Mechanobiological bone reaction quantified by positron emission tomography

Area of Science:

• Biomedical Engineering
• Nuclear Medicine
• Orthodontics

Background:

• Bone turnover changes due to stress injury are clinically assessed using nuclear medicine.
• Quantitative links between tracer uptake and mechanical forces in human jawbones are not well understood.

Purpose of the Study:

• To investigate the relationship between bone metabolism (via 18F-fluoride PET) and mechanical stimuli (via FEA) in the residual ridge after removable partial denture (RPD) insertion.

Main Methods:

• 18F-fluoride PET/CT scans assessed bone metabolism before and after RPD treatment.
• Patient-specific 3D finite element (FE) models were created from CT data.
• Mechanical stimuli (stress, strain, strain energy density) were calculated using FEA and compared to PET standardized uptake values (SUVs).

Main Results:

• RPD insertion increased occlusal forces, leading to higher mechanical stimuli in the residual bone.
• Increased SUVs in PET scans corresponded to regions with higher mechanical stimuli.
• A strong correlation (R² > 0.8, P < 0.001) was found between SUV and von Mises stress (VMS) and strain energy density (SED) in cancellous bone post-RPD insertion.

Conclusions:

• A significant correlation exists between bone metabolism and mechanical stimuli in the jawbone following RPD insertion.
• PET/CT scans and FEA can detect metabolic changes in loaded bone rapidly, offering a new, non-destructive method for monitoring bone remodeling.
• This patient-specific approach aids in understanding and managing prosthetically driven bone remodeling.