Echo‐intensity characterization at implant sites and novel diagnostic ultrasonographic markers for peri‐implantitis

Aim To apply high‐frequency ultrasound (HFUS) echo intensity for characterizing peri‐implant tissues at healthy and diseased sites and to investigate the possible ultrasonographic markers of health versus disease. Materials and Methods Sixty patients presenting 60 implants diagnosed as healthy ( N = 30) and peri‐implantitis ( N = 30) were assessed with HFUS. HFUS scans were imported into a software where first‐order greyscale outcomes [i.e., mean echo intensity (EI)] and second‐order greyscale outcomes were assessed. Other ultrasonographic outcomes of interest involved the vertical extension of the hypoechoic supracrestal area (HSA), soft‐tissue area (STA) and buccal bone dehiscence (BBD), among others. Results HFUS EI mean values obtained from peri‐implant soft tissue at healthy and diseased sites were 122.9 ± 19.7 and 107.9 ± 24.7 grey levels (GL); p = .02, respectively. All the diseased sites showed the appearance of an HSA that was not present in healthy implants (area under the curve = 1). The proportion of HSA/STA was 37.9% ± 14.8%. Regression analysis showed that EI of the peri‐implant soft tissue was significantly different between healthy and peri‐implantitis sites (odds ratio 0.97 [95% confidence interval: 0.94–0.99], p = .019). Conclusions HFUS EI characterization of peri‐implant tissues shows a significant difference between healthy and diseased sites. HFUS EI and the presence/absence of an HSA may be valid diagnostic ultrasonographic markers to discriminate peri‐implant health status.