Clinical, Cosmetic and Investigational Dentistry (Jun 2020)
Ultrasound Sonography to Detect Focal Osteoporotic Jawbone Marrow Defects: Clinical Comparative Study with Corresponding Hounsfield Units and RANTES/CCL5 Expression
Abstract
Johann Lechner,1 Bernd Zimmermann,2 Marlene Schmidt,3 Volker von Baehr4 1Department of Clinical Research, Clinic Integrative Dentistry, Munich, Germany; 2Medical Devices, QINNO, Wessling, Germany; 3Department of Statistics, STEYR Motorenwerke, Steyr, Austria; 4Department of Immunology and Allergology, Institute for Medical Diagnostics Berlin, GermanyCorrespondence: Johann Lechner Tel +49-89-6970129Fax +49-89-6925830Email [email protected]: The presently used impulse echo ultrasound examination is not suitable to provide relevant and reliable information about the jawbone, because ultrasound (US) almost completely reflects from the hard cortical jawbone. At the same time, “focal osteoporotic bone marrow defects” (BoneMarrowDefects = BMD) in jawbone are the subject of scientific presentations and discussions.Purpose: Can a newly developed trans-alveolar ultrasonic sonography (TAU-n) device locate and ascertain BMD?Patients and Methods: TAU-n consists of a two-part handpiece with an extraoral ultrasound transmitter and an intraoral ultrasound receiver. The TAU-n computer display shows the different jawbone densities with corresponding colour coding. The changes in jawbone density are also displayed numerically. The validation of TAU-n readings: A usual orthopantomogram (2D-OPG) on its own is not suitable for unequivocally determining jawbone density and has to be excluded from this validation. For validation, a 3D-digital volume tomogram/cone beam computer tomogram (DVT/CBCT) with the capacity to measure Hounsfield units (HU) and a TAU-n are used to determine the presence of preoperative BMD in 82 patient cases. Postoperatively, histology samples and multiplex analysis of RANTES/CCL5 (R/C) expression derived from surgically cleaned BMD areas are evaluated.Results: In all 82 bone samples, DVT-HU, TAU-n values and R/C expressions show the presence of BMD with chronic inflammatory character. However, five histology samples showed no evidence of BMD. All four evaluation criteria (DVT-HU, TAU-n, R/C, histology) confirm the presence of BMD in each of the 82 samples.Conclusion: The TAU-n method almost completely matches the diagnostic reliability of the other methods. The newly developed TAU-n scanner is a reliable and radiation-free option to detect BMD.Keywords: trans-alveolar ultrasonography, cone beam computed tomography, RANTES/CCL5, Hounsfield units, cavitational osteonecrosis of jawbone
