https://orcid.org/0000-0001-9800-0276
Abstract
Introduction
The presently used impulse echo ultrasound examination is not suitable to provide relevant and reliable information about the jawbone, because ultrasound (US) almost completely reflects from the hard cortical jawbone. At the same time, “focal osteoporotic bone marrow defects” (BoneMarrowDefects = BMD) in jawbone are the subject of scientific presentations and discussions.
Purpose
Can a newly developed trans-alveolar ultrasonic sonography (TAU-n) device locate and ascertain BMD?
Patients and Methods
TAU-n consists of a two-part handpiece with an extraoral ultrasound transmitter and an intraoral ultrasound receiver. The TAU-n computer display shows the different jawbone densities with corresponding colour coding. The changes in jawbone density are also displayed numerically. The validation of TAU-n readings: A usual orthopantomogram (2D-OPG) on its own is not suitable for unequivocally determining jawbone density and has to be excluded from this validation. For validation, a 3D-digital volume tomogram@/cone beam computer tomogram (DVT@/CBCT) with the capacity to measure Hounsfield units (HU) and a TAU-n are used to determine the presence of preoperative BMD in 82 patient cases. Postoperatively, histology samples and multiplex analysis of RANTES@/CCL5 (R@/C) expression derived from surgically cleaned BMD areas are evaluated.
Results
In all 82 bone samples, DVT-HU, TAU-n values and R/C expressions show the presence of BMD with chronic inflammatory character. However, five histology samples showed no evidence of BMD. All four evaluation criteria (DVT-HU, TAU-n, R/C, histology) confirm the presence of BMD in each of the 82 samples.
Conclusion
The TAU-n method almost completely matches the diagnostic reliability of the other methods. The newly developed TAU-n scanner is a reliable and radiation-free option to detect BMD.
Abbreviations
AIOJ, Aseptic-Ischemic Osteonecrosis of Jawbone; BMD, Bone Marrow Defects; CBCT, Cone Beam Computed Tomography; CCL5, Chemokine (C-C motif) ligand 5; DVT, Digital Volume Tomography; FDOJ, Fatty-Degenerative Osteonecrosis/Osteolysis of Jawbone; HU, Hounsfield Units; Log, logarithmic; OPG, Orthopantomogram; R/C, RANTES/CCL5; RANTES, Regulated on Activation, Normal T cell Expressed and Secreted; TAU, Trans-Alveolar Ultrasonography; TAU-n, New Trans-Alveolar Ultrasonography Device; US, Ultrasound.
Acknowledgments
English-language editing of this manuscript was provided by Journal Prep and Dr. Elmar Jung.
Disclosure
CaviTAU® (Munich, Germany), the company that designed the new TAU-n apparatus and associated software, provided these tools without charge for the purposes of this study. The ultrasonography procedure was carried out at the Clinic for Integrative Dentistry Munich. CaviTAU® and the Clinic for Integrative Dentistry are in ongoing discussions regarding numerous collaborative arrangements to further improve and verify the new TAU apparatus, CaviTAU®, as it is introduced to the market. Dr. Johann Lechner is the holder of a patent PCT/EP2018/084199 used in CaviTAU®. The authors report no other conflicts of interest in this work.