Department of Dentistry and Oral Surgery, Keio University School of Medicine, Tokyo, Japan.
Department of Dentistry and Oral Surgery, Keio University School of Medicine, Tokyo, Japan.
Int J Oral Maxillofac Surg. 2022 Jul;51(7):942-948. doi: 10.1016/j.ijom.2021.11.012. Epub 2021 Dec 20.
The aim of this study was to clarify the clinical significance of bone metabolism in the mandibular condyles in determining condylar resorptive changes. Twelve condyles of patients with idiopathic condylar resorption and degenerative joint disease were analysed using Tc HMDP SPECT/CT at baseline and subsequent computed tomography during the follow-up period. Twenty-two healthy condyles were enrolled as controls. After generating three-dimensional SPECT/CT images, two independent observers scored the degree of condylar uptake and measured the morphological changes in the condylar height and condylar volume. In the group with positive condylar uptake, the follow-up computed tomography showed significant decreases in condylar height (-1.69 ± 0.93 mm) and condylar volume (-12.51 ± 10.30%) when compared to healthy controls (condylar height, 0.09 ± 0.54 mm; condylar volume, -0.29 ± 4.22%) (P < 0.001). Moreover, the degree of uptake correlated with the changes in condylar height (observer 1, P = 0.012; observer 2, P = 0.039) and condylar volume (observer 1, P = 0.005; observer 2, P = 0.037). These results suggest that condylar bone metabolism is closely related to the resorptive activity. Thus, SPECT/CT would be useful in the prognostic evaluation or determination of treatment strategies for idiopathic condylar resorption and degenerative joint disease.
本研究旨在阐明下颌骨髁突骨代谢在确定髁突吸收变化中的临床意义。对 12 例特发性髁突吸收和退行性关节病患者,在基线时采用 Tc-HMDP SPECT/CT 检查,并在随访期间行后续 CT 检查。将 22 例健康髁突作为对照组。生成三维 SPECT/CT 图像后,两位独立观察者对髁突摄取程度进行评分,并测量髁突高度和体积的形态变化。在阳性摄取组中,与健康对照组相比,随访 CT 显示髁突高度显著降低(-1.69 ± 0.93 mm)和髁突体积减小(-12.51 ± 10.30%)(髁突高度:0.09 ± 0.54 mm;髁突体积:-0.29 ± 4.22%)(P < 0.001)。此外,摄取程度与髁突高度变化(观察者 1,P = 0.012;观察者 2,P = 0.039)和髁突体积变化(观察者 1,P = 0.005;观察者 2,P = 0.037)相关。这些结果表明,髁突骨代谢与吸收活性密切相关。因此,SPECT/CT 可用于特发性髁突吸收和退行性关节病的预后评估或治疗策略的确定。