First Standard Quantification of Ultrasound Attenuation in Healthy Periodontal Soft Tissues In Vivo

This study presents the first quantifications of ultrasound attenuation in oral soft tissues using validated standard techniques and serves as foundational step in advancing quantitative ultrasound (QUS) imaging in dentistry. Current standards of care in clinics for diagnosing periodontal diseases such as inflammation are limited by subjectivity, qualitive assessment, and late-stage indication. As a result, the application of ultrasonography is emerging as a surrogate for non-invasive and quantitative assessments and a relatively new research area with significant potential biomarkers to be explored. Many QUS analyses rely on quantifying ultrasound attenuation coefficient (UAC), as a confounding factor. Here, in a swine cohort (N=10), we characterized the high-frequency (24 MHz) UAC of healthy periodontal tissues (gingiva) in vivo. UAC were estimated using spectral difference method. Five interproximal oral sites were imaged from four oral quadrants: Premolar 3-Mesial, Premolar3-Distal, Premolar4-Distal, Molar1-Distal, and Molar2-Distal. A total of 162 oral sites were analyzed. The respective medians (1st-quartile|3rd-quartile) UACs for these oral sites were 1.66 (1.25|1.99), 1.37 (1.06|1.64), 0.99 (0.8|1.25), 1.08 (0.89|1.47), and 1.28 (0.94|1.24) dB/MHz.cm. The gingival attenuation mean at Premolar3-Mesial was significantly higher than any other oral sites while the rest of them showed non-significance difference in their means. Across all non-significant oral sites, the average UAC was 1.17 dB/MHz.cm with a standard deviation of 0.49 dB/MHz.cm. This work not only characterized an important acoustic property of oral tissues for the first time but also contributes to future development of a number of QUS biomarkers for periodontal/dental healthcare that rely on accurate attenuation knowledge.