Time course of bone metabolism at the residual ridge beneath dentures observed using 18F-fluoride positron emission computerized-tomography/computed tomography (PET/CT)

Abstract

ObjectiveExcessive pressure due to wearing mal-adapting dentures is well known to cause residual bone resorption beneath the denture. X-rays have been commonly utilized to evaluate the changes in the bone beneath the denture. However, X-ray images merely detect bone density and relatively large changes in the bone shape and structure, whereas nuclear medicine imaging can detect functional changes, which occur prior to structural changes. This article aimed to describe the time course of the bone metabolism at the residual ridge beneath the denture following denture use by 18F-fluoride positron emission computerized-tomography (PET)/computed tomography (CT) scanning.MethodsThree subjects, who had a free-end edentulous mandible, were treated with a denture replacing the edentulous region of the dental arch. The metabolic changes in the residual bone beneath the denture were assessed by 18F-fluoride PET/CT imaging. 18F-fluoride PET/CT scanning was performed at baseline, and 4–6 and 13 weeks after denture use. A volume of interest (VOI) was placed on their mandibles at the edentulous region beneath the denture on the PET/CT image. CT value and mean standardized uptake value (SUV) of the VOI were calculated. The difference in the time variation between the CT value and SUV was analyzed.ResultsThe adaptation of the denture base to the residual ridge was successful, and there was no trouble such as pain at the residual ridge beneath the denture. The SUVs of each VOI significantly increased at 4–6 weeks after denture use and then decreased at 13 weeks in all three subjects (P < 0.05; two-way ANOVA, Dunnett test). On the other hand, the CT images showed no obvious changes in the bone shape or structure beneath the dentures, and the CT values of each VOI remained static after denture use in all three subjects.ConclusionsThis study indicates that in the present first-time removable partial denture (RPD) users, wearing of a well-adapted RPD initially increased bone metabolism beneath the denture and then decreased it at around 13 weeks after RPD use without any bone structural changes detectable by clinical X-rays. These metabolic changes are a mechanobiological reaction to the pressure induced by RPD use.

Bone metabolism induced by denture insertion in positron emission tomography

“…Despite no clinical problem on the abutment tooth, such as pain or increasing tooth mobility, the SUV of alveolar bone in Subject A reached a high value of 14·8, a possible level indicating tumour . The previous study reported this bone metabolic changes were temporary . In the other word, even a well‐adapted denture can change the bone metabolism significantly for the first‐time denture user, though temporarily.…”

Comparison of standardized uptake values measured on 18F-NaF PET/CT scans using three different tube current intensities

“…However, the level of mAs on 18 F-NaF or 18 F-FDG PET/CT studies is a matter of discussion and a wide range of values may be found in the literature ( 15 , 16 ) . With the use of phantoms, some researchers have demonstrated that CT tube current intensity as low as 10 mAs could be appropriate to perform attenuation correction on PET/CT studies ( 24 , 25 ) .…”

“…However, there are scarce studies in the literature on the most appropriate mAs values. In the literature it is possible to find values ranging from 15 mAs ( 15 ) to 95 mAs ( 16 ) . Therefore, it is necessary to evaluate the adequate mAs values in light of current advances in technology as well as the ALARA principles.…”

Development of a bioactive implant for repair and potential healing of cranial defects

“…The fluoride ion exchanges with the hydroxyl group in the bone mineral hydroxyapatite crystal to form fluoro apatite. 15,21 Therefore, tracer uptake reflects bone remodel ing and represents vascularized vital osseous tissue. The images showed uptake within the entire implant with a marked intensity at the anterior part, providing evidence of bone formation.…”