Ultrasonic Periodontal Probing Based on the Dynamic Wavelet Fingerprint
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Ultrasonic Periodontal Probing Based on the Dynamic Wavelet Fingerprint Jidong Hou Department of Applied Science, The College of William & Mary, Williamsburg, VA 23187-8795, USA Email: [email protected]
S. Timothy Rose Valley Periodontics, 2535 Northern Road, Appleton, WI 54914, USA Email: [email protected]
Mark K. Hinders Department of Applied Science, The College of William & Mary, Williamsburg, VA 23187-8795, USA Email: [email protected] Received 17 August 2004; Revised 4 October 2004; Recommended for Publication by Dimitrios Tzovaras Manual pocket depth probing has been widely used as a retrospective diagnosis method in periodontics. However, numerous studies have questioned its ability to accurately measure the anatomic pocket depth. In this paper, an ultrasonic periodontal probing method is described, which involves using a hollow water-filled probe to focus a narrow beam of ultrasound energy into and out of the periodontal pocket, followed by automatic processing of pulse-echo signals to obtain the periodontal pocket depth. The signal processing algorithm consists of three steps: peak detection/characterization, peak classification, and peak identification. A dynamic wavelet fingerprint (DWFP) technique is first applied to detect suspected scatterers in the A-scan signal and generate a two-dimensional black and white pattern to characterize the local transient signal corresponding to each scatterer. These DWFP patterns are then classified by a two-dimensional FFT procedure and mapped to an inclination index curve. The location of the pocket bottom was identified as the third broad peak in the inclination index curve. The algorithm is tested on full-mouth probing data from two sequential visits of 14 patients. Its performance is evaluated by comparing ultrasonic probing results with that of full-mouth manual probing at the same sites, which is taken as the “gold standard.” Keywords and phrases: ultrasonic, periodontal, probe, wavelet.
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INTRODUCTION
Most adults have a mild form of periodontal disease, while over 20 percent of older Americans have severe periodontal disease [1, 2, 3]. Periodontal disease involves the loss of tooth connective tissue (attachment) with subsequent destruction of tooth-supporting bone, leading to loss of teeth. In addition to being a major cause of tooth loss, periodontal disease has recently been associated with several systemic diseases. Animal and population-based studies have demonstrated an association between periodontal disease and diabetes, cardiovascular disease, stroke, and adverse pregnancy outcomes [4, 5, 6]. Despite the widespread problem of periodontal disease today, currently available diagnostic tests are limited in their effectiveness. None is a completely reliable indicator of periodontal disease activity and the best available diagnostic aid, probing pocket depths, is only a retrospective analysis of attachment already lost [7, 8, 9, 10, 11, 12, 13]. In traditional
probing, which is now routinely done in the general dentistry office [14], a metal probe is inserted
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