Bisphosphonate-related osteonecrosis of the jaw: clinical correlations with computerized tomography presentation

Clin Oral Investig. 2010 Feb;14(1):43-50. doi: 10.1007/s00784-009-0311-3. Epub 2009 Jul 15.

Abstract

The aim of this study was to correlate clinical and computerized tomography (CT) features of bisphosphonate-related osteonecrosis of the jaws (BRONJ). All ONJ patients for whom there was complete CT scan imaging were eligible. Selected clinical parameters retrieved from their medical records were analyzed for correlation with CT parameters. The clinical presentation of BRONJ was supported by findings in CT imaging in 78.3%. The lesion's size on CT correlated with the presence of purulent secretion (p = 0.03). When sequestrum was present, the median lesion's size on CT was relatively big (28 mm, range 21-43 mm). The mandibular canal cortex was never breached. CT has reasonable detection competence for diagnosing BRONJ. Purulent secretion indicates the likelihood that a more extensive involvement will be displayed on CT. A large lesion on CT should raise the index of suspicion for sequestrum. The CT appearance of a continuous cortex of the mandibular canal may serve as a differential parameter between BRONJ and metastasis to the jaw.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Bone Density Conservation Agents / adverse effects*
  • Diphosphonates / adverse effects*
  • Female
  • Humans
  • Jaw Diseases / chemically induced
  • Jaw Diseases / diagnostic imaging*
  • Jaw Diseases / pathology
  • Male
  • Middle Aged
  • Osteonecrosis / chemically induced
  • Osteonecrosis / diagnostic imaging*
  • Osteonecrosis / pathology
  • Tomography, X-Ray Computed

Substances

  • Bone Density Conservation Agents
  • Diphosphonates