Role of three-phase bone scintigraphy and fluorodeoxyglucose positron emission tomography in monitoring hyperbaric oxygen therapy combined with conservative surgery for refractory osteomyelitis

Authors

• Yu Nakai, Department of Oral Diagnosis and Medicine, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
• Ken-ichiro Sakata, Department of Oral Diagnosis and Medicine, Faculty of Dental Medicine, Hokkaido University, Sapporo, JapanFollow
• Masayuki Shinohara, Department of Oral Diagnosis and Medicine, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
• Yusuke Nakamura, Department of Oral Diagnosis and Medicine, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
• Keisuke Nakamura, Department of Oral Diagnosis and Medicine, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
• Tougo Tanabe, Department of Oral Diagnosis and Medicine, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
• Taku Kimura, Department of Oral Diagnosis and Medicine, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
• Takuya Asaka, Department of Oral Diagnosis and Medicine, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
• Jun Sato, Department of Oral Diagnosis and Medicine, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
• Yoshimasa Kitagawa, Department of Oral Diagnosis and Medicine, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan

First Page

1608

Last Page

1617

Abstract

Background/purpose: The anti-inflammatory effect of hyperbaric oxygen therapy (HBOT) on osteomyelitis of the jaw has not been sufficiently quantified. In this study, we aimed to quantitatively evaluate the effects of HBOT and postoperative disease status in patients with jaw osteomyelitis treated with minimally invasive surgery combined with HBOT using nuclear medicine imaging.

Materials and methods: The study included 11 patients who underwent sequestrectomy or saucerization and preoperative HBOT in our department between 2008 and 2015. The underlying etiologies were dental infection-related osteomyelitis (four cases; hereinafter ODONT group), osteoradionecrosis (four cases; hereinafter ORN group), or medication-related osteonecrosis of the jaw (three cases; hereinafter medication-related osteonecrosis of the jaw (MRONJ) group). Quantitative assessments were performed using SUVmax from fluorodeoxyglucose positron emission tomography (FDG-PET) and region-of-interest measurements from bone scintigraphy obtained before and after HBOT. Mean values and standard deviations were calculated, and pre- to post-treatment differences were defined as changes. Clinical cure was defined as the absence of symptom recurrence at 3 months postoperatively.

Results: The overall cure rate at 3 months postoperatively was 90.9% (10/11 cases). The greatest magnitude of change was observed in the ODONT group for FDG-PET and in the ORN group for bone scintigraphy. Furthermore, post-treatment variability tended to be greater than pretreatment variability in the ORN group for FDG-PET and in the MRONJ group for bone scintigraphy.

Conclusion: Nuclear medicine imaging may be helpful for quantitatively assessing the therapeutic effect of HBOT in jaw osteomyelitis and may contribute to improved treatment response evaluation.

Recommended Citation

Nakai, Yu; Sakata, Ken-ichiro; Shinohara, Masayuki; Nakamura, Yusuke; Nakamura, Keisuke; Tanabe, Tougo; Kimura, Taku; Asaka, Takuya; Sato, Jun; and Kitagawa, Yoshimasa (2026) "Role of three-phase bone scintigraphy and fluorodeoxyglucose positron emission tomography in monitoring hyperbaric oxygen therapy combined with conservative surgery for refractory osteomyelitis," Journal of Dental Sciences: Vol. 21: Iss. 3, Article 28.
Available at: https://jds.ads.org.tw/journal/vol21/iss3/28

Publication Date

2026