Added diagnostic value of SPECT/CT for detecting periapical and periodontal inflammation in patients with medication-related osteonecrosis of the jaw.

OBJECTIVE: Single-photon emission computed tomography/computed tomography (SPECT/CT) has recently gained widespread acceptance as a valuable diagnostic tool in dentistry. The aim of this study was to determine whether SPECT/CT provides added value in dental focus assessment.

MATERIALS AND METHODS: Twenty-one patients with medication-related osteonecrosis of the jaw (MRONJ) underwent panoramic radiography and SPECT/CT. The maximum and mean standardized uptake values (SUVs) were calculated for quantitative analysis of 99mTc- hydroxymethylene diphosphonate uptake. The maximum and mean SUVs obtained from SPECT/CT were compared between periapical and periodontal inflammatory areas and healthy tissues. SPECT/CT parameters were analyzed using the Mann-Whitney U test. Statistical significance was set at p < 0.05.

RESULTS: The maximum SUVs for areas without inflammation (4.39 ± 1.41) were significantly lower than those for periapical and periodontal inflammatory areas (7.53 ± 3.54, p < 0.001). The mean SUVs showed a similar trend (areas without inflammation, 2.03 ± 0.61; periapical and periodontal inflammation, 3.21 ± 1.36, p < 0.001).

CONCLUSION: Bone SPECT/CT may provide additional metabolic information on dental diseases, such as periapical inflammation and periodontal disease, thereby helping to identify areas of inflammation in the maxilla and mandible.