Use of sequential bone scintigraphy for monitoring onlay grafts to grossly atrophic jaws

To evaluate the capability of sequential bone scintigraphy for assessing the viability of avascular onlay grafts in combination with primary or secondary implant placement. Forty-six patients with severe alveolar ridge atrophy received full-arch onlay grafts from the iliac crest. Twenty patients rec...

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Veröffentlicht in:Dento-maxillo-facial radiology 1997-03, Vol.26 (2), p.117-124
Hauptverfasser: Schliephake, H, Berding, G, Neukam, F W, Bothe, K J, Gratz, K F, Hundeshagen, H
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container_end_page 124
container_issue 2
container_start_page 117
container_title Dento-maxillo-facial radiology
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creator Schliephake, H
Berding, G
Neukam, F W
Bothe, K J
Gratz, K F
Hundeshagen, H
description To evaluate the capability of sequential bone scintigraphy for assessing the viability of avascular onlay grafts in combination with primary or secondary implant placement. Forty-six patients with severe alveolar ridge atrophy received full-arch onlay grafts from the iliac crest. Twenty patients received primary insertion of endosseous implants, while secondary implant placement was performed in 26 patients after an average interval of 95 days. In cases of primary implant placement, bone scintigraphy was performed after grafting and before abutment connection. In patients with secondary insertion, bone scans were performed after grafting, before and after implant placement and before abutment connection. For bone scintigraphy, 8 MBq 99mTc-MDP/kg body weight were administered intravenously and anterior views of the skull were obtained 3 h later. Regions of interest were drawn over the grafted area and over the calvarium as a reference area. Ratios of count densities between jaw and calvarium were calculated as a measure of tracer uptake. Bone grafts with primary insertion of implants showed a significant decrease (P = 0.0001) in ratios calculated for the whole graft from a mean of 3.53 after grafting to 2.35 before abutment connection. In cases of secondary implant placement, ratios decreased significantly after grafting from 4.04 to 2.78 before implant placement (P = 0.0001). After implant placement, there was a significant increase to 3.28 (P = 0.0062), which was followed again by a significant decrease to a mean ratio of 2.58 (P = 0.0437). Sequential bone scintigrams can provide information about the viability of the graft at the time of implant insertion and may thus indicate the ability of the grafted bone to accomplish osseointegration.
doi_str_mv 10.1038/sj.dmfr.4600219
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Forty-six patients with severe alveolar ridge atrophy received full-arch onlay grafts from the iliac crest. Twenty patients received primary insertion of endosseous implants, while secondary implant placement was performed in 26 patients after an average interval of 95 days. In cases of primary implant placement, bone scintigraphy was performed after grafting and before abutment connection. In patients with secondary insertion, bone scans were performed after grafting, before and after implant placement and before abutment connection. For bone scintigraphy, 8 MBq 99mTc-MDP/kg body weight were administered intravenously and anterior views of the skull were obtained 3 h later. Regions of interest were drawn over the grafted area and over the calvarium as a reference area. Ratios of count densities between jaw and calvarium were calculated as a measure of tracer uptake. Bone grafts with primary insertion of implants showed a significant decrease (P = 0.0001) in ratios calculated for the whole graft from a mean of 3.53 after grafting to 2.35 before abutment connection. In cases of secondary implant placement, ratios decreased significantly after grafting from 4.04 to 2.78 before implant placement (P = 0.0001). After implant placement, there was a significant increase to 3.28 (P = 0.0062), which was followed again by a significant decrease to a mean ratio of 2.58 (P = 0.0437). 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source Oxford University Press Journals All Titles (1996-Current); MEDLINE
subjects Adult
Aged
Alveolar Bone Loss - diagnostic imaging
Alveolar Bone Loss - surgery
Bone Transplantation - diagnostic imaging
Chi-Square Distribution
Dental Implantation, Endosseous - methods
Dentistry
Evaluation Studies as Topic
Female
Humans
Jaw - diagnostic imaging
Male
Mandible - diagnostic imaging
Maxilla - diagnostic imaging
Middle Aged
Radiography, Panoramic
Radionuclide Imaging
Technetium Tc 99m Medronate
title Use of sequential bone scintigraphy for monitoring onlay grafts to grossly atrophic jaws
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