The question of whether MRI can be used to diagnose early periodontitis is an issue that has been studied for some time. This study looks at how MRI can be used to detect these issues and compares it to the other options available.
MRI findings correlate with clinical testings
Periapical radiographic examination is an important component of periodontal evaluation. However, these films are often insufficient to detect the early signs of periodontitis. A CBCT (cone beam computed tomography) can improve upon the conventional approach to the imaging of teeth and periodontal structures.
This technology produces accurate, three-dimensional images of the teeth and other periodontal tissues. It also avoids geometric superposition, which makes it easier to see the subtle changes in the bone.
For instance, this procedure is able to measure the thickness of the masticatory mucosa and can quantify the strength of the cementoenamel junction. In addition, the probe can be used to measure the thickness of the periodontal ligament.
Another interesting feature is the ability to detect periodontal ligament thickness using ultrasound. This instrument uses 29MHz ultrasound to record a series of measurements. The results can be used to calculate the periodontal ligament length and thickness.
Another useful MRI function is detecting a difference between the height of the alveolar crest and the height of the alveolar bone. Typically, this is done by measuring the distance from the cementoenamel junction to the crest of the alveolar bone.
Similarly, a CBCT can be used to visualize the extent of periodontal bone loss. One may see the width of the periodontal ligament space, the level of the lamina dura, the apex of the alveolar ridge, and the degree of the root bony plate destruction.
As a result, a CBCT can be considered as an adjunctive technique during surgical procedures. With its numerous advantages over the conventional radiograph, a future periodontist will likely use it to evaluate and treat his patients.
When diagnosing periodontal disease, a CBCT can provide the information you need to make the right decision about treatment.
Oedema size
One of the first things you might notice when your dentist performs a check up is the pocket depth. This is one of the most important factors when it comes to identifying and treating gum disease. It is a measure of the amount of inflammation that has erupted in the space between your teeth and gums. When you have a healthy mouth, the pocket depth is typically between 1 and 3 millimeters. But when you have gum disease, that measurement becomes a lot deeper.
There are several reasons why your pocket might be too deep. If food particles are allowed to accumulate in this space, they can erode the supporting structures that hold your teeth in place. Plus, tartar can build up and make this pocket even more problematic.
The best way to determine if you have a problem is to get a professional cleaning. Your dentist may also refer you to a periodontist. During this procedure, your hygienist will remove any tartar that has built up, a process called scaling. Some dentists will also utilize a laser to help achieve the same result.
While your hygienist is at it, she or he may recommend you consider taking a mouthwash. A strong antibacterial mouthwash can be very helpful in removing plaque and keeping gums clean. Also, make sure to floss every day. Not only will it prevent bacteria from building up on your teeth, but it will also keep your breath fresh.
Lastly, be aware that periodontitis has no cure, but there are treatments available to keep it at bay. You might not see any results right away, but with proper care you can enjoy a brighter, healthier smile for years to come.
MRI signal intensities for T2 sequence
MRI is a powerful tool to help detect and monitor changes in the periodontal and oral musculature. It provides sufficient spatial resolution and contrast to differentiate pathological tissues from normal tissues. During an MRI examination, osseous oedema may be present, which may serve as a surrogate marker for early stages of periodontal disease. However, few studies have been conducted on MRI and periodontitis. These studies aim to assess the suitability of MRI to represent periodontitis and determine the feasibility of MRI in monitoring the periodontal inflammatory process.
One MRI sequence used to determine changes in the tooth-supporting bone of periodontal patients is the T1 fat saturated sequence. This enables the detection of trilaminar stratification.
Another MRI sequence is the GRE T2WI. This is a relatively new MRI technique that uses different TE times to determine the uniformity of the magnetic field. It also allows the study of degenerative diseases. When combined with conventional MRI sequences, it facilitates the detection of small lesions, which is important for early detection and diagnosis.
In this study, the signal intensities for the T2 and T1 sequences were measured in a sample of healthy control subjects. They were correlated with probing depth measurements made at collection sites. Those measurements support the current understanding of periodontal disease.
The MRI signal intensities for the T2 and T1 are based on the proton density and proton spin-lattice relaxation time of the tissue. During a T1 relaxation, the magnitude of energy released is proportional to the speed of the protons. As the protons resume their alignment, the rate of energy release is reduced.
This decrease in the RSI correlates with reductions in inflammation and probing depth in gingival tissues. Similarly, a reduction in osseous oedema is associated with periodontal pocket depth.
Comparison of OPT and MRI to detect early periodontitis
In order to understand the impact of periodontal disease monitoring, we compared magnetic resonance imaging (MRI) and optical probing (OPT) in detecting early periodontitis. The objective was to identify the possible added value of periodontal disease monitoring.
MRI is an advanced imaging technique that is used to visualize soft tissues, as well as bony structures. It is known to produce high tissue contrast. However, it is not known if MRI can detect the inflammatory changes associated with periodontitis.
OPT, on the other hand, is an established and reliable method for detecting periodontal damage. Both of these procedures are non-ionizing and use a relatively low dose of radiation. MRI has the potential to provide a more detailed visualization of the periodontal space. Several studies have been performed to determine whether MRI is appropriate for a variety of periodontal conditions.
As part of the present study, 1179 periodontitis-affected teeth were examined in 42 periodontitis patients. The OPT and MRI findings were compared to a group of periodontal healthy subjects. Moreover, a sample of 230 molars were chosen for volumetric measurements.
Osseous oedema was significantly correlated with bleeding on probing. The size of the oedema was associated with the type of tooth and pocket depth. Interestingly, sites with a shallow pocket depth had no osseous oedema. On the other hand, sites with a deep pocket had more intense oedema.
Osseous oedema is an indication of early periodontal changes. These changes usually precede bone loss. Nevertheless, periapical radiographs often underestimate the extent of periodontal bone loss. Hence, additional information on the process within the bone is needed.
Despite its limitations, MRI can provide new options for periodontal disease monitoring. Especially, MRI is superior to CBCT in depiction of cortical bone and hard tissues.
Future studies should study both forms of tooth pain in one experimental setup
Aside from the usual suspects, there is a plethora of new research on the human jaw, teeth and gums. The baffling challenge is determining which is the best amongst the competition. We are also fortunate that the lab has a large animal collection which allows us to pursue the latest in behavioural neuroscience. In addition, we are well placed to study tooth pain at its most intense. Currently, our lab is in the throes of a multicentre study on the role of odontoblasts in pain transduction and signalling. It is only a matter of time before the first patient is enrolled in a controlled environment. Hence, the next few months will be dedicated to exploring new and exciting avenues of advocay.
Amongst our harried ranks, a small number of us are lucky enough to be on call for the aforementioned study. Although the aforementioned studies are not likely to yield a gold medal, we hope we have been a part of the kinks. Besides, we have our own unique set of DNA to play with, and it is always good to have the option to go where the lions are.
