current zenith with gray scale imaging. The phenomenon sound which are perceived is the result of changes which are periodic in the pressure of air against the eardrum. The periodicity of these changes ranging from 1500 to 20,000 cycles per second (hertz [Hz]). By definition, ultrasound has a periodicity >20 kHz. Thus it is distinguished from other waveforms which are mechanical simply by having a vibratory frequency more than the human audible range. Diagnostic ultrasonography (sonography), uses vibratory frequencies in the range of 1–20 MHz. Scanners which are used for sonography generate impulses which is electrical that are converted into sound waves which is of high frequency help of a transducer.

Transducer is a device that transform one form of energy into another-in this case, electrical energy can be converted into sonic energy. The most important part of the transducer is a thin piezoelectric crystal or material which is made up of a great number of dipoles arranged in a pattern of geometric. A dipole may be thought of as a distorted molecule which has two ends that appears to have a posi-

1.As diagnostic aid: ultrasonography probe gives a system of mapping for noninvasive procedure and calculate as well as record various measurements of subject's periodontal ligaments relative to a fixed point such as cementoenamel junction. This probe uses ultrasound to detect periodontal ligament and cement-enamel junction. This ultrasound probe records a series of measure-

2.Assessment of periodontium: an ultrasonic scanner that functions at a frequency of 29 MHz has been used to detect the dimensional relationship between hard and soft structures of periodontium. This device also used to assess the gingival thickness before and after mucogingival surgery for gingival

recession and to calculate the thickness of masticatory mucosa.

tive charge on one end and a negative charge on the other.

Applications of ultrasound in periodontics:

ments which is painless.

• Assessment of the inferior alveolar nerve before extraction of mandibular third

• Periodontal assessment;

• Endodontic assessment;

• Alveolar ridge loss;

molar impactions.

**12. Ultrasonography**

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