Abstract
Ultrasonography (USG) has been utilized in several areas of medicine, to date. Recently, USG is beginning to take attention in dentistry, as a safe, noninvasive, ionize radiation-free, cost-effective, and dynamic imaging modality. Ultrasound is promising that it can be used in many areas in the orthodontic treatment stages, including diagnosis, treatment, and posttreatment, but there is limited information in relation to some applications.
The use of USG is identified and discussed in the fields of masticatory muscles, tongue and swallowing, airway, temporomandibular joint, soft tissue thickness, pubertal growth and bone age estimation, midpalatal suture evaluation, periodontal changes during orthodontic tooth movement, and tooth movement and root resorption.
This chapter will evaluate the current studies in the literature investigating the use of ultrasound imaging in many orthodontic practices, examine the results from the most common to the latest and shed light on new studies.
Access provided by Autonomous University of Puebla. Download chapter PDF
Similar content being viewed by others
Keywords
15.1 Introduction
Orthodontics is the art and science that considers harmonizing crowded teeth, jaw relationships, abnormal teeth bites, and circumoral muscles and deals with jaw orthopedics in children/adults that may need surgery-assistant prosedures [1].
The understanding of the complex anatomy, correlations, and adjacent structures of the craniofacial skeleton is essential for treatment planning and management. Radiographic scanning is the complementary part of the entire evaluation of the orthodontic cases. In orthodontic practice, the aim of the imaging involves ensuring additional information for the diagnosis of skeletal/dental problems, soft tissues, and their interrelationships [2].
The radiographic findings obtained from conventional diagnostic tools (e.g., panoramic and lateral cephalometric images) have been integrated with clinical data for orthodontic diagnosis and planning, assessment of growth and development, and evaluation of treatment course and outcomes [2].
Every technique has its own advantages, disadvantages, and limitations [3]. However, the potential risks of radiography, some investigators have been directed to the new methodologies [4]. Ultrasonography (USG) has been utilized in the medical field as a diagnostic and therapeutic device [5]. Ultrasound is a recently introduced field of application in dentistry. Since the first study by Baum et al. [6], in dental practice, many different and new usages of Ultrasound imaging have been stated.
The aim of this chapter is to give an overview of the applications of USG in orthodontic clinics and broadening researchers’ horizons depending on the recent studies in the literature.
15.2 Evaluation of the Muscles of Mastication
Orthodontic treatment planning is, not to stand completely on biomechanical considerations, but it needs consideration of the maxillofacial muscular component of each case. The craniofacial muscles have assumed to be a great significance in treatment stages, including the etiology and active treatment of occlusal problems and deformation of the jaw, and the stability of treatment [7].
Among imaging modalities, it has been demonstrated that USG has a capability for providing information by displaying muscle structural changing8 (Fig. 15.1). Ultrasound imaging is usually performed on the superficial tissues in the maxillofacial area, as the hard tissues absorbed the sound waves and the sound beam can not transmit deep tissues [8,9,10]. Also, the transducer can not always cover the cross-sectional area of the muscle [11, 12]. Despite the disadvantages of the technique, USG offers important advantages, which made it proper for longitudinal researches, especially in children [11,12,13].
Ultrasound has been represented as a reliable imaging method for accurately measuring the thickness and cross-sectional area of the masticatory muscles and for calculating changes in local cross-sectional parameters of the craniofacial muscle groups in vivo [11,12,13,14,15,16,17,18,19,20,21].
The thickness measurement has been utilized commonly in studies that evaluated Ultrasound imaging of masticatory muscles. Also, the crosssections, transversal areas, and the transverse dimensions have been evaluated [13, 22,23,24]. The images have obtained unilaterally and bilaterally, in the course of relaxation and/or contraction [25].
15.2.1 Masseter
The masseter was the most common masticatory muscle investigated [25]. The muscle’s thickness, cross-sectional area, volume, and length have been used for the morphometric analysis of the masseter (Fig. 15.2). It is possible to make comparisons, as it constitutes objective data [26, 27].
Several studies investigated the measurements of the masseter muscle by USG within different conditions, including correlations between the thickness of masseter and facial morphology [15, 19, 20, 28,29,30,31,32,33], dental arch width [34, 35], thickness of alveolar process, mandibular symphysis, mandibular inclination [20], and integrated orthodontic treatment/functional appliances outcome [36,37,38,39].
USG has been utilized for thickness and/or cross-sections to explore the interactions with temporomandibular joint dysfunction (TMD), muscle palpation pain, facial morphology, bite force, and occlusal factors, specifically of the incisors and molars [15].
It has also evaluated the relationships between the masseter muscle volume and selected cephalometric values with USG [40].
In the literature, we determined the significant inhomogeneity in the published studies’ data. The measurement of the masseter muscle with ultrasound imaging is offered in different analyzes as an accurate method, reliable, and reproducible. However, in future researches, to increase the value of the methodology and results of the studies, data may need to be exhibited and analyzed in new hypothesis tests, also taking into account the heterogeneity of the studies.
15.2.2 Temporalis
After the masseter muscle, the most second masticatory muscle studied [25].
A study conducted by Rasheed et al. [41], reported that patients with an open or deep bite in the mixed dentition have a statistically thicker anterior temporalis muscle than patients with normal occlusion. Castelo et al. [42] compared the normal and crossbite sides, the mixed-crossbite group presented a significantly thicker anterior temporalis muscle at rest for the crossbite side than the normal side.
15.2.3 Other Muscles of the Stomatognathic System
The medial and lateral pterygoid muscles have not been assessed with USG, as they are not superficial muscles, and thus they do not diagnose on the ultrasound imaging, clearly [25].
Raadsheer et al. [43] examined the correlations between bite force (magnitude and directions), facial morphology, and masticatory muscle thickness (masseter, temporalis, and digastric muscle). A preliminary study by Macrae et al. [44] reported that USG is an effective imaging method for the measurement of the anterior belly of the digastric muscle and submental muscle group (Fig. 15.3). In addition, the authors have concluded that on MRI imaging, measuring the cross-sectional area of the geniohyoid muscle and mylohyoid muscle thickness was not possible, as poor border representation.
Şatıroğlu et al. [45] investigated the thickness of the masseter, levator labii superioris, and zygomaticus major muscles by USG and evaluated the correlation between facial and masticatory muscle thickness and vertical facial morphology. The authors found that masseter muscle thickness was significantly associated with vertical facial measurements, but the facial muscles were not correlated with the vertical facial morphology.
Several authors explored the relationship between the orbicularis oris muscle and malocclusion states [46], treatment outcomes [47, 48], and skeletal and dental variables [49] (Fig. 15.4).
A study by Coclici et al. [50] used ultrasound device for displaying the posttreatment muscular alterations in class II and class III malocclusion patients and measured the length, width, and cross-sectional area of the masseter and suprahyoid muscles (mylohyoid and geniohyoid muscle). Variable adaptive response to orthognathic surgery has been detected in the mandibular muscles.
Impellizzeri et al. [51] aimed to evaluate the association between the masticatory and cervical muscles (temporalis, masseter, and sternocleidomastoid) thickness and facial asymmetries in young individuals (Fig. 15.5). It has been concluded that a significant relationship between facial asymmetries and masticatory and cervical musculature, and there are thinner muscles in the latero-deviation side than in the contralateral normal side, in cases untreated.
Future studies should standardize the methods and parameters for reducing errors and optimizing accuracy with a large-scale population. The use of ultrasound continues a promising option for the study of muscles of mastication.
In addition, Doppler sonography can be helpful for investigating the arteries in and around the masseter muscle and this method has the capability for evaluating pathological alterations in the muscles and arteries [25]. In a study conducted by Ariji et al. [52], the change of muscle thickness immediately after exercise showed a significant correlation with minimum blood-flow velocity.
15.3 Analysis of Tongue, Hyoid, and Swallowing
The tongue is a largely movable muscular organ within the orofacial region and for years, it has been theorized that the tongue size, postures, and functions must have a relationship to the surrounding oral cavity. It is assumed that the tongue size, postures, and functions have great importance for the etiology of malocclusions and dentofacial deformities [53].
Several methods are available for assessment of the tongue’s size in vivo: direct measurements [54], different impression techniques [55], and the fluid displacement method [56]. Recently, different imaging methods have been used in tongue volume assessment: cephalometrics [57], computed tomography (CT) [58], cone-beam computed tomography (CBCT) [59], and magnetic resonance imaging (MRI) [60]. However, all techniques have their own clinical indications, advantages, and disadvantages.
Two-dimensional (2D) ultrasound is used for tongue function evaluation such as swallowing [61, 62] and speech [63] as well as for estimating tongue thickness, and tongue volume [64]. Three-dimensional (3D) ultrasound is already performed for the tongue posture assessment [65], as a device for the evaluation of tongue function [66].
15.3.1 Tongue Volume
Wojtczak et al. [64] examined tongue volume that was obtained from the multiplication of the midsagittal cross-sectional images of the tongue by its width in transverse scans, using 2D USG. The correlation between the tongue volume and mandibular arch size [55], vertical facial height, chin position has been demonstrated in clinical studies [67]. Hren ve Barbič [68], aimed to evaluate tongue size and it has been found that tongue volumes are significantly greater in skeletal Class III patients than normal. Also, larger tongues correlate with more severe skeletal Class III malocclusion.
Hren ve Barbic [68] and Barbič et al. [53] have utilized 3D USG for evaluating tongue volume. During USG investigation, each patient sits in upright resting positions and their heads fixed with a strap, so that the Frankfurt horizontal line was parallel to the floor. The 3D convex transducer was positioned on the skin of mouth floor in the midsagittal plane, submentally. The tongue volume evaluation was performed using 4D VIEW program software. The 3D Ultrasound technologies provide a multi-planar image of the region of interest or of certain pathology as well as perform more accurate analyses of them [53].
15.3.2 Tongue Posture
Tongue posture has been described as an etiologic factor in malocclusion development, including anterior open bite and articulation disorders as well as that plays an important role in anterior open bite treatment planning and posttreatment stability [69, 70]. It is believed that the tongue resting posture to be even more important for the dentoalveolar development and dental occlusion than the tongue function during swallowing or speaking [71].In the view of total time, swallowing and speaking is too short to affect the balance of the forces acting on dentoalveolar development.
In the orofacial region, the tone and pressure of the resting tongue is one of the most important long-acting forces on the adjacent structures represented [72, 73]. Clinical evaluation of the tongue dynamics and resting postures are important parts of functional diagnostics [65]. A study by Kravanja et al. [74], who evaluated the tongue posture in children showed that the 3D ultrasound was found to be the most objective method to identify tongue posture in growing children and it could be an important device in functional diagnostics before, during, and after orthodontic treatment.
15.3.3 Tongue Movement
Tongue movement is related to some disorders, such as dysphagia. A better understanding of tongue movement in detail is important for the diagnosis and treatment of such diseases [75]. The tongue posture and function can be evaluated by clinical examination, including observation of tongue movements with lips apart and palpation of the temporalis and masseter muscles during swallowing. Because of anatomical limitations, these methods are not enough for objective evaluation [62]. Additional techniques have been developed and used for tongue movement evaluation, such as videofluoroscopy [76,77,78], electromyography [79,80,81], electromagnetic articulography [82], palatography [83], MRI [84], scintigraphy [85], and tongue pressure measurements [86]. Between these methods, the use of videofluoroscopy, which records the dynamic movement of radiopaque barium through the upper digestive tract by conventional X-rays, is considered as the standard criterion for the deglutition and dysphagia evaluation [87,88,89,90]. However, especially the disadvantages of irradiation, repeated evaluations are often avoided.
The advantages of ultrasonography for being noninvasive, detailed, repeatable, and real-time soft tissue scanning makes it superior for deglutitive tongue research [91]. The first time, Shawker et al. [92] used B-mode USG to evaluate tongue movements during swallowing. Peng et al. [93, 94] used M-mode sonography for quantitative and qualitative tongue functions assessment. The tongue was viewed by a hyperechoic line in the M-mode traces and that synchronized with the tongue movements during swallowing [75]. Peng et al. [93], divided the swallowing pattern obtained into five phases (phases I, IIa, IIb, IIIa, and IIIb) based on each turn points determined on the M-mode images (Fig. 15.6). This mode allows recording and successful separation of duration, speed, and range of tongue movements in each phase. Peng et al. [95] used the cushion scanning technique (CST) to manage the problems such as the movement of the transducer during examination and compression of the submental region that resulted in abnormal swallowing patterns. However, there is a conflict with using this technique because that increases the distance between the transducer and the floor of the mouth which could decrease the image resolution.
Cheng et al. [96] found that there are significant correlations between tongue movement during swallowing and dentofacial forms using B + M-Mode sonography combined with the CST, especially in the amplitude of the early final phase. They concluded that as the arch length increased, the duration of swallowing prolonged significantly in the late final phase.
Peng et al. [97] stated that the tongue movements of mature swallowing and tongue-thrust swallowing can be differentiated with USG. Based on this study, Tongue-thrust swallowers had a longer late transport phase than mature swallowers, and the tongue speed was faster in the early final phase compared with mature swallowers.
Ardakani et al. [98] investigated the swallowing patterns of the tongue using B-mode Sonography. They concluded that the majority of abnormal or inconsistent swallowing patterns were detected in patients of mandibular prognathism.
Ovsenik et al. [71] compared the swallowing pattern and tongue function during swallowing in children with unilateral posterior crossbite (ULCB) in deciduous dentition by B + M-mode USG. The ultrasound analysis showed that duration, range, and speed of the tongue movements during swallowing significantly differ between children with and without ULCB.
In another study, Vaishnevi et al. [99], investigated the relationship between tongue movement and facial morphology in three types of malocclusion and found that the skeletal class III cases have prolonged duration of tongue movement and greater motion magnitude in the early final phase (III A) of swallowing. Also, there is a decrease in the motion range and duration of swallowing in the skeletal class II individuals.
15.3.4 Hyoid Bone Displacement
The measurements of tongue, hyoid, and laryngeal movements have been used to evaluate swallowing in USG studies [100,101,102,103,104,105,106,107]. The hyoid bone is the point of attachment for muscular and nonmuscular tissues of the floor of the mouth, tongue, and larynx and its movement functions as a marker of the integrity of the hyoid/larynx/epiglottis unit [100]. Under normal physiologic conditions, timely and adequate laryngeal elevation along with hyoid bone movement is an important part of the swallowing movement [108, 109]. The hyoid bone is easily viewed on USG in the sagittal plane as a hyperechoic area with a posterior acoustic.
Shadow (Fig. 15.7). USG allows for detailed evaluation via frame-by-frame images when real-time swallow(s) is acquired. Particularly, the hyoid bone displacements during a swallow can be measured [110].
Yabunaka et al. [111] stated that the trajectory of the hyoid bone in the sagittal plane can be a feasible option for detecting some anomalies in swallowing. Similarly, Chen et al. [112] demonstrated that submental USG is a reliable and accurate technique for the hyoid bone movement assessment and that could be an aid in dysphagia screening and evaluation.
Effective bolus flow and pharyngeal clearing need enough hyoid bone movement during swallowing. Feng et al. [113] evaluated the association between the geniohyoid muscle size-function and hyoid bone movement during swallowing. The authors measured the cross-sectional area of the geniohyoid muscle, geniohyoid muscle contraction velocity, and the hyoid bone displacement in healthy young adults. A correlation has been found between the size of the geniohyoid muscle and hyoid bone movement.
15.4 Evaluation of the Airway
Airway obstruction and mouth breathing are among the etiological factors of malocclusion. Therefore, airway evaluation has great importance in clinical practice. The assessment is performed using lateral cephalometric radiography, commonly [114]. Cone-beam Computed Tomography scans can be utilized for assessing the morphology and mechanical behavior of the upper airway bony and soft tissue structures [115]. Also, various methods, including MRI, endoscopic procedures (e.g., fiber-optic, nasopharyngoscopy, fluoroscopy), acoustic reflection, and optical coherence tomography are feasible to display these structures [116,117,118,119].
In the literature, there are limited studies with the ultrasound-assisted evaluation of the upper airway. However, it has been demonstrated that USG has great potential for identifying the anatomic structures of the upper airway [120,121,122]. Bajracharya et al. [123] studied several sonographic parameters (soft tissue thickness at level of hyoid bone, epiglottis and vocal cords, visibility of hyoid bone in sublingual ultrasound, hyomental distance in head-extended position, and hyomental distance ratio) and they suggested the potential use of USG in the airway assessment (Fig. 15.8). Future studies may ensure that the information and understanding of the biomechanics of upper airway structures and their physiology in the different clinical scenarios.
15.5 The Temporomandibular Joint Evaluation
Temporomandibular joint disorder (TMD) is a general term for disorders affecting the masticatory muscles, temporomandibular joint (TMJ)-related structures, or all [124]. The prevalence of TMD is ranging from 10% to 70%, among the general population [125]. There may be different causes and different specific conditions in the etiology of TMD [126]. The TMDs may cause problems in some of the orthodontic patients, therefore TMJ assessment before, during, and after orthodontic treatment have great significance [127]. There are several methods and techniques used in the diagnosis of TMD, along with the basic clinical examination [126].
Panoramic radiography, conventional (linear or complex motion) tomography, helical or multi-slice computed tomography (CT), and cone-beam computed tomography (CBCT) are used to view the bony components, and magnetic resonance imaging (MRI) is used to evaluate the soft tissue components (discs) of the TMJ [128]. Bone scintigraphy can help for diagnosis of the osteoarthritis and joint inflammation [129, 130]. However, these methods have advantages and limitations to each.
The diagnosis of TMD can be performed by USG imaging of TMJ and adjacent tissues (Fig. 15.9). A study by Gateno et al. [131], investigated the accuracy of USG to visualize the position of mandibular condylar within the glenoid fossa. They supported that USG can be used as an objective method, during orthognathic surgery for reproducing the condylar position. However, a meta-analysis by Klatkiewicz et al. [126] resulted that there were no standardized procedures for using ultrasound scanning of the temporomandibular joint and further research is needed that should concern both normal and abnormal TMJs.
15.6 Determination of Soft Tissue Thickness at Orthodontic Miniscrew Placement Sites
Loss of anchorage in orthodontic treatments is often an important problem that risks treatment outcomes. Temporary skeletal anchorage instruments have been indicated as a reliable solution for situations where anchorage is critical. The use of orthodontic miniscrews in clinical orthodontics has revolutionized anchorage control, opening a new era [132].
The stability and success of orthodontic miniscrews depend on various factors, including the screw implantation site, the miniscrew angulation, the quality and quantity of cortical bone, the insertion and removal torques, the degree of miniscrew to bone contact, inflammation degree of the peri-orthodontic miniscrew tissues, the soft tissues thickness and mobility, the patient’s craniofacial morphology, and the screw dimensions [133,134,135,136,137,138,139].
Risk of failure of orthodontic miniscrews surrounded by nonkeratinized mucosa is higher than for screws surrounded by keratinized mucosa, for the soft tissue component of stability [140]. In the different candidate, areas for screw placement have different soft tissue thicknesses. Therefore, evaluation of the quantitative differences in gingival thickness for miniscrew implantation is one of the significant factors affecting surgical success [141].
Measurements on the thickness of oral mucosa can be acquired by direct methods, such as using a needle or periodontal probe with an endodontic file stopper and biopsy, or indirect measurement using radiographic images. USG is an alternative method that has the potential for providing an evaluation of the soft tissue thickness [142].
Cha et al. [141] evaluated the gingival thickness of potential sites for miniscrew placement in the buccal-attached gingiva and the palatal masticatory mucosa. Mucosal thickness was measured intraorally with an ultrasonic gingival thickness meter (5 MHz).
A study by Parmar et al. [132] aimed to examine the soft tissue thicknesses at potential miniscrew implantation zones and to prescribe a guideline for miniscrew selection in orthodontic clinics. The measurements were performed with A-mode ultrasound device that uses the pulse-echo principle with the frequency was 10 MHz at 10%. The transducer was placed perpendicular to the most gingival surface.
Cha et al. [141] and Parmar et al. [132] concluded that evaluation of the gingival tissues could help in selecting a proper miniscrew in orthodontic practice.
Schulze et al. [142] reported that using B-mode and A-mode ultrasonography is acceptable in various clinical practices for measuring the mucosal thickness accurately. However, B-mode USG is a capable device for soft tissue diagnostics, that needs a small transducer for measurements in the oral cavity.
Although the quantity and quality of cortical bone greatly influenced the stability of mini-screws, also the width of the attached gingiva on the buccal and palatal surfaces in the interdental areas must be considered before surgery [143]. Maximum retention can be obtained when an adequate length of the screw is placed in areas of thin gingival tissue and thick cortical bone [144].
The validity and reliability of USG were shown for measuring soft tissue thickness in different anatomical locations of the oral cavity [145,146,147,148,149], and that offers great potential in presurgical assessment for placement of orthodontic miniscrew placement.
15.7 Determining Pubertal Growth and Bone Age
In the human beings, skeletal maturation has a great value for the detection of growth and differentiation processes [150, 151]. Bone age is an important indicator of the skeletal and biological maturity of an individual. The knowledge of the skeletal maturation and the stage of growth can provide useful information for many clinical practices as well as in orthodontic procedures such as treatment planning, the timing of treatment, and selection of the treatment method [152].
Radiological indicators have been used for bone age estimation [153]. For this, several techniques are generally utilized based on hand-wrist radiographs. In clinical practice, the Greulich-Pyle (an atlas method which compares the radiograph of the individual with the nearest standard radiograph in the atlas) and Tanner-Whitehouse (a scoring method which focuses on skeletal maturity for each patient hand and wrist bone) methods are preferred commonly [154,155,156].
In recent years, because of the possible side effects and damages of ionizing radiation, there is an increasing focus on the establishment of nonionizing imaging methods for age estimation [157]. Some researchers have used USG, which has many advantages and as an ionized radiation-free imaging technique, to estimate bone age [157,158,159,160].
The bone age estimation by ultrasonography is not a new method. In children, the hip [158], iliac and radius bones [159], and ossification center of the wrist [160] have been used as sonographic landmarks for determination of the skeletal age previously.
Carpenter and Lester [161] stated that there was a significant difference between chronologic age and bone age in the different regions of hand and genders. Also, in children under age 10 years, the entire hand should be taken to consider for evaluation of bone age, maybe with less interest on the carpal bones, they may cause over- and under-estimated results greatly. They concluded that bone age estimation based on the metacarpals and phalanxes more accurate than wrist and carpal bone age readings.
Nessi et al. [160], Bilgili et al. [157], and Hajalioghli et al. [4] have followed the same protocol for ultrasonographic bone age evaluation. These researchers aimed assessment of the ossification centers, which were viewed as hyperechoic foci with acoustic shadowing, in sonographic images of the radius and ulna distal epiphysis, carpal bones, epiphyses of the first and third metacarpals, and epiphysis of the middle phalanx (Fig. 15.10). Schmidt et al. [151] have targeted examining ossification of the distal radial epiphysis and the ossification stages were categorized. Nessi et al. [160] mentioned that USG is a valuable technique for scanning skeletal maturation of the ossification centers of the hand and wrist (sesamoid bone and DP3). Bilgili et al. [157] who aimed to described hand and wrist ultrasonography charts that present all carpal bones, phalangeal, and metacarpal epiphyses by placing the probe in transverse and longitudinal planes for each finger. They reported significant correlations between radiographic and ultrasonographic results in both genders (71.1% of male cases and 84.4% of female cases) and stated that maturity of carpal bones varies greatly. Daneff et al. [162] concluded that conventional USG has the potential for identifying the ossification centers of the hand and wrist and can be preferred as a harmless follow-up method in cases with growth problems. Khan et al. [163], who used an automatic USG device, reported that a low correlation between USG and radiography in their work. In contrast, Hajalioghli et al. [4] reported that conventional radiography can be replaced by USG for bone age estimation. According to a study by Ağırman et al. [152], USG is an alternative method to conventional radiography in the bone age estimation and viewing sesamoid bone and MP3 capping, which is the indicator of pubertal growth.
Although, the reliability of the results of USG examinations largely depends on the experience of each practitioner. It is necessary to study with larger groups to make a standard evaluation of bone age in sonography.
15.8 Evaluation of the Midpalatal Suture
Maxillary transverse constriction is concerning various issues that include posterior crossbite (dental and/or skeletal), occlusal disharmony, dental crowding, pharyngeal airway narrowing, tongue posture alterations, mouth breathing, abnormal muscular function, and esthetic problems [164,165,166]. The choice of treatment depends on many clinical conditions [167]. Rapid palatal expansion (RPE) is a routine orthodontic treatment that aims to increase the transversal width with the midpalatal suture and the circummaxillary sutural system separation. RPE corrects that by stretching of collagenous fibers and the local formation of a new bone [168]. However, in patients with a midpalatal suture opening, RPE has been recommended, but the surgically assisted rapid maxillary expansion (SARME) has been needed in patients with a full midpalatal suture ossification [167, 169].
The midpalatal suture is one of the critical areas for maxillary expansion as the zygomatic buttress and the pterygomaxillary junction [170]. Oral radiographs and CT are imaging methods used for the evaluation of palatal suture maturation, commonly. However, radiography/CT involves ionizing radiation. In the orthopedic literature, it is reported that USG is accurate and reliable method to assess distraction osteogenesis wounds in long bones [171, 172].
Examination of the midpalatal suture has been performed from outside the mouth on the skin overlying (probe has been placed in the region between the nasal columella–labial junction and the upper lip), and the ultrasound beam was oriented perpendicular to the bone surface [173]. To the best of our knowledge, there are two published studies of sutural expansion with USG in RPE and SARPE patients [170, 173].
Sumer et al. [170] evaluated sutural mineralization at five-time points during the SARME and retention protocol for three patients, scoring each patient’s callus formation via semiquantitative bone fill scores (0–3).
Gumussoy et al. [173] utilized the USG examination in 29 RPE patients, and they measured the amount of sutural expansion as mesiodistal length at every stage (immediately after appliance practice, 10 turns, and 20 turns). They reported that the surfaces of the bone segments were easily viewed, and examination in the expansion area could be performed accurately during the active phase of the expansion. The expansion zone was identified by a nonhomogeneous and hyperechoic, sharply demarcated area (Fig. 15.11). Also, they mentioned that the system is not enough for viewing of the whole anatomy, as the field of view depends on the linear probe and scanning angle. Therefore, it was stated that the scoring system used by Sumer et al. [170] is not suitable.
Overall, these studies did not present solid evidence of their validity for the accurate determination of the maturation of the palatal suture. However, when we think about the disadvantages and limitations of other imaging modalities, further evaluations can show the accuracy of ultrasonography examinations for this purpose.
15.9 Ultrasonographic Evaluation of Periodontal Changes During Orthodontic Tooth Movement
The periodontal tissue reaction to tooth movement by orthodontic forces consists of remodeling changes in the periodontal ligament, alveolar bone, and gingiva [174]. Real-time, in vivo visualization of the alterations induced by orthodontic tooth movement in the morphology of the anatomical structures of the periodontium, would be helpful for managing the treatment plan and assessment of the tissue response to orthodontic forces [175]. Previous studies concluded that USG is suitable for evaluating the cortical bone, periodontal space, sulcular depth, the characteristics of the gingiva, and length of the anatomical crown [176, 177].
A study by Zimbran et al. [175] aimed to examine whether changes that appear, induced by the orthodontic canine retraction, in periodontal tissues can be diagnosed by USG. Sonographic scans were performed from outside the mouth on the skin overlying, in three different areas of the canines buccal surface (mesial, middle, and distal) and three times (before, during, and after retraction). The transducer (40 MHz frequency pulses) was placed in a longitudinal plane. Four different distances were measured, including depth of the sulcus, thickness of the gingiva, length of the supracrestal fibers, width of periodontal space. The authors found significant results for sulcus depth measurement and distance between marginal gingiva and alveolar crest, immediately after force application on the middle and mesial area of the canine. They concluded that high-resolution USG has the potential to reveal changes in periodontium during orthodontic tooth movement (Fig. 15.12) (Fig. 15.13).
15.10 Effect of Low-Intensity Pulsed Ultrasound (LIPUS) on Tooth Movement and Root Resorption
Orthodontically induced root resorption (OIRR) is an undesirable outcome of orthodontic treatment [178]. The prevalence of OIRR is higher than 90% [179], and from minor to severe, the incidence of OIRR ranges from 94% to 6.6%, respectively [180]. Lund et al. [180] reported that 6.6% of the orthodontic patients had at least one tooth with OIRR more than 4 mm. Mirabella and Artun [181] indicated that about 4% of orthodontic patients with generalized resorption of the six anterior teeth of greater than 3 mm. During treatment, several studies have mentioned that probably about 5% of adults and only 2% of adolescents show at least one tooth with severe resorption of greater than 5 mm.
Several etiologic reasons have been reported that can influence OIRR, including biological (susceptibility, genetics, and systemic factors), mechanical, and combined factors [182]. However, the relationship between severe OIRR and the possible etiologic factors is unclear [1]. Sasaki [183] reported that osteoprotegerin (OPG)/RANK/Receptor activator of nuclear factor kappa-B ligand (RANKL) pathway that controls the osteoclastogenesis and odontoclastogenesis exist in physiologic root resorption in deciduous teeth [1]. Some studies indicated that OPG and RANKL levels increase during the application of heavy forces and severe root resorption [182, 184,185,186]. Also, it has been detected that increased RANKL production and low OPG expression, which stimulated the formation of osteoclast, in PDL cells from severe OIRR patients [186].
Several methods have been used in OIRR treatment, including the bisphosphonate application to rats’ teeth [187]; allowing for self-healing for 70 days [179] or after retention [188]; topical corticosteroid [189]; calcium hydroxide root canal treatment [190]; and recently low-intensity pulsed ultrasound (LIPUS-acoustic pressure waves) in humans [191, 192], and in experimental animals [193,194,195,196]. Previous reports concluded that LIPUS modulates the OPG/RANK/RANKL balance, so it minimizes and shows a suppressive effect on osteoclastogenesis. In studies in experimental animals and in humans, it has been detected that LIPUS increased cementum formation and predentine/dentine [191, 195,196,197,198,199].
Accelerated tooth movement has received increasing attention by clinicians for minimizing possible OIRR, shortening treatment duration, saving patient compliance, and reducing side effects of prolonged orthodontic treatment such as enamel decalcification, periodontitis, and psychological impact [1]. Several techniques have been previously reported to reduce treatment periods, including pulsed electromagnetic fields [200], electrical currents [201], corticotomy [202], distraction osteogenesis [203], mechanical vibration [204], photobiomodulation [205], low-level laser therapy [206], and LIPUS.
The 30 mW/cm2 output signal of LIPUS device (1.5 MHz, pulse 200 μs, delivered at 20% duty cycle, 30 mW/cm2, 20 min daily) has been approved for clinical use [207]. LIPUS device has been used in bone regeneration and fracture healing approved by the U.S. FDA (Food and Drug Administration) for bone regeneration and fracture healing [208].
In addition, a pilot study, within the limitations, reported that LIPUS combined with functional appliances can be used for treating enhancing mandibular growth in children with hemifacial microsomia [197].
However, LIPUS use in these treatments is still controversial because of inconsistency among all trials [209], adverse effects [210], underlying mechanisms remain unclear partly. Therefore, a proper understanding of the complete mechanism of LIPUS stimulation needs further research.
References
El-Bialy T. Application of LIPUS in orthodontics. In: Therapeutic ultrasound in dentistry. Cham: Springer; 2018. p. 63–9.
Harrell WE, Scarfe WC, Pinheiro LR, Farman AG. Applications of CBCT in orthodontics. In maxillofacial cone beam computed tomography. Cham: Springer; 2018. p. 645–714.
Dhiman S, Maheshwari S, Verma SK. Assessment of maturity in orthodontics: a review. J Adv Clin Res Insights. 2015;2(2):100–3.
Hajalioghli P, Tarzamni MK, Arami S, Fouladi DF, Ghojazadeh M. The utility of ultrasonographic bone age determination in detecting growth disturbances; a comparative study with the conventional radiographic technique. Skelet Radiol. 2015;44(9):1351–6.
Sharma S, Rasila D, Singh M, Mohan M. Ultrasound as a diagnostic boon in dentistry a review. Int J Sci Stud. 2014;2:70–6.
Baum G, Greenwood I, Slawski S, Smirnow R. Observation of internal structures of teeth by ultrasonography. Science. 1963;139:495–6.
Pepicelli A, Woods M, Briggs C. The mandibular muscles and their importance in orthodontics: a contemporary review. Am J Orthod Dentofac Orthop. 2005;128(6):774–80.
Ariji E, Ariji Y, Yoshiura K, Kimura S, Horinouchi Y, Kanda S. Ultrasonographic evaluation of inflammatory changes in the masseter muscle. Oral Surg Oral Med Oral Pathol. 1994;78:797–801.
Martin AO. Can ultrasound cause genetic damage? J Clin Ultrasound. 1984;12:11–20.
Stewart HF, Moore RM. Development of the health risk evaluation data for diagnostic ultrasound. J Clin Ultrasound. 1984;12:493–500.
Raadsheer MC, Van Eijden TM, Van Spronsen PH, Van Ginkel FC, Kiliaridis S, Prahl-Andersen B. A comparison of human masseter muscle thickness measured by ultrasonography and magnetic resonance imaging. Arch Oral Biol. 1994;39:1079–84.
Raadsheer MC, Kiliaridis S, Van Eijden TM, Van Ginkel FC, Prahl-Andersen B. Masseter muscle thickness in growing individuals and its relation to facial morphology. Arch Oral Biol. 1996;41:323–32.
Close PJ, Stokes MJ, L’Estrange PR, Rowell J. Ultrasonography of masseter muscle size in normal young adults. J Oral Rehabil. 1995;22:129–34.
Wilson IR, Crocker EF. An introduction to ultrasonography in oral surgery. Oral Surg Oral Med Oral Pathol. 1985;59:236–41.
Bakke M, Tuxen A, Vilmann P, Jensen BR, Vilmann A, Toft M. Ultrasound image of human masseter muscle related to bite force, electromyography, facial morphology and occlusal factors. Scand J Dent Res. 1992;100:164–71.
Bertram S, Rudisch A, Bodner G, Emshoff R. The short-term effect of stabilization-type splints on the local asymmetry of masseter muscle sites. J Oral Rehabil. 2001;28:1139–43.
Bertram S, Brandlmaier I, Rudisch A, Bodner G, Emshoff R. Crosssectional characteristics of the masseter muscle: an ultrasonographic study. Int J Oral Maxillofac Surg. 2003;32:64–8.
Emshoff R, Bertram S. The short-term effect of stabilization-type splints on local cross-sectional dimensions of muscles of the head and neck. J Prosthet Dent. 1998;80:457–61.
Kiliaridis S, Kälebo P. Masseter muscle thickness measured by ultrasonography and its relation to facial morphology. J Dent Res. 1991;70:1262–5.
Kubota M, Nakano H, Sanjo I, Satoh K, Sanjo T, Kamegai T, Ishikawa F. Maxillofacial morphology and masseter muscle thickness in adults. Eur J Orthod. 1998;20:535–42.
Sano K, Ninomiya H, Sekine J, Pe MB, Inokuchi TJ. Application of magnetic resonance imaging and ultrasonography to preoperative evaluation of masseteric hypertrophy. J Craniomaxillofac Surg. 1991;19:223–6.
Emshoff R, Bertram S. The ultrasonic value of local muscle hypertrophy in patients with temporomandibular joint disorders. J Prosthet Dent. 1995;73:373–6.
Emshoff R, Bertram S, Strobl H. Ultrasonographic cross-sectional characteristics of muscles of the head and neck. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999;87:93–106.
Emshoff R, Bertram S, Brandlmaier I, Scheiderbauer G, Rudisch A, Bodner G. Ultrasonographic assessment of local cross-sectional dimensions of masseter muscle sites: a reproducible technique? J Oral Rehabil. 2002;29:1059–62.
Serra MD, Gavião MBD, dos Santos Uchôa MN. The use of ultrasound in the investigation of the muscles of mastication. Ultrasound Med Biol. 2008;34(12):1875–84.
Smith MW, Faulkner A. Perceptual adaptation by normally hearing listeners to a simulated “hole” in hearing. J Acoust Soc Am. 2006;120(6):4019–30.
Oliveira JHPD, Dourado Filho MGD, Melo TMA, Lima NSD, Marcelino Filho M, Silva HJD. Evidence of measures of normalcy for thickness of masseter muscle evaluated with ultrasound: a review study. Revista CEFAC. 2015;17(1):238–52.
Uchida Y, Motoyoshi M, Shigeeda T, Shinohara A, Igarashi Y, Sakaguchi M, et al. Relationship between masseter muscle size and maxillary morphology. Eur J Orthod. 2011;33:654–9.
Benington PC, Gardener JE, Hunt NP. Masseter muscle volume measured using ultrasonography and its relationship with facial morphology. Eur J Orthod. 1999;21:659–70.
Satiroğlu F, Arun T, Işik F. Comparative data on facial morphology and muscle thickness using ultrasonography. Eur J Orthod. 2005;27:562–7.
Ngom PI, Ly BA, Diagne F, Diouf JS, Chakib O, Hennequin M. Masseter muscle thickness in relation to craniofacial morphology. Int Orthod. 2008;6:251–67.
Rani S, Ravi MS. Masseter muscle thickness in different skeletal morphology: an ultrasonographic study. Indian J Dent Res. 2010;21:402–7.
Rohila AK, Sharma VP, Shrivastav PK, Nagar A, Singh GP. An ultrasonographic evaluation of masseter muscle thickness in different dentofacial patterns. Indian J Dent Res. 2012;23:726–31.
Kiliaridis S, Georgiakaki I, Katsaros C. Masseter muscle thickness and maxillary dental arch width. Eur J Orthod. 2003;25(3):259–63.
Tircoveluri S, Singh JR, Rayapudi N, Karra A, Begum M, Challa P. Correlation of masseter muscle thickness and intermolar width-an ultrasonography study. J Int Oral Health. 2013;5(2):28.
Trawitzki LV, Dantas RO, Mello-Filho FV, Elias-Júnior J. Effect of treatment of dentofacial deformity on masseter muscle thickness. Arch Oral Biol. 2006;51(12):1086–92.
Kiliaridis S, Mahboubi PH, Raadsheer MC, Katsaros C. Ultrasonographic thickness of the masseter muscle in growing individuals with unilateral crossbite. Angle Orthod. 2007;77(4):607–11.
Kiliaridis S, Mills CM, Antonarakis GS. Masseter muscle thickness as a predictive variable in treatment outcome of the twin-block appliance and masseteric thickness changes during treatment. Orthod Craniofac Res. 2010;13(4):203–13.
Trawitzki LV, Dantas RO, Elias-Júnior J, Mello-Filho FV. Masseter muscle thickness three years after surgical correction of class III dentofacial deformity. Arch Oral Biol. 2011;56(8):799–803.
Naser-Ud-Din S, Thoirs K, Sampson WJ. Ultrasonography, lateral cephalometry and 3D imaging of the human masseter muscle. Orthod Craniofac Res. 2011;14:33–43.
Rasheed SA, Prabhu NT, Munshi AK. Electromyographic and ultrasonographic observations of masseter and anterior temporalis muscles in children. J Clin Pediatr Dent. 1996;20:127–32.
Castelo PM, Gavião MBD, Pereira LJ, Bonjardim LR. Masticatory muscle thickness, bite force, and occlusal contacts in young children with unilateral posterior crossbite. Eur J Orthod. 2007;29(2):149–56.
Raadsheer MC, Van Eijden TMGJ, Van Ginkel FC, Prahl-Andersen B. Contribution of jaw muscle size and craniofacial morphology to human bite force magnitude. J Dent Res. 1999;78(1):31–42.
Macrae PR, Jones RD, Myall DJ, Melzer TR, Huckabee ML. Cross-sectional area of the anterior belly of the digastric muscle: comparison of MRI and ultrasound measures. Dysphagia. 2013;28(3):375–80.
Şatıroğlu F, Arun T, Işık F. Comparative data on facial morphology and muscle thickness using ultrasonography. Eur J Orthod. 2005;27(6):562–7.
Prabhu NT, Munshi AK. Ultrasonographic observation of the circumoral musculature: an in vivo study. J Clin Pediatr Dent. 1995;19:195–203.
Anupam Kumar T, Kuriakose S. Ultrasonographic evaluation of effectiveness of circumoral muscle exercises in adenotonsillectomized children. J Clin Pediatr Dent. 2005;29(1):49–55.
Das UM, Beena JP. Effectiveness of circumoral muscle exercises in the developing dentofacial morphology in adenotonsillectomized children: an ultrasonographic evaluation. J Indian Soc Pedod Prev Dent. 2009;27(2):94.
Barbosa TDS, Gavião MBD, Pupo LS, Castelo PM, Pereira LJ. Associations between orbicularis oris thickness and skeletal and dental variables in mixed dentition. Rev Odontol UNESP. 2012;41(6):402–7.
Coclici A, Hedeşiu M, Bran S, Băciuţ M, Dinu C, Rotaru H, Roman R. Early and long-term changes in the muscles of the mandible following orthognathic surgery. Clin Oral Investig. 2019;23:3437–44.
Impellizzer A, Serritella E, Putrino A, Vizzielli G, Polimeni A, Galluccio G. Assessment of masticatory and cervical muscles’ thickness by ultrasonography in patients with facial asymmetry. Clin Ter. 2019;170(4):e272–7.
Ariji Y, Sakuma S, Kimura Y, Kawamata A, Toyama M, Kurita K, Ito Y, Ariji E. Colour Doppler sonographic analysis of blood-flow velocity in the human facial artery and changes in masseter muscle thickness during low-level static contraction. Arch Oral Biol. 2001;46:1059–64.
Barbič U, Verdenik I, Mušič MM, Hren NI. Three-dimensional ultrasound evaluation of tongue volume. Slov Med J. 2016;85(4) https://doi.org/10.6016/ZdravVestn.1477.
Oliver RG, Evans SP. Tongue size, oral cavity size and speech. Angle Orthod. 1986;56(3):234–43.
Tamari K, Shimizu K, Ichinose M, Nakata S, Takahama Y. Relationship between tongue volume and lower dental arch sizes. Am J Orthod Dentofac Orthop. 1991;100(5):453–8.
Bandy HE, Hunter WS. Tongue volume and the mandibular dentition. Am J Orthod. 1969;56(2):134–42.
Cuccia AM, Campisi G, Cannavale R, Colella G. Obesity and craniofacial variables in subjects with obstructive sleep apnea syndrome: comparisons of cephalometric values. Head Face Med. 2007;3:41. https://doi.org/10.1186/1746-160X-3-41.
Roehm EG. Computed tomographic measurement of tongue volume relative to its surrounding space. Am J Orthod. 1982;81(2):172. https://doi.org/10.1016/0002-9416(82)90044-6.
Uysal T, Yagci A, Ucar FI, Veli I, Ozer T. Cone-beam computed tomography evaluation of relationship between tongue volume and lower incisor irregularity. Eur J Orthod. 2013;35(5):555–62. https://doi.org/10.1093/ejo/cjr054.
Iida-Kondo C, Yoshino N, Kurabayashi T, Mataki S, Hasegawa M, Kurosaki N. Comparison of tongue volume/oral cavity volume ratio between obstructive sleep apnea syndrome patients and normal adults using magnetic resonance imaging. J Med Dent Sci. 2006;53(2):119–26.
Casas MJ, Seo AH, Kenny DJ. Sonographic examination of the oral phase of swallowing: bolus image enhancement. J Clin Ultrasound. 2002;30:83–7.
Ovsenik M, Volk J, Marolt MM. A 2D ultrasound evaluation of swallowing in children with unilateral posterior crossbite. Eur J Orthod. 2014;36:665–71.
Shawker TH, Sonies BC. Tongue movement during speech: a real-time ultrasound evaluation. J Clin Ultrasound. 1984;12:125–33.
Wojtczak JA. Submandibular sonography: assessment of hyomental distances and ratio, tongue size, and floor of the mouth musculature using portable sonography. J Ultrasound Med. 2012;31(4):523–8.
Volk J, Kadivec M, Music MM, Ovsenik M. Three-dimensional ultrasound diagnostics of tongue posture in children with unilateral posterior crossbite. Am J Orthod Dentofac Orthop. 2010;138(5):608–12.
Bressmann T, Thind P, Uy C, Bollig C, Gilbert RW, Irish JC. Quantitative three-dimensional ultrasound analysis of tongue protrusion, grooving and symmetry: data from 12 normal speakers and a partial glossectomee. Clin Linguist Phon. 2005;19(6–7):573–88.
Yoo E, Murakami S, Takada K, Fuchihata H, Sakuda M. Tongue volume in human female adults with mandibular prognathism. J Dent Res. 1996;75(12):1957–62.
Hren NI, Barbič U. Tongue volume in adults with skeletal class III dentofacial deformities. Head Face Med. 2016;12(1):12.
Johnson NCL, Sandy JR. Tooth position and speech - is there a relationship? Angle Orthod. 1999;69:306–10.
Farronato G, Giannini L, Riva R, Galbiati G, Maspero C. Correlations between malocclusions and dyslalias. Eur J Paediatr Dent. 2012;13:13–8.
Ovsenik M. Incorrect orofacial functions until 5 years of age and their association with posterior crossbite. Am J Orthod Dentofac. 2009;136:375–81.
Proffit WR. Equilibrium theory revisited: factors influencing position of the teeth. Angle Orthod. 1978;48:175–86.
Stahl F, Grabowski R, Gaebel M, Kundt G. Relationship between occlusal findings and orofacial myofunctional status in primary and mixed dentition- part II: prevalence of orofacial dysfunctions. J Orofac Orthop. 2007;68:74–90.
Kravanja SL, Hocevar-Boltezar I, Music MM, Jarc A, Verdenik I, Ovsenik M. Three-dimensional ultrasound evaluation of tongue posture and its impact on articulation disorders in preschool children with anterior open bite. Radiol Oncol. 2018;52(3):250–6.
Li C, Li J, Zhang C, Cao X, Li N, Song D, Yu T. Application of B+ M-mode ultrasonography in assessing deglutitive tongue movements in healthy adults. Med Sci Monit. 2015;21:1648.
Avdiunina IA, Popova LM, Dokuchaeva NV, et al. Videofluoroscopy study of swallowing in neurogenic dysphagia. Anesteziol Reanimatol. 2000;4:64–8. [in Russian]
Rivelsrud MC, Osten PE, Conradi S, et al. Videofluoroscopy in the examination of swallowing disorders. A useful method for evaluation of rehabilitation. Tidsskr Nor Laegeforen. 1995;115(10):1241–3. [in Norwegian]
Olszewska E, Rutkowska J, Czajkowska A, et al. Selected surgical managements in snoring and obstructive sleep apnea patients. Med Sci Monit. 2012;18(1):CR13–8.
Vaiman M, Eviatar E, Segal S. Surface electromyographic studies of swallowing in normal subjects: a review of 440 adults. Report 2. Quantitative data: amplitude measures. Otolaryngol Head Neck Surg. 2004;131(5):773–80.
McNamara JAJ, Moyers RE. Electromyography of the oral phase of deglutition in the rhesus monkey (Macaca mulatta). Arch Oral Biol. 1973;18(8):995–1002.
Vaiman M, Krakovski D, Haitov Z. Oxycodone and dexamethasone for pain management after tonsillectomy: a placebo-controlled EMG assessed clinical trial. Med Sci Monit. 2011;17(10):PI25–31.
Steele CM, Van Lieshout PH. Use of electromagnetic midsagittal articulography in the study of swallowing. J Speech Lang Hear Res. 2004;47(2):342–52.
Chi-Fishman G, Stone M. A new application for electropalatography: swallowing. Dysphagia. 1996;11(4):239–47.
Hartl DM, Albiter M, Kolb F, et al. Morphologic parameters of normal swallowing events using single-shot fast spin echo dynamic MRI. Dysphagia. 2003;18(4):55–62.
Valenza V, Galli J, Romano L, et al. Oropharyngoesophageal scintigraphy in the evaluation of swallowing disorders after surgery for oral cancer. Clin Nucl Med. 2001;26(12):1054–7.
Ono T, Hori K, Nokubi T. Pattern of tongue pressure on hard palate during swallowing. Dysphagia. 2004;19(4):259–64.
Logemann JA. Swallowing physiology and pathophysiology. Otolaryngol Clin N Am. 1988;21(4):613–23.
Logemann JA. Approaches to management of disordered swallowing. Baillieres Clin Gastroenterol. 1991;5(2):269–80.
Logemann JA. Dysphagia: evaluation and treatment. Folia Phoniatr Logop. 1995;47(3):140–64.
Kujawski K, Stasiak M, Rysz J. The evaluation of esophageal stenting complications in palliative treatment of dysphagia related to esophageal cancer. Med Sci Monit. 2012;18(5):CR323–9.
Tamburrini S, Solazzo A, Sagnelli A, et al. Amyotrophic lateral sclerosis: sonographic evaluation of dysphagia. Radiol Med. 2010;115(5):784–93.
Shawker TH, Sonies B, Stone M, Baum BJ. Real-time ultrasound visualization of tongue movement during swallowing. J Clin Ultrasound. 1983;11:485–90.
Peng CL, Jost-Brinkmann PG, Lin CT. Classification and interpretation of the oral swallowing phase with BM mode ultrasound. Radiologe. 1995;35:747–52.
Peng CL, Jost-Brinkmann PG, Miethke RR, Lin CT. Ultrasonographic measurement of tongue movement during swallowing. J Ultrasound Med. 2000;19:15–20.
Peng CL, Jost-Brinkmann PG, Miethke RR. The cushion scanning technique: a method of dynamic tongue sonography and its comparison with the transducer-skin coupling scanning technique during swallowing. Acad Radiol. 1996;3(3):239–44.
Cheng CF, Peng CL, Chiou HY, Tsai CY. Dentofacial morphology and tongue function during swallowing. Am J Orthod Dentofac Orthop. 2002;122(5):491–9.
Peng CL, Jost-Brinkmann PG, Yoshida N, Chou HH, Lin CT. Comparison of tongue functions between mature and tongue-thrust swallowing—an ultrasound investigation. Am J Orthod Dentofac Orthop. 2004;125(5):562–70.
Ardakani FE. Evaluation of swallowing patterns of the tongue using real-time B-mode sonography. J Contemp Dent Pract. 2006;7(3):67–74.
Vaishnevi NT, Rajasekharan A, Aravind D, Kumar A. The assessment of relationship between facial morphology and tongue function during swallowing-an ultrasound study. J Dent Med Sci. 2014;13(9):49–58.
Chi-Fishman G, Sonies BC. Effects of systematic bolus viscosity and volume changes on hyoid bone kinematics. Dysphagia. 2002;17:278.
Chi-Fishman G, Sonies BC. Kinematic strategies for hyoid movement in rapid sequential swallowing. J Speech Lang Hear Res. 2002;45:457.
Frattali CM, Sonies BC, Chi-Fishman G, et al. Effects of physostigmine on swallowing and oral motor functions in patients with progressive supranuclear palsy: a pilot study. Dysphagia. 1999;14:165.
Kuhl V, Eicke BM, Dieterich M, et al. Sonographic analysis of laryngeal elevation during swallowing. J Neurol. 2003;250:333.
Shawker TH, Sonies B, Stone M, et al. Real time ultrasound visualization of tongue movement during swallowing. J Clin Ultrasound. 1983;11:485.
Shawker TH, Sonies B, Hall TE, et al. Ultrasound analysis of tongue, hyoid, and larynx activity during swallowing. Investig Radiol. 1984;19:82.
Soder N, Miller N. Using ultrasound to investigate intrapersonal variability in durational aspects of tongue movement during swallowing. Dysphagia. 2002;17:288.
Sonies BC, Parent LJ, Morrish K, et al. Durational aspects of the oral-pharyngeal phase of swallow in normal adults. Dysphagia. 1988;3:1.
Logemann JA. Evaluation and treatment of swallowing disorders. Nerang, QLD: Pro-Ed Australia; 1983.
Ekberg O. The normal movements of the hyoid bone during swallow. Investig Radiol. 1986;21:408e10.
Scarborough DR, Waizenhofer S, Siekemeyer L, Hughes M. Sonographically measured hyoid bone displacement during swallow in preschool children: a preliminary study. J Clin Ultrasound. 2010;38(8):430–4.
Yabunaka K, Sanada H, Sanada S, Konishi H, Hashimoto T, Yatake H, et al. Sonographic assessment of hyoid bone movement during swallowing: a study of normal adults with advancing age. Radiol Phys Technol. 2011;4(1):73–7.
Chen YC, Hsiao MY, Wang YC, Fu CP, Wang TG. Reliability of ultrasonography in evaluating hyoid bone movement. J Med Ultrasound. 2017;25(2):90–5.
Feng X, Cartwright MS, Walker FO, Bargoil JH, Hu Y, Butler SG. Ultrasonographic evaluation of geniohyoid muscle and hyoid bone during swallowing in young adults. Laryngoscope. 2015;125(8):1886–91.
Miles PG, Vig PS, Weyant RJ, Forrest TD, Rockette HE Jr. Craniofacial structure and obstructive sleep apnea syndrome: a qualitative analysis and meta-analysis of the literature. Am J Orthod Dentofac Orthop. 1996;109:163–72.
Mah JK, Yi L, Huang RC, Choo H. Advanced applications of cone beam computed tomography in orthodontics. Semin Orthod. 2011;17:57–71.
Schwab RJ. Upper airway imaging. Clin Chest Med. 1998;19:33–54.
Schwab RJ, Goldberg AN. Upper airway assessment: radiographic and other imaging techniques. Otolaryngol Clin N Am. 1998;31:931–68.
Stuck BA, Maurer JT. Airway evaluation in obstructive sleep apnea. Sleep Med Rev. 2008;12:411–36.
Kuo GP, Torok CM, Aygun N, Zinreich SJ. Diagnostic imaging of the upper airway. Proc Am Thorac Soc. 2011;8:40–5.
Singh M, Chin KJ, Chan VW, Wong DT, Prasad GA, Yu E. Use of sonography for airway assessment: an observational study. J Ultrasound Med. 2010;29(1):79–85.
Kristensen MS. Ultrasonography in the management of the airway. Acta Anaesthesiol Scand. 2011;55(10):1155–73.
Osman A, Sum KM. Role of upper airway ultrasound in airway management. J Intensive Care. 2016;4(1):52.
Cata JP. Ultrasound-assisted evaluation of the airway in clinical anesthesia practice: past, present and future. Int J. 2015;1(1):2.
Salemi F, Shokri A, Maleki FH, Farhadian M, Dashti G, Ostovarrad F, Ranjzad H. Effect of field of view on detection of condyle bone defects using cone beam computed tomography. J Craniofac Surg. 2016;27(3):644–8.
Kundu H, Basavaraj P, Kote S, Singla A, Singh S. Assessment of TMJ disorders using ultrasonography as a diagnostic tool: a review. J Clin Diagn Res. 2013;7:3116–20.
Klatkiewicz T, Gawriołek K, Radzikowska MP, Czajka-Jakubowska A. Ultrasonography in the diagnosis of temporomandibular disorders: a meta-analysis. Med Sci Monit. 2018;24:812–7.
Svensson B, Adell R, Kopp S. Temporomandibular disorders in juvenile chronic arthritis patients. A clinical study. Swed Dent J. 2000;24:83–92.
Barghan S, Tetradis S, Mallya SM. Application of cone beam computed tomography for assessment of the temporomandibular joints. Aust Dent J. 2012;57(s1):109–18.
Bag AK, Gaddikeri S, Singhal A, et al. Imaging of the temporomandibular joint: an update. World J Radiol. 2014;28:567–82.
Petscavage-Thomas JM, Walker EA. Unlocking the jaw: advanced imaging of the temporomandibular joint. Am J Roentgenol. 2014;203:1047–58.
Gateno J, Miloro M, Hendler BH, Horrow M. The use of ultrasound to determine the position of the mandibular condyle. J Oral Maxillofac Surg. 1993;51(10):1081–6.
Parmar R, Reddy V, Reddy SK, Reddy D. Determination of soft tissue thickness at orthodontic miniscrew placement sites using ultrasonography for customizing screw selection. Am J Orthod Dentofac Orthop. 2016;150(4):651–8.
Deguchi T, Takano-Yamamoto T, Kanomi R, Hartsfield JK Jr, Roberts WE, Garetto LP. The use of small titanium screws for orthodontic anchorage. J Dent Res. 2003;82:377–81.
Miyawaki S, Koyama I, Inoue M, Mishima K, Sugahara T, Takano-Yamamoto T. Factors associated with the stability of titanium screws placed in the posterior region for orthodontic anchorage. Am J Orthod Dentofac Orthop. 2003;124:373–8.
Cheng SJ, Tseng IY, Lee JJ, Kok SH. A prospective study of the risk factors associated with failure of mini-implants used for orthodontic anchorage. Int J Oral Maxillofac Implants. 2004;19:100–6.
Kim JW, Ahn SJ, Chang YI. Histomorphometric and mechanical analyses of the drill-free screw as orthodontic anchorage. Am J Orthod Dentofac Orthop. 2005;128:190–4.
Cho HJ. Clinical applications of mini-implants as orthodontic anchorage and the peri-implant tissue reaction upon loading. J Calif Dent Assoc. 2006;34:813–20.
Park HS, Jeong SH, Kwon OW. Factors affecting the clinical success of screw implants used as orthodontic anchorage. Am J Orthod Dentofac Orthop. 2006;130:18–25.
Kuroda S, Sugawara Y, Deguchi T, Kyung HM, Takano-Yamamoto T. Clinical use of miniscrew implants as orthodontic anchorage: success rates and postoperative discomfort. Am J Orthod Dentofac Orthop. 2007;131:9–15.
Park HS, Kwon TG, Sung JH. Non-extraction treatment with microscrew implants. Angle Orthod. 2004;74:539–49.
Cha BK, Lee YH, Lee NK, Choi DS, Baek SH. Soft tissue thickness for placement of an orthodontic miniscrew using an ultrasonic device. Angle Orthod. 2008;78(3):403–8.
Schulze RK, Ćurić D, d'Hoedt B. B-mode versus A-mode ultrasonographic measurements of mucosal thickness in vivo. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;93(1):110–7.
Cacciafesta V, Bumann A, Cho JH, Graham JW, Paquette DE, Park HS, et al. Skeletal anchorage: part I. J Clin Orthod. 2009;43:303–17.
Kim HJ, Yun HS, Park HD, Kim DH, Park YC. Soft-tissue and cortical-bone thickness at orthodontic implant sites. Am J Orthod Dentofac Orthop. 2006;130:177–82.
Muller HP, Barrieshi-Nusair KM, Kononen E. Repeatability of ultrasonic determination of gingival thickness. Clin Oral Investig. 2007;11:439–42.
Muller HP, Kononen E. Variance components of gingival thickness. J Periodontal Res. 2005;40:239–44.
Tzoumpas M, Mohr B, Kurtulus-Waschulewski I, Wahl G. The use of high-frequency ultrasound in the measurement of thickness of the maxillary attached gingiva. Int J Prosthodont. 2015;28:374–82.
Furtak A, Leszczynska E, Sender-Janeczek A, Bednarz W. The repeatability and reproducibility of gingival thickness measurement with an ultrasonic device. Dent Med Probl. 2018;55:281–8.
Rajpoot N, Nayak A, Nayak R, Bankur PK. Evaluation of variation in the palatal gingival biotypes using an ultrasound device. J Clin Diagn Res. 2015;9:ZC56–60.
Pelsmaekers B, Loos R, Carels C, Derom C, Vlietinck R. The genetic contribution to dental maturation. J Dent Res. 1997;76:1337–40.
Schmidt S, Schibor M, Pfeiffer H, Schmeling A, Schulz R. Age dependence of epiphyseal ossification of the distal radius in ultrasound diagnostics. Int J Legal Med. 2013;127(4):831–8.
Torenek Ağırman K, Bilge OM, Miloğlu Ö. Ultrasonography in determining pubertal growth and bone age. Dentomaxillofac Radiol. 2018;47(7):20170398.
Roche AF. A study of skeletal maturation in a group of Melbourn children. Aust Paediatr J. 1967;3:123–7.
Paesano PL, Vigone MC, Siragusa V, Chiumello G, Maschio AD, Mora S. Assessment of skeletal maturation in infants: comparison between 2 methods in hypothyroid patients. Pediatr Radiol. 1998;28:622–6.
Tanner JM, Whitehouse RH, Marshall WA, Healy MJR, Goldstein H. Assessment of skeletal maturity and prediction of adult height (TW method). 2nd ed. London: Academic Press; 1983.
Greulich WW, Pyle SI. Radiographic atlas of skeletal development of the hand and wrist. 2nd ed. Stanford, CA: Stanford University Press; 1959.
Bilgili Y, Hizel S, Kara SA, Sanli C, Erdal HH, Altinok D. Accuracy of skeletal age assessment in children from birth to 6 years of age with the ultrasonographic version of the Greulich-Pyle atlas. J Ultrasound Med. 2003;22(7):683–90.
Castriota-Scanderbeg A, Sacco MC, Emberti-Gialloreti L, Fraracci L. Skeletal age assessment in children and young adults: comparison between a newly developed sonographic method and conventional methods. Skelet Radiol. 1998;27(5):271–7.
Wagner UA, Diedrich V, Schmitt O. Determination of skeletal maturity by ultrasound: a preliminary report. Skelet Radiol. 1995;24(6):417–20.
Nessi R, Garattini G, Bazzini E, Zaffaroni R, Lazzerini F. Ultrasonography assessment of ossification foci of the wrist and pubertal growth spurt. La Radiol Med. 1997;94(1–2):43–6.
Carpenter CT, Lester EL. Skeletal age determination in young children: analysis of three regions of the hand/wrist film. J Pediatr Orthop. 1993;13(1):76–9.
Daneff M, Casalis C, Bruno CH, Bruno DA. Bone age assessment with conventional ultrasonography in healthy infants from 1 to 24 months of age. Pediatr Radiol. 2015;45:1007–15.
Khan KM, Sarafoglou K, Somani A, Frohnert B, Miller BS. Can ultrasound be used to estimate bone mineral density in children with growth problems? Acta Paediatr. 2013;102(9):e407–12.
Aloufi F, Preston CB, Zawawi KH. Changes in the upper and lower pharyngeal airway spaces associated with rapid maxillary expansion. ISRN Dent. 2012;2012:290964.
Vidya VS, Sumathi FA. Rapid maxillary expansion as a standard treatment for obstructive sleep apnea syndrome: a systematic review. J Dent Med Sci. 2015;14(2):51–5.
Jang HI, Kim SC, Chae JM, Kang KH, Cho JW, Chang NY, et al. Relationship between maturation indices and morphology of the midpalatal suture obtained using cone-beam computed tomography images. Kor J Orthod. 2016;46(6):345–55.
Suri L, Taneja P. Surgically assisted rapid palatal expansion: a literature review. Am J Orthod Dentofac Orthop. 2008;133(2):290–302.
McNamara JA, Brudon WL. Orthodontics and dentofacial orthopedics. Ann Arbor: Needham Press; 1995. p. 211e2.
Silva Filho OG, Magro AC, Capelozza FI. Early treatment of the class III malocclusion with rapid maxillary expansion and maxillary protraction. Am J Orthod Dentofac Orthop. 1998;113(2):196–203.
Sumer AP, Ozer M, Sumer M, Danaci M, Tokalak F, Telcioglu NT. Ultrasonography in the evaluation of midpalatal suture in surgically assisted rapid maxillary expansion. J Craniofac Surg. 2012;23(5):1375–7.
Maffulli N, Hughes T, Fixsen JA. Ultrasonographic monitoring of limb lengthening. J Bone Joint Surg. 1992;74:130Y132.
Derbyshire ND, Simpson AH. A role for ultrasound in limb lengthening. Br J Radiol. 1992;65:576Y580.
Gumussoy I, Miloglu O, Bayrakdar IS, Dagistan S, Caglayan F. Ultrasonography in the evaluation of the mid-palatal suture in rapid palatal expansion. Dentomaxillofac Radiol. 2014;43(8):20140167.
Rygh P, Brudvik P. The histological responses of the periodontal ligament to horizontal orthodontic loads. In: Berkovitz BB, Moxham BJ, Newman HN, editors. The periodontal ligament in health and disease. St Louis: Mosby; 1995.
Zimbran A, Dudea D, Gasparik C, Dudea S. Ultrasonographic evaluation of periodontal changes during orthodontic tooth movement-work in progress. Clujul Med. 2017;90(1):93.
Zimbran A, Dudea S, Dudea D. Evaluation of periodontal tissues using 40 MHz ultrasonography. Preliminary report. Med Ultrason. 2013;15(1):6–9.
Chifor R, Hedeşiu M, Bolfa P, Catoi C, Crişan M, Serbănescu A, et al. The evaluation of 20 Mhz ultrasonography, computed tomography scans as compared to direct microscopy of periodontal system assessment. Med Ultrason. 2011;13(2):120–6.
Tsesis I, Fuss Z, Rosenberg E, Taicher S. Radiographic evaluation of the prevalence of root resorption in a Middle Eastern population. Quintessence Int. 2008;39:e40–4.
Harry MR, Sims MR. Root resorption in bicuspid intrusion. A scanning electron microscope study. Angle Orthod. 1982;52:235–58.
Lund H, Gröndahl K, Hansen K, Gröndahl H-G. Apical root resorption during orthodontic treatment. A prospective study using cone beam CT. Angle Orthod. 2012;82:480–7.
Mirabella AD, Artun J. Risk factors for apical root resorption of maxillary anterior teeth in adult orthodontic patients. Am J Orthod Dentofac Orthop. 1995b;108:48–55.
Kaley J, Philips C. Factors related to root resorption in edgewise practice. Angle Orthod. 1991;61:125–32.
Sasaki T. Differentiation and functions of osteoclasts and odontoclasts in mineralized tissue resorption. Microsc Res Tech. 2003;61:483–95.
Reitan K. Biomechanical principals and reactions. In: Vanarsdall RL, Graber TM, editors. Orthodontics: current principals and techniques. Saint Louis, PA: Mosby; 1985. p. 101–92.
Hoeve T, Mulie MR. The effect of antero-posterior incisor repositioning on the palatal cortex as studied with laminography. J Clin Orthod. 1976;10:802–22.
Sharpe W, Reed B, Subtelny JD, Polson A. Orthodontic relapse, apical root resorption, and crestal alveolar bone levels. Am J Orthod Dentofac Orthop. 1987;91:252–8.
Igarashi K, Adachi H, Mitani H, Shinoda H. Inhibitory effect of the topical administration of a bisphosphonate (risedronate) on root resorption incident to orthodontic tooth movement in rats. J Dent Res. 1996;75:1644–9.
Owman-Moll P, Kurol J, Lundgren D. Repair of orthodontically induced root resorption in adolescents. Angle Orthod. 1995;65:403–8. Discussion 409–410
Keum K-Y, Kwon O-T, Spängberg LS, Kim C-K, Kim J, Cho M-I, et al. Effect of dexamethasone on root resorption after delayed replantation of rat tooth. J Endod. 2003;29:810–3.
Aqrabawi J, Jamani K. Severe external root resorption arrested by conventional endodontic treatment. Dent Update. 2005;32:224–6.
El-Bialy T, El-Shamy I, Graber TM. Repair of orthodontically induced root resorption by ultrasound in humans. Am J Orthod Dentofac Orthop. 2004;126:186–93.
Raza H, Major PW, Dederich D, El-Bialy T. Effect of low-intensity pulsed ultrasound on orthodontically induced root resorption caused by torque: A prospective double-blind controlled clinical trial. Angle Orthod. 2016;35(2):349–58.
Al-Daghreer S, Doschak MR, Sloane AJ, Major PW, Heo G, Scurtescu C, Tsui YY, El-Bialy T. Effect of LIPUS on orthodontically induced root resorption in beagle dogs. Ultrasound Med Biol. 2014;40(6):1187–96.
Inubushi T, Tanaka E, Rego EB, Ohtani J, Kawazoe A, Tanne K, Miyauchi M, Takata T. Low-intensity ultrasound stimulation inhibits resorption of the tooth root induced by experimental force application. Bone. 2013;53:497–506.
Liu Z, Xu J, E L, Wang D. Ultrasound enhances the healing of orthodontically induced root resorption in rats. Angle Orthod. 2012;82:48–55.
Rego EB, Inubushi T, Miyauchi M, Kawazoe A, Tanaka E, Takata T, Tanne K. Ultrasound stimulation attenuates root resorption on rat replanted molars and impairs TNF-α signaling in vitro. J Periodontal Res. 2011;46:648–54.
El-Bialy T, Hassan AH, Alyamani A, Albaghdadi T. Treatment of hemifacial microsomia by therapeutic ultrasound and hybrid functional appliance. A non-surgical approach. J Clin Trials. 2010;2:29–36.
Inubushi T, Tanaka E, Rego EB, Kitagawa M, Kawazoe A, Ohta A, Okada H, Koolstra JH, Miyauchi M, Takata T, Tanne K. Effects of ultrasound on the proliferation and differentiation of cementoblast lineage cells. J Periodontol. 2008;79:1984–90.
El-Bialy TH, Zaki AE, Evans CA. Effect of ultrasound on rabbit mandibular incisor formation and eruption after mandibular osteodistraction. Am J Orthod Dentofac Orthop. 2003;124:427–34.
Showkatbakhsh R, Jamilian A, Showkatbakhsh M. The effect of pulsed electromagnetic fields on the acceleration of tooth movement. World J Orthod. 2010;11:52–6.
Kim DH, Park YG, Kang SG. The effects of electrical current from a micro-electrical device on tooth movement. Kor J Orthod. 2008;38:337.
Hassan AH, Al-Fraidi AA, Al-Saeed SH. Corticotomy-assisted orthodontic treatment: review. Open Dent J. 2010;13:159–64.
Işeri H, Kişnişci R, Bzizi N, Tüz H. Rapid canine retraction and orthodontic treatment with dentoalveolar distraction osteogenesis. Am J Orthod Dentofac Orthop. 2005;127:533–41.
Nishimura M, Chiba M, Ohashi T, Sato M, Shimizu Y, Igarashi K, Mitani H. Periodontal tissue activation by vibration: intermittent stimulation by resonance vibration accelerates experimental tooth movement in rats. Am J Orthod Dentofac Orthop. 2008;133:572–83.
Ojima K, Dan C, Kumagai Y, Schupp W. Invisalign treatment accelerated by photobiomodulation. J Clin Orthod. 2016;50:309–17.
Yamaguchi M, Hayashi M, Fujita S, Yoshida T, Utsunomiya T, Yamamoto H, Kasai K. Low-energy laser irradiation facilitates the velocity of tooth movement and the expressions of matrix metalloproteinase-9, cathepsin K, and alpha(v) beta(3) integrin in rats. Eur J Orthod. 2010;32:131–9.
Wijdicks CA, Virdi AS, Sena K, Sumner DR, Leven RM. Ultrasound enhances recombinant human BMP-2 induced ectopic bone formation in a rat model. Ultrasound Med Biol. 2009;35:1629–37.
Qamruddin I, Alam MK, Khamis MF, et al. Minimally invasive techniques to accelerate the orthodontic tooth movement: a systemic review of animal studies. Biomed Res Int. 2015;2015:608530.
Lou S, Lv H, Li Z, Tang P, Wang Y. Effect of low-intensity pulsed ultrasound on distraction osteogenesis: a systematic review and meta-analysis of randomized controlled trials. J Orthop Surg Res. 2018;13(1):205.
Maung WM, Nakata H, Miura M, Miyasaka M, Kim YK, Kasugai S, Kuroda S. Low-intensity pulsed ultrasound stimulates osteogenic differentiation of periosteal cells in vitro. Tissue Eng Part A. 2020; https://doi.org/10.1089/ten.TEA.2019.0331. [Epub ahead of print]
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2021 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Orhan, K., Görürgöz, C. (2021). USG Imaging in Orthodontics. In: Orhan, K. (eds) Ultrasonography in Dentomaxillofacial Diagnostics. Springer, Cham. https://doi.org/10.1007/978-3-030-62179-7_15
Download citation
DOI: https://doi.org/10.1007/978-3-030-62179-7_15
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-62178-0
Online ISBN: 978-3-030-62179-7
eBook Packages: MedicineMedicine (R0)