Detection of active alveolar bone destruction in human periodontal disease by analysis of radiopharmaceutical uptake after a single injection of 99m-Tc-methylene diphosphonate.

Abstract

Previous studies have shown that, following a single injection of 99m‐Tc‐MDP, measurement of bone‐seeking radiopharmaceutical uptake can detect “active” alveolar bone loss due to periodontal disease in beagle dogs, as determined by radiographs taken at the time of, and several months after, the nuclear medicine procedure. The efficacy of this diagnostic test. however, had not been assessed in human periodontal disease. The ability of a single bone‐seeking radiopharmaceutical uptake examination to detect “active” alveolar bone loss due to periodontal disease in human patients was assessed by comparing a single uptake measurement to the rate of bone loss determined from serial radiographs taken over a 6‐month period. Uptake was expressed as a ratio of the cpm from the alveolar bone divided by the cpm from the non‐tooth supporting bone of the nuchal crest. High uptake ratios were associated with “active” loss and low uptake ratios were associated with little if any change in alveolar bone height (p < 0.001). The nuclear medicine examination was an accurate detector of periodontal disease activity in nearly 80% of the individual teeth studied. These data indicate that high bone‐seeking radiopharmaceutical uptake ratios may be pathognomonic of active bone loss in human periodontal disease.