Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technical University, Ismaninger Str. 22, 81675, Munich, Germany.
Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital, Ludwig-Maximilians-University, Munich, Germany.
Eur Radiol. 2024 May;34(5):3115-3122. doi: 10.1007/s00330-023-10327-6. Epub 2023 Oct 19.
T2 STIR MRI sequences can detect preclinical changes associated with periodontal inflammation, i.e. intraosseous edema in the tooth-supporting bone. In this study, we assessed whether MRI can be used for monitoring periodontal disease.
In a prospective cohort study, we examined 35 patients with periodontitis between 10/2018 and 04/2019 by using 3D isotropic T2-weighted short tau inversion recovery (STIR) and Fast Field Echo T1-weighted Black bone sequences. All patients received standardized clinical exams before and three months after non-surgical periodontal therapy. Bone marrow edema extent was quantified in the STIR sequence at 922 sites before and after treatment. Results were compared with standard clinical findings. Non-parametric statistical analysis was performed.
Non-surgical periodontal treatment caused significant improvement in mean probing depth (p < 0.001) and frequency of bleeding on probing (p < 0.001). The mean depth of osseous edema per site was reduced from a median [IQR] of 2 [1, 3] mm at baseline to 1 [0, 3] mm, (p < 0.001). Periodontal treatment reduced the frequency of sites with edema from 35 to 24% (p < 0.01).
The decrease of periodontal bone marrow edema, as observed with T2 STIR MR imaging, is indicative of successful periodontal healing.
T2 STIR hyperintense bone marrow edema in the periodontal bone decreases after treatment and can therefore be used to evaluate treatment success. Furthermore, MRI reveals new options to depict hidden aspects of periodontitis.
• T2 STIR hyperintense periodontal intraosseous edema was prospectively investigated in 35 patients with periodontitis before and after treatment and compared to clinical outcomes. • The frequency of affected sites was reduced from 35 to 24% (p < 0.001), and mean edema depth was reduced from a median [IQR] of 2 [1, 3] mm at baseline to 1 [0, 3] mm 3 months after treatment. (p < 0.001). • T2 STIR sequences can be used to monitor the posttreatment course of periodontitis.
T2 短 tau 反转恢复（STIR）MRI 序列可检测与牙周炎相关的临床前变化，即支持牙齿的骨内骨髓水肿。本研究旨在评估 MRI 是否可用于监测牙周病。
在一项前瞻性队列研究中，我们于 2018 年 10 月至 2019 年 4 月期间使用 3D 各向同性 T2 加权短 tau 反转恢复（STIR）和快速现场回波 T1 加权黑骨序列检查了 35 例牙周炎患者。所有患者在非手术牙周治疗前后均接受了标准化的临床检查。在治疗前后，在 STIR 序列中对 922 个部位的骨髓水肿程度进行量化。将结果与标准临床发现进行比较，并进行非参数统计分析。
非手术牙周治疗可显著改善平均探诊深度（p < 0.001）和探诊出血频率（p < 0.001）。每个部位的骨水肿深度中位数（IQR）从基线时的 2 [1, 3] 毫米降低至治疗后 1 [0, 3] 毫米（p < 0.001）。牙周治疗将水肿部位的频率从 35%降低至 24%（p < 0.01）。
T2 STIR MR 成像观察到的牙周骨骨髓水肿减少表明牙周愈合成功。
牙周骨 T2 STIR 高信号骨髓水肿在治疗后减少，因此可用于评估治疗效果。此外，MRI 提供了新的方法来描述牙周炎的隐匿性方面。
• 本研究前瞻性地研究了 35 例牙周炎患者治疗前后 T2 STIR 高信号牙周骨内骨内水肿，并将其与临床结果进行比较。• 受影响部位的频率从 35%降至 24%（p < 0.001），平均水肿深度从基线时的中位数（IQR）2 [1, 3] 毫米降至治疗后 3 个月时的 1 [0, 3] 毫米（p < 0.001）。• T2 STIR 序列可用于监测牙周炎的治疗后病程。
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