technetium-tc-99m-medronate and Pericoronitis

To evaluate the effect of platelet-rich fibrin (PRF) on the early bone healing process with bone scintigraphy based on technetium-99m methylene diphosphonate uptake in third molar extraction sockets.. Fourteen patients with bilaterally soft tissue impacted third mandibular molars were included in the study. The right and left impacted third molars were surgically extracted in the same session. PRF was randomly administered into one of the extraction sockets, whereas the contralateral sockets were left without treatment. Four weeks after surgery, scintigrams were obtained to evaluate scintigraphic differences between PRF-treated and non-PRF-treated sockets. After completion of the clinical study, PRF samples were evaluated by light and scanning electron microscopy.. The average increase in technetium-99m methylene diphosphonate uptake as an indication of enhanced bone healing did not differ significantly between PRF-treated and non-PRF-treated sockets 4 weeks postoperatively (P > .05). Abundant fibrin and inflammatory cells were observed by light microscopic examination of PRF samples. Scanning electron microscopic analysis of PRF revealed the existence of platelet aggregates in a fibrin network and crystalline particles on the outer surface of PRF.. PRF might not lead to enhanced bone healing in soft tissue impacted mandibular third molar extraction sockets 4 weeks after surgery. PRF exhibits the potential characteristics of an autologous fibrin matrix. However, whether the presence of crystal-like particles on the outer surface of PRF alters bone healing should be investigated further.

Topics: Adult; Blood Platelets; Female; Fibrin; Follow-Up Studies; Humans; Male; Microscopy, Electron, Scanning; Molar, Third; Osteoblasts; Osteogenesis; Pericoronitis; Platelet Aggregation; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Tooth Extraction; Tooth Socket; Tooth, Impacted; Wound Healing; Young Adult

The literature on diffuse sclerosing osteomyelitis of the mandible has included at least two groups of lesions: (1) those from which bacterial infectious agents are rarely isolated (chronic-tendoperiostitis); and (2) those from which bacteria are readily isolated (true diffuse sclerosing osteomyelitis). The latter should be distinguished from secondarily infected florid osseous dysplasia. In this article the features of 16 patients with sclerotic jawbone lesions associated with symptoms of infection are analyzed. Eleven patients showed a large area of sclerosis of the mandible that was not restricted to the alveolar process and was surrounding an infectious focus. The histologic pattern revealed a deposition of reactive bone. These lesions are considered to represent true diffuse sclerosing osteomyelitis. The remaining five patients showed sclerotic lesions restricted to the alveolar process in one or more quadrants of the jaws. Apart from inflammation and reactive changes, histologic pattern revealed a fibroblastic stroma with bone and cementum-like structures that are formed by metaplasia. These lesions are considered to represent secondarily infected florid osseous dysplasia.

Topics: Adolescent; Adult; Aged; Diagnosis, Differential; Female; Fibrous Dysplasia of Bone; Humans; Male; Mandibular Diseases; Middle Aged; Osteomyelitis; Periapical Periodontitis; Pericoronitis; Radiography, Panoramic; Sclerosis; Technetium Tc 99m Medronate