Scintigraphic evaluation of healing response after heterograft usage for alveolar extraction cavity.
OBJECTIVE
Reconstruction of bone defects remains an important problem in oral and maxillofacial surgery. Restoration of defect sites with various grafting materials is a valuable approach to the solution of this problem. The aim of this study was to evaluate the effects of the use of heterografts on osteoblastic activity by means of a radionuclide technique.


METHODS
The postextraction alveolar cavities of impacted mandibular third molars on 22 patients were used as a healing model for this study. Granulated freeze-dried heterograft material of bovine origin was used on 11 patients; the other 11 patients constituted a control group. On each patient, three-phase bone scans were performed on postoperative days 7 and 28.


RESULTS
Although dynamic and blood pool studies showed similar patterns with respect to the mean values of asymmetry ratios of operation sites to the contralateral sides for the 7th- and 28th-day scans, static-phase bone scans revealed that healing response through osteoinduction was more prominent in the study group than in the control group. A significant increase in the mean value of the ratio from the first scan to the second was observed on static images in the study group (first scan, 1.6 +/- 0.2; second scan, 2.0 +/- 0.5; p < 0.05). However, the same ratio failed to show any significant change in the control group (first scan, 1.5 +/- 0.2; second scan, 1.5 +/- 0.3; p > 0.05).


CONCLUSIONS
Static-phase bone scintigraphy showed that when freeze-dried heterograft material is used to fill alveolar extraction cavities, it stimulates osteoblastic activity, which in turn leads to acceleration of the healing process and helps to maintain the linearity of bony structure. Moreover, radionuclide study can be used to evaluate the viability of freeze-dried heterografts in the 4th postoperative week, at which time no additional increase in perfusion resulting from surgical trauma was found in our series.
Gülaldi
N C
NC
Department of Nuclear Medicine, Faculty of Medicine, University of Hacettepe, Ankara, Turkey.
Shahlafar
J
J
Makhsoosi
M
M
Caner
B
B
Araz
K
K
Erbengi
G
G
D000539:Alveolar Process / Q000000981:diagnostic imaging; D000543:Alveoloplasty / Q000379:methods*; D000818:Animals; D016025:Bone Transplantation / Q000000981:diagnostic imaging*; D002417:Cattle; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D005612:Freeze Drying; D006085:Graft Survival; D006801:Humans; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging / Q000601:surgery; D008964:Molar, Third / Q000601:surgery; D010006:Osteoblasts / Q000000981:diagnostic imaging / Q000502:physiology; D010012:Osteogenesis; D011862:Radiography, Panoramic; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013669:Technetium Tc 99m Medronate; D014021:Tissue Preservation; D014081:Tooth Extraction; D014095:Tooth, Impacted / Q000601:surgery; D014183:Transplantation, Heterologous; D014945:Wound Healing
D019275:Radiopharmaceuticals; D013669:Technetium Tc 99m Medronate