Radiographic Predictors of Bone Exposure in Patients with Stage 0 Medication-related Osteonecrosis of the Jaws

Overview

Journal Oral Surg Oral Med Oral Pathol Oral Radiol

Publisher Elsevier

Specialties Dentistry
General Surgery

Date 2018 Sep 30

PMID 30266375

Citations 16

Authors

Akrivoula Soundia

Danny Hadaya

Sanjay M Mallya

Tara L Aghaloo

Sotirios Tetradis

Affiliations

Soon will be listed here.

Abstract

Objective: The aim of this study was to explore the radiographic appearance of stage 0 medication-related osteonecrosis of the jaws (MRONJ) and examine 5 radiographic parameters (trabecular sclerosis, cortical erosion, periosteal reaction, sequestration, and crater-like defect) as predictors of progression to bone exposure.

Study Design: Twenty-three patients with a history of antiresorptive therapy, no bone exposure, and nonspecific signs and symptoms were included. Intraoral photographs, panoramic and cone beam computed tomography (CBCT) images at initial visit, and follow-up intraoral photographs were reviewed. Three patients had dental disease (DD), 10 patients with stage 0 MRONJ did not progress to bone exposure (NBE), and 10 patients progressed to bone exposure (BE). Radiographic parameters were scored as absent (0), localized (1), or extensive (2), and their sum formed the composite radiographic index (CRI).

Results: DD patients demonstrated minimal radiographic findings, and their CRI was significantly lower than that of NBE and BE patients. Additionally, BE patients demonstrated a higher radiographic index compared with NBE patients. Intriguingly, sequestration was observed in the initial CBCT of 9 (90%) of 10 BE patients, whereas 80% of NBE patients showed absence of sequestration at initial CBCT examination.

Conclusions: CBCT imaging can aid in the differentiation of stage 0 MRONJ from dental disease. Radiographic sequestration at initial presentation can serve as a predictor of future bone exposure in patients with stage 0 MRONJ.

Citing Articles

The Role of Cone Beam Computed Tomography (CBCT) in the Diagnosis and Clinical Management of Medication-Related Osteonecrosis of the Jaw (MRONJ).

Ko Y, Yang W, Leung Y Diagnostics (Basel). 2024; 14(16).

PMID: 39202187 PMC: 11353876. DOI: 10.3390/diagnostics14161700.

Comparison of quantitative radiomorphometric predictors of healthy and MRONJ-affected bone using panoramic radiography and cone-beam CT.

Aslan E, Onem E, Mert A, Baksi B Dentomaxillofac Radiol. 2024; 53(6):407-416.

PMID: 38810135 PMC: 11358619. DOI: 10.1093/dmfr/twae024.

Pathophysiology of Medication-Related Osteonecrosis of the Jaw-A Minireview.

Tetradis S, Allen M, Ruggiero S JBMR Plus. 2023; 7(8):e10785.

PMID: 37614299 PMC: 10443081. DOI: 10.1002/jbm4.10785.

Quantitative indices for cone-beam CT assessment of Medication-Related Osteonecrosis of the Jaw - a scoping review.

Badabaan G, Creanga A, Singer S, Strickland M, Subramanian G Saudi Dent J. 2023; 35(2):133-140.

PMID: 36942207 PMC: 10024109. DOI: 10.1016/j.sdentj.2022.12.012.

Inhibition of HMGB1/RAGE Signaling Reduces the Incidence of Medication-Related Osteonecrosis of the Jaw (MRONJ) in Mice.

Gkouveris I, Hadaya D, Elzakra N, Soundia A, Bezouglaia O, Dry S J Bone Miner Res. 2022; 37(9):1775-1786.

PMID: 35711109 PMC: 9474692. DOI: 10.1002/jbmr.4637.

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