Clinical factors associated with jawbone remineralization after nonsurgical treatment and imaging-based insights into its processes.

Objectives: This study aimed to clarify the clinical factors and processes associated with jawbone remineralization at sites of tumor-induced bone destruction after nonsurgical treatment by analyzing clinical factors, computed tomography (CT) values, and positron emission tomography (PET)/CT images.

Methods: The data of 58 patients with jawbone destruction due to oral tumors or metastatic lesions who received radiation therapy or chemotherapy were retrospectively analyzed. Clinical factors, treatment modalities, and CT and PET/CT images at the time of bone destruction and remineralization were analyzed. CT values were measured at 0, 3, 6, and 12 months after treatment, and the ratios to the reference values were calculated.

Results: Among the 58 patients studied, 23 had remineralization, 25 showed no significant changes, and 10 had progressive bone resorption. Significant factors influencing remineralization included age, tumor histology, site of jawbone destruction, type of bone destruction, and radiation dose. The mean CT values at the remineralized sites increased progressively, and significant age- and sex-related differences were observed at 12 months. Patients younger than 18 years had CT values and bone-morphology changes comparable to reference sites. Post-treatment PET/CT revealed significant ¹⁸F-FDG accumulation with metabolic activity patterns resembling those of bone remineralization.

Conclusions: Bone remineralization following jawbone destruction is influenced by patient-specific characteristics and treatment-related factors. Changes in CT values during bone remineralization and metabolic activity detected using PET/CT provide insights into the underlying processes of bone remineralization.

Trial registration: Registration number: E2023-0253. Registration date: February 19, 2024 (Hiroshima University Epidemiological Research Ethics Committee).