pyrophosphate and Jaw-Diseases

Bisphosphonate (BP) therapy has modified the natural history of many bone metabolic diseases. Amino-bisphosphonates nowadays represent the primary therapeutic choice for the treatment of osteoporosis and for prevention of fractures. Osteonecrosis of the mandible and maxilla (ONJ) is a rare disease usually occurring in cancer patients with bone metastases treated with high doses of intravenous BPs. Some cases have been described in patients taking amino-BPs for osteoporosis, but the specific drug utilized, its dosage and use of the oral route have reduced that risk considerably (estimated at 1/100,000 subjects a year). Prevention of ONJ include good oral hygiene habits in all patients and, in a subject who has been treated for more than three years, conservative dental procedures when possible, an appropriate antibiotic therapy and a careful follow-up when invasive oral interventions are necessary, are recommended by dentists and bone metabolism experts alike.

Topics: Bone and Bones; Bone Neoplasms; Diphosphates; Dose-Response Relationship, Drug; Female; Humans; Jaw Diseases; Male; Osteonecrosis; Osteoporosis; Risk Factors

The present paper compares scintigraphy using leucocytes labelled with 111 indium oxine sulphate with conventional 99Tc pyrophosphate scintigraphy for the investigation of inflammatory processes in the region of the jaw bones. It also tries to establish whether progress can be made in the field of differential diagnosis using a combination of these two methods of investigation. It is shown that conventional scintigraphy using 99Tc pyrophosphate represents an approved method of investigation, whereas scintigraphy using autologous leucocytes does not as yet fulfil the expectations that have been placed in it.

Topics: Abscess; Bone Cysts; Diphosphates; Granulocytes; Humans; Hydroxyquinolines; Indium; Jaw Diseases; Maxillary Sinus; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging; Sinusitis; Technetium; Technetium Tc 99m Pyrophosphate