Periodontal probing is a useful diagnostic tool to estimate the periodontal pocket depth and assess the status of periodontal disease, but is limited by systematic and random errors. Here, we used photoacoustic imaging in tandem with a food grade cuttlefish ink contrast agent to specifically measure pocket depths in swine models (n=27 teeth) and then compared this to Williams probe. Photoacoustic imaging used a Vevo LAZR imaging system (Visualsonics) at 40 MHz. Spectral data was collected at both 680 and 800 nm to discriminate between the photoacoustic signal from stains and contrast agent. The pocket depths were measured on the sagittal view of the 3D images as well as with a Williams probe before photoacoustic imaging. The Bland-Altman plots show that 97% of our samples fell within ± 1.96 standard deviations of the differences between the depths measured by photoacoustic imaging and the probe (95% confidence interval) at mesial, lingual and buccal, and distal locations. Small bias values of -0.04, +0.17, and -0.2 mm were identified at mesial, lingual and buccal, and distal locations, respectively; the 95% confidence intervals are plotted as well and all are < 1.0 mm. The photoacoustic imaging approach also offered 0.01 mm precision and could cover the entire pocket versus the probe-based approach that is limited to only a few sites.
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