Focal Osteoporotic Marrow Defect: Report of 100 New Cases with Ultrasonography Scans

Abstract

Focal osteoporotic marrow defect (FOMD) may be the earliest detectable form of the ischemic marrow disorders. The exact cause is unknown, but three theories have been proposed in the literature. A fourth is presented in this paper. In this study, 100 biopsies were examined histologically and were diagnosed as FOMD, based upon consistent histological characteristics. Until recently, the only diagnostic criteria were radiographic evaluation and incisional biopsy. In February 2002, a through-transmission alveolar ultrasonic test (Cavitat 4000, Cavitat Medical Technologies, Inc., Aurora, CO) was approved by the US Food and Drug Administration and by Health Canada for detection of low bone density and bone desiccation, both features of FOMD and chronic ischemic bone disease. Within this article, the diagnostic criteria and pathological findings of FOMD will be presented. The three current theories concerning its etiology will be briefly presented and a fourth theory will be proposed.

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Notes on contributors

Wesley E. Shankland, II

Dr. Wesley E. Shankland, II graduated from the Ohio State University with a B.S. degree, majoring in biochemistry and zoology. He graduated in 1978 with a dental degree from the same university and returned to graduate school and earned an M.S. in 1993 and a Ph.D. in 1997, both in anatomy. He maintains a practice in Columbus, Ohio, limited to the diagnosis and treatment of craniofacial pain and temporomandibular disorders (TMD). Dr. Shankland has written over 100 scientific articles, a manual of head and neck anatomy, chapters in several textbooks, and three books. He is Past President of the American Academy of Craniofacial Pain (formerly the American Academy of Head, Neck, and Facial Pain), a member of the American Academy of Orofacial Pain, the Association of Clinical Anatomists, the American Association for the Advancement of Science, and the Christian Medical and Dental Society. He has lectured throughout the world concerning head and neck anatomy, craniofacial pain, diagnosis of headache pain, soft tissue injuries resulting from motor vehicle accidents, and TMD. He is on the editorial board of four scientific journals and is an Associate Editor of CRANIO: The Journal of Craniomandibular Practice.

Jerry E. Bouquot

Dr. Jerry Bouquot received his D.D.S. and M.S. degrees from the University of Minnesota, with post doctoral fellowships to the Mayo Clinic and the Royal Dental College in Copenhagen, Denmark as the receipient of a Career Development Award from the American Cancer Society. He was on the faculty of West Virginia University for 20 years, 17 years as Chairman of the Department of Oral & Maxillofacial Pathology. Currently, Dr. Bouquot is Professor and Director of Surgical Pathology, University of Texas at Houston. He is also the Director of Head & Neck Diagnostics of America, a national biopsy service with contributors from 44 states and Canada.