Scintigraphy in early detection of mandibular disorders

Technetium methylenediphosphonate scintigraphy was used to study the effect of irradiation on mandibular uptake. Determination of relative mandibular uptake allows comparison of results in different subjects, while determination of individual normalized mandibular uptake increases the significance of differences found in the same subject at different times. A very uniform increase of about 25% was recorded after radiotherapy of about 50 Gy; the uptake returned to pretherapeutic levels in 9 months. Osteoradionecrosis--and especially osteomyelitis--clearly increases the uptakes above the values of the irradiation effect. To increase the usefulness of scintigraphy in the early detection of an imminent complication, we recommend pretherapeutic control scintigraphy in all cases liable to such complications.