{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T19:02:04Z","timestamp":1788375724776,"version":"build-2803163510"},"reference-count":49,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T00:00:00Z","timestamp":1763596800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Conventional radiographic methods, although considered the gold standard for dental implantology, are not exempt from certain limitations, including their two-dimensional nature, the exposure to ionizing radiation and the inability to assess soft tissues. Ultrasonography (US) has recently emerged as a promising diagnostic tool due to its non-invasive and radiation-free properties. This systematic review aimed to evaluate the clinical applications of ultrasonography in implant dentistry, focusing on both preoperative planning and postoperative monitoring and to compare its diagnostic performance with conventional imaging modalities. Methods: A comprehensive search was performed in PubMed, Scopus, Web of Science, and Cochrane databases (2005\u20132025) to identify clinical studies evaluating the diagnostic applications of ultrasonography in implant dentistry. The review included randomized controlled trials, diagnostic accuracy studies, case series and case reports. Risk of bias was assessed using the RoB-2 tool for RCTs, QUADAS-2 for diagnostic studies and the JBI checklist for case reports and series. Results: 17 eligible studies were included in this review, comprising 4 RCTs, 10 diagnostic accuracy studies, 2 case report and 1 case series, for a total of 371 patients evaluated. Ultrasonography proved effective in the preoperative setting for evaluating mucosal thickness, keratinized mucosa, tissue phenotype, ridge width and bone morphology, often showing high agreement with CBCT and clinical measurements. In the postoperative phase, US enabled monitoring of soft tissue healing, vascular perfusion, graft maturation and detection of peri-implant pathology, with some studies showing correlations between early ultrasonographic findings and long-term clinical outcomes. Comparative studies revealed strong concordance with CBCT (mean deviations &lt; 0.5\u20131 mm) and superior performance in both soft tissue visualization and cases affected by radiographic artifacts. Conclusions: Ultrasonography represents a promising adjunctive tool in implant dentistry, capable of complementing or, in selected scenarios, replacing conventional radiographic methods. While current evidence highlights its diagnostic potential across different stages of implant therapy, further standardized, large-scale clinical studies are required before routine integration into daily practice.<\/jats:p>","DOI":"10.3390\/jcm14228239","type":"journal-article","created":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T12:02:42Z","timestamp":1763640162000},"page":"8239","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Diagnostic Applications of Ultrasound Imaging in Dental Implantology: A Systematic Review"],"prefix":"10.3390","volume":"14","author":[{"given":"Carlo","family":"Barausse","sequence":"first","affiliation":[{"name":"Oral Surgery Unit, Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, 40125 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3346-7057","authenticated-orcid":false,"given":"Subhi","family":"Tayeb","sequence":"additional","affiliation":[{"name":"Oral Surgery Unit, Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, 40125 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Sansavini","sequence":"additional","affiliation":[{"name":"Oral Surgery Unit, Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, 40125 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8782-8991","authenticated-orcid":false,"given":"Gerardo","family":"Pellegrino","sequence":"additional","affiliation":[{"name":"Oral Surgery Unit, Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, 40125 Bologna, Italy"},{"name":"Department of Health Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Felice","sequence":"additional","affiliation":[{"name":"Oral Surgery Unit, Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, 40125 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.ijom.2014.10.023","article-title":"Evaluation of survival and success rates of dental implants reported in longitudinal studies with a follow-up period of at least 10 years: A systematic review","volume":"44","author":"Moraschini","year":"2015","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1424","DOI":"10.1177\/0022034518792567","article-title":"Trends in Dental Implant Use in the U.S., 1999\u20132016, and Projections to 2026","volume":"97","author":"Elani","year":"2018","journal-title":"J. Dent. Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1111\/j.1601-5037.2010.00489.x","article-title":"Clinical evaluation of an implant maintenance protocol for the prevention of peri-implant diseases in patients treated with immediately loaded full-arch rehabilitations","volume":"9","author":"Corbella","year":"2011","journal-title":"Int. J. Dent. Hyg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"S158","DOI":"10.1111\/jcpe.12334","article-title":"Peri-implant health and disease. A systematic review of current epidemiology","volume":"42","author":"Derks","year":"2015","journal-title":"J. Clin. Periodontol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"S304","DOI":"10.1002\/JPER.17-0588","article-title":"Peri-implant health, peri-implant mucositis, and peri-implantitis: Case definitions and diagnostic considerations","volume":"89","author":"Renvert","year":"2018","journal-title":"J. Periodontol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1111\/prd.12287","article-title":"Soft tissue-related complications and management around dental implants","volume":"81","author":"Chackartchi","year":"2019","journal-title":"Periodontol. 2000"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1016\/j.ijom.2013.11.012","article-title":"Systemic risk factors for peri-implant bone loss: A systematic review and meta-analysis","volume":"43","author":"Clementini","year":"2014","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1111\/prd.12588","article-title":"Diagnostic measures for monitoring and follow-up in periodontology and implant dentistry","volume":"95","author":"Ramseier","year":"2024","journal-title":"Periodontol. 2000"},{"key":"ref_9","first-page":"441","article-title":"A comparative study on the use of digital panoramic and periapical radiographs to assess proximal bone height around dental implants","volume":"47","author":"Gutmacher","year":"2016","journal-title":"Quintessence Int."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1093\/dmfr\/twaf002","article-title":"Methods for assessing peri-implant marginal bone levels on digital periapical radiographs: A meta-research","volume":"54","author":"Vilela","year":"2025","journal-title":"Dentomaxillofac. Radiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1007\/s11282-023-00683-w","article-title":"Analysis of peri-implant bone defects by using cone beam computed tomography (CBCT): An integrative review","volume":"39","author":"Costa","year":"2023","journal-title":"Oral Radiol."},{"key":"ref_12","first-page":"77","article-title":"CBCT vs other imaging modalities to assess peri-implant bone and diagnose complications: A systematic review","volume":"11","author":"Jacobs","year":"2018","journal-title":"Eur. J. Oral Implantol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1111\/prd.12591","article-title":"Nonionizing diagnostic imaging modalities for visualizing health and pathology of periodontal and peri-implant tissues","volume":"95","author":"Yeung","year":"2024","journal-title":"Periodontol. 2000"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"20180076","DOI":"10.1259\/dmfr.20180076","article-title":"Updates on ultrasound research in implant dentistry: A systematic review of potential clinical indications","volume":"47","author":"Bhaskar","year":"2018","journal-title":"Dentomaxillofac. Radiol."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Chan, H.L., Sinjab, K., Chung, M.P., Chiang, Y.C., Wang, H.L., Giannobile, W.V., and Kripfgans, O.D. (2017). Non-invasive evaluation of facial crestal bone with ultrasonography. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0171237"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Reda, R., Zanza, A., Cicconetti, A., Bhandi, S., Miccoli, G., Gambarini, G., and Di Nardo, D. (2021). Ultrasound Imaging in Dentistry: A Literature Overview. J. Imaging, 7.","DOI":"10.3390\/jimaging7110238"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"50","DOI":"10.4329\/wjr.v8.i1.50","article-title":"Review on the applications of ultrasonography in dentomaxillofacial region","volume":"8","author":"Evirgen","year":"2016","journal-title":"World J. Radiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1016\/j.cden.2018.03.007","article-title":"Ultrasound in Dentistry: Toward a Future of Radiation-Free Imaging","volume":"62","author":"Angelopoulos","year":"2018","journal-title":"Dent. Clin. N. Am."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1126\/science.139.3554.495","article-title":"Observation of internal structures of teeth by ultrasonography","volume":"139","author":"Baum","year":"1963","journal-title":"Science"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1111\/cid.13231","article-title":"The feasibility of ultrasonography for the measurement of periodontal and peri-implant phenotype: A systematic review and meta-analysis","volume":"25","author":"Fan","year":"2023","journal-title":"Clin. Implant. Dent. Relat. Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"20190445","DOI":"10.1259\/dmfr.20190445","article-title":"Ultrasonography for diagnosis of peri-implant diseases and conditions: A detailed scanning protocol and case demonstration","volume":"49","author":"Chan","year":"2020","journal-title":"Dentomaxillofac. Radiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1111\/clr.14302","article-title":"Sonography in the diagnosis of peri-implant bone defects: An in vitro study on native human mandibles","volume":"35","author":"Bykhovsky","year":"2024","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1111\/cid.12245","article-title":"Ultrasonic Assessment of Mucosal Thickness around Implants: Validity, Reproducibility, and Stability of Connective Tissue Grafts at the Buccal Aspect","volume":"18","author":"Eghbali","year":"2016","journal-title":"Clin. Implant. Dent. Relat. Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1111\/jcpe.14139","article-title":"Comparison of Ultrasonography, CBCT, Transgingival Probing, Colour-Coded and Periodontal Probe Transparency With Histological Gingival Thickness: A Diagnostic Accuracy Study Revisiting Thick Versus Thin Gingiva","volume":"52","author":"Sabri","year":"2025","journal-title":"J. Clin. Periodontol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"105136","DOI":"10.1016\/j.jdent.2024.105136","article-title":"Intraoral ultrasonography image registration for evaluation of partial edentulous ridge: A methodology and validation study","volume":"148","author":"Kripfgans","year":"2024","journal-title":"J. Dent."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1186\/s40729-025-00634-6","article-title":"Are dental magnetic resonance imaging and ultrasonography techniques reliable alternatives for treatment planning dental implants? A systematic review and meta-analysis","volume":"11","author":"Zhang","year":"2025","journal-title":"Int. J. Implant. Dent."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"20200309","DOI":"10.1259\/dmfr.20200309","article-title":"Accuracy of high-resolution ultrasound (US) for gingival soft tissue thickness mesurement in edentulous patients prior to implant placement","volume":"50","year":"2021","journal-title":"Dentomaxillofac. Radiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"100892","DOI":"10.1016\/j.ortho.2024.100892","article-title":"Comparison of gingival thickness by CBCT versus transgingival probing and estimation of cut-off values for gingival phenotype\u2014A cross-sectional study in adults","volume":"22","author":"Gupta","year":"2024","journal-title":"Int. Orthod."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1080\/02841850410008207","article-title":"Ultrasonography in follow-up of soft tissue augmentation of the face with synthetic materials: A pilot study","volume":"45","author":"Giovagnorio","year":"2004","journal-title":"Acta Radiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1111\/jcpe.13889","article-title":"Doppler ultrasonographic evaluation of tissue revascularization following connective tissue graft at implant sites","volume":"52","author":"Tavelli","year":"2025","journal-title":"J. Clin. Periodontol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/j.aanat.2017.11.003","article-title":"Ultrasound assessment of soft tissue augmentation around implants in the aesthetic zone using a connective tissue graft and xenogeneic collagen matrix\u20141-year randomised follow-up","volume":"217","author":"Puzio","year":"2018","journal-title":"Ann. Anat."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1002\/JPER.23-0014","article-title":"Keratinized mucosa width assessment at implant sites using high-frequency ultrasonography","volume":"94","author":"Tavelli","year":"2023","journal-title":"J. Periodontol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1111\/clr.13758","article-title":"Comprehensive peri-implant tissue evaluation with ultrasonography and cone-beam computed tomography: A pilot study","volume":"32","author":"Siqueira","year":"2021","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e13401","DOI":"10.1111\/cid.13401","article-title":"Ultrasonography-Guided Dental Implant Surgery: A Feasibility Study","volume":"27","author":"Nava","year":"2025","journal-title":"Clin. Implant. Dent. Relat. Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1111\/jre.13296","article-title":"Soft tissue elasticity at teeth and implant sites. A novel outcome measure of the soft tissue phenotype","volume":"59","author":"Tavelli","year":"2024","journal-title":"J. Periodontal Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1586","DOI":"10.1111\/jcpe.13976","article-title":"Echo-intensity characterization at implant sites and novel diagnostic ultrasonographic markers for peri-implantitis","volume":"51","author":"Barootchi","year":"2024","journal-title":"J. Clin. Periodontol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.oooo.2021.07.006","article-title":"Ultrasonographic evaluation of edentulous crestal bone topography: A proof-of-principle retrospective study","volume":"133","author":"Sinjab","year":"2022","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e89","DOI":"10.1016\/j.oooo.2018.08.014","article-title":"Feasibility of a combination of intraoral UHFUS and CBCT in the study of peri-implantitis","volume":"127","author":"Izzetti","year":"2019","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1002\/cap.10234","article-title":"Ridge augmentation planning, wound healing evaluation, and peri-implant tissue phenotype assessment with ultrasonography: A case report","volume":"14","author":"Sirinirund","year":"2024","journal-title":"Clin. Adv. Periodontics"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.tripleo.2007.01.014","article-title":"Sonography of periimplant buccal bone defects in periodontitis patients: A pilot study","volume":"105","author":"Bertram","year":"2008","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1315","DOI":"10.1002\/JPER.23-0102","article-title":"Non-invasive assessment of peri-implant mucosal thickness: A cross-sectional study","volume":"94","author":"Raabe","year":"2023","journal-title":"J. Periodontol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1111\/jcpe.13424","article-title":"Ultrasonographic tissue perfusion analysis at implant and palatal donor sites following soft tissue augmentation: A clinical pilot study","volume":"48","author":"Tavelli","year":"2021","journal-title":"J. Clin. Periodontol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1007\/s00784-011-0533-z","article-title":"Intraoral ultrasonography: Development of a specific high-frequency probe and clinical pilot study","volume":"16","author":"Salmon","year":"2012","journal-title":"Clin. Oral Investig."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1177\/00220345211035684","article-title":"Ultrasonographic Tissue Perfusion in Peri-implant Health and Disease","volume":"101","author":"Barootchi","year":"2022","journal-title":"J. Dent. Res."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1186\/s40729-021-00375-2","article-title":"Ultrasonography for noninvasive and real-time evaluation of peri-implant soft and hard tissue: A case series","volume":"7","author":"Kripfgans","year":"2021","journal-title":"Int. J. Implant. Dent."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1002\/JPER.19-0342","article-title":"Ultrasonography for chairside evaluation of periodontal structures: A pilot study","volume":"91","author":"Tattan","year":"2020","journal-title":"J. Periodontol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: A revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"529","DOI":"10.7326\/0003-4819-155-8-201110180-00009","article-title":"QUADAS-2: A revised tool for the quality assessment of diagnostic accuracy studies","volume":"155","author":"Whiting","year":"2011","journal-title":"Ann. Intern. Med."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/22\/8239\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T12:21:32Z","timestamp":1763641292000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/22\/8239"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,20]]},"references-count":49,"journal-issue":{"issue":"22","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["jcm14228239"],"URL":"https:\/\/doi.org\/10.3390\/jcm14228239","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,20]]}}}