Diagnostic accuracy and clinical applications of ultrasound in aesthetic dentistry and facial soft-tissue characterization: a systematic review
Abstract
The purpose of this systematic review was to evaluate the diagnostic accuracy and clinical applications of high-frequency ultrasound (HFUS) in the assessment of orofacial soft tissues within aesthetic dentistry, periodontology, peri-implantology, and facial aesthetic procedures. A comprehensive search of PubMed, Scopus, was conducted for studies published between 2010 and 2025. Eligible studies assessed the accuracy, reproducibility, or clinical utility of HFUS and Doppler ultrasound for gingival thickness measurement, characterization of orofacial soft tissues, detection of dermal filler complications, or vascular mapping. Data extraction included study design, diagnostic parameters, and clinical outcomes. Due to heterogeneity in methodologies and outcome measures, the findings were synthesized qualitatively. A total of 21 studies met the inclusion criteria. HFUS demonstrated high diagnostic accuracy for gingival thickness evaluation, with mean differences below 0.3 mm compared with cone-beam computed tomography (CBCT) and transgingival probing. In aesthetic applications, HFUS and Doppler ultrasound accurately identified complications such as filler migration, granulomas, nodularity, fibrosis, and vascular compromise, enabling real-time image-guided interventions. Additionally, Doppler ultrasound enhanced procedural safety by delineating facial arterial pathways, particularly in high-risk regions. Reproducibility across studies was high, with intraclass correlation coefficients ranging from 0.89 to 0.96. High-frequency ultrasound is a reliable, non-invasive, and clinically valuable imaging tool for evaluating orofacial soft tissues, diagnosing complications associated with dermal fillers, and guiding aesthetic procedures. While current evidence supports its integration into dental and facial aesthetic practice, standardized imaging protocols and further prospective research are necessary to strengthen diagnostic consistency and clinical applicability.
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