Ohbayashi Yumiko, Nakai Fumi, Iwasaki Akinori, Ogawa Takaaki, Yamamoto Yuka, Nishiyama Yoshihiro, Miyake Minoru
Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, 761-0793, Kagawa, Japan.
Department of Radiology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, 761-0793, Kagawa, Japan.
Odontology. 2017 Jul;105(3):382-390. doi: 10.1007/s10266-016-0279-9. Epub 2016 Oct 21.
The duration of antiresorptive therapy is an important risk factor for medication-related osteonecrosis of the jaw. We performed a pilot study using quantitative analysis by bone scintigraphy to test the hypothesis that mandibular metabolism is affected by long-term bisphosphonate (BP) therapy. Our primary objectives were to assess changes in bone metabolism of the mandible in response to long-term BP therapy and compare the bone metabolism changes of the mandible with other bone sites. We compared the metabolic difference at the site in the mandible unaffected by disease, the humerus and the femur between 14 osteoporosis patients who were being treated with BP (BP group) and 14 patients who were not being treated with BP (control group) using a quantitative analysis and bone scintigraphy. Study endpoints were the mean and maximum bone uptake values (BUVs) quantified using bone scintigraphy images of the mandible, humerus and femur. Quantified images of the site in the mandible unaffected by disease had significantly higher mean and maximum BUVs compared to the controls (mean, 0.74 vs. 0.49, p = 0.019; max., 1.29 vs. 0.85, p = 0.009, respectively). The mean and maximum BUV of femur ROIs in the BP group were significantly lower than those in control patients (mean BUV, 0.23 vs. 0.30, p = 0.039; max. BUV, 0.43 vs. 0.53, p = 0.024, respectively). This is the first report of mandible changes in response to long-term BP treatment, using bone scintigraphy. The results using bone scintigraphy demonstrated that the bone metabolism of the intact mandible is affected by a long-term administration of BP.
抗吸收治疗的持续时间是与药物相关的颌骨坏死的一个重要风险因素。我们进行了一项初步研究，采用骨闪烁显像定量分析来检验长期双膦酸盐（BP）治疗会影响下颌骨代谢这一假设。我们的主要目标是评估长期BP治疗后下颌骨骨代谢的变化，并将下颌骨的骨代谢变化与其他骨部位进行比较。我们使用定量分析和骨闪烁显像，比较了14例正在接受BP治疗的骨质疏松患者（BP组）和14例未接受BP治疗的患者（对照组）在下颌骨未受疾病影响部位、肱骨和股骨的代谢差异。研究终点是使用下颌骨、肱骨和股骨的骨闪烁显像图像量化的平均和最大骨摄取值（BUVs）。与对照组相比，下颌骨未受疾病影响部位的量化图像平均和最大BUVs显著更高（平均，0.74对0.49，p = 0.019；最大，1.29对0.85，p = 0.009）。BP组股骨ROI的平均和最大BUV显著低于对照患者（平均BUV，0.23对0.30，p = 0.039；最大BUV，0.43对0.53，p = 0.024）。这是首次使用骨闪烁显像报告长期BP治疗后下颌骨的变化。骨闪烁显像的结果表明，长期服用BP会影响完整下颌骨的骨代谢。
