Bone scintigraphy as an adjunct for the diagnosis of oral diseases

Bone scintigraphy is a very sensitive method for the detection of osteoblastic activity of the skeleton. The technique consists of imaging the uptake of bone-seeking radiopharmaceuticals, particularly technetium-99m labeled diphosphonates, in the mineral component of bone, which consists of hydroxyapatite crystals and calcium phosphate, as well as in the organic matrix such as collagen fibers. Plain radiographs, computed tomography, and magnetic resonance imaging are classified as structural imaging modalities, whereas bone scintigraphy is a functional method. In many cases, radionuclide imaging techniques are the only means by which early physiologic changes that are a direct result of biochemical alteration may be assessed, before significant bone mineral changes can be detected by other means. Since many oral diseases may cause metabolic changes in the oromaxillofacial complex, it would be of great value to use bone scintigraphy to evaluate more completely some conditions involving the bones in the region to formulate more appropriate treatment plans. Based upon the current literature, the authors discuss the possible applications of bone scintigraphy as a diagnostic and treatment planning adjunct for oral diseases. Bone scintigraphy has proven particularly useful in the study of malignant lesions and in the evaluation of vascularized bone grafts used for maxillofacial reconstructions.