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2010 Apr-Jun; Vol 1, No 2:e3 |
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Bisphosphonate-Related Osteonecrosis of the Jaw Bone: Radiological Pattern and the Potential Role of CBCT in Early Diagnosis J Oral Maxillofac Res 2010 (Apr-Jun);1(2):e3 doi:10.5037/jomr.2010.1203 |
Bisphosphonate-Related Osteonecrosis of the Jaw Bone: Radiological Pattern and the Potential Role of CBCT in Early Diagnosis
1Oral Imaging Center, Department of Dentistry, Oral Pathology and Maxillofacial Surgery, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium
2Department of Dentistry, Faculty of Clinical Sciences, University of Maiduguri, Maiduguri, Nigeria
3Department of Paediatric Dentistry and Special Dental Care, School of Dentistry, Oral Pathology and Maxillofacial Surgery, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium
4Private Periodontologist, Antwerp, Belgium.
Corresponding author:
Department of Dentistry, Faculty of Clinical Sciences
University of Maiduguri
P.M.B. 1069, Maiduguri
Nigeria
E-mail: olutayo.james@gmail.com
ABSTRACT
Objectives: To systematize the clinico-radiological symptoms and course of bisphosphonate-related osteonecrosis of jaw bone and to evaluate the diagnostic potential of various radiological techniques to detect mild osteonecrosis in each stage of the disease.
Material and Methods: The sample consisted of 22 patients previously diagnosed with extraoral malignant disease. Diagnosis was based on a clinical examination in conjunction to digital panoramic radiography and cone beam computed tomography (CBCT). Two dentomaxillofacial radiologists reviewed all images.
Results: Twenty patients showed mandibular involvement clinically, while two others had a maxillary involvement. Four stages of the disease were proposed based on the clinico-radiological findings. Subclinical cortical and lamina dura thickening was detected with only three-dimensional CBCT and periapical images, while ulceration and cortical bone thickening was detected only by three-dimensional CBCT. Mixed sclerotic, lytic bone destruction involving alveolar and basal bone with or without encroachment on the mandibular canal, pathological mandibular fractures were detected by two-dimensional panoramic and three-dimensional CBCT images. Other findings are non healing extraction sockets, periapical radiolucencies, osteolysis, sequestra, oroantral fistula, and periosteal new bone formation.
Conclusions: The present study showed that bisphosphonate-related osteonecrosis of jaw bone occurs in four distinct clinico-radiological stages. For mild cases, panoramic image diagnosis was much less obvious, whereas cone beam computed tomography was able to fully characterise the bony lesions and describe their extent and involvement of neighbouring structures in all cases. Thus cone beam computed tomography might better contribute to the prevention of bisphosphonate-related osteonecrosis of jaw bone as well to the disease management.
J Oral Maxillofac Res 2010 (Apr-Jun);1(2):e3
doi:10.5037/jomr.2010.1203
Accepted for publication: 30 March 2010
Keywords: bisphosphonates; osteonecrosis jaw; cone-beam CT; early diagnosis.
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To cite this article: Bisphosphonate-Related Osteonecrosis of the Jaw Bone: Radiological Pattern and the Potential Role of CBCT in Early Diagnosis. J Oral Maxillofac Res 2010;1(2):e3 |
Received: 16 December 2009 | Accepted: 30 March 2010 | Published: 1 July 2010
Copyright: © The Author(s). Published by JOMR under CC BY-NC-ND 3.0 licence, 2010.