Bisphosphonate-Related Osteonecrosis of the Jaw Bone: Radiological Pattern and the Potential Role of CBCT in Early Diagnosis
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...
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| Format: | Article |
| Language: | English |
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Lithuanian University of Health Sciences, Faculty of Odontology
2010-04-01
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| Series: | eJournal of Oral Maxillofacial Research |
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| Online Access: | http://www.ejomr.org/JOMR/archives/2010/2/e3/e3ht.pdf |
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| author | James Olutayo Jimoh Olubanwo Agbaje Reinhilde Jacobs Vicky Verhaeghe Filip Vande Velde Frans Vinckier |
| author_facet | James Olutayo Jimoh Olubanwo Agbaje Reinhilde Jacobs Vicky Verhaeghe Filip Vande Velde Frans Vinckier |
| author_sort | James Olutayo |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-5d63c8812ec44ea6a11b42e388328209 |
| institution | DOAJ |
| issn | 2029-283X |
| language | English |
| publishDate | 2010-04-01 |
| publisher | Lithuanian University of Health Sciences, Faculty of Odontology |
| record_format | Article |
| series | eJournal of Oral Maxillofacial Research |
| spelling | doaj-art-5d63c8812ec44ea6a11b42e3883282092025-08-20T02:53:18ZengLithuanian University of Health Sciences, Faculty of OdontologyeJournal of Oral Maxillofacial Research2029-283X2010-04-0112e3Bisphosphonate-Related Osteonecrosis of the Jaw Bone: Radiological Pattern and the Potential Role of CBCT in Early DiagnosisJames OlutayoJimoh Olubanwo AgbajeReinhilde JacobsVicky VerhaegheFilip Vande VeldeFrans VinckierObjectives: 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.http://www.ejomr.org/JOMR/archives/2010/2/e3/e3ht.pdfbisphosphonatesjawosteonecrosiscone-beam CTearly diagnosis |
| spellingShingle | James Olutayo Jimoh Olubanwo Agbaje Reinhilde Jacobs Vicky Verhaeghe Filip Vande Velde Frans Vinckier Bisphosphonate-Related Osteonecrosis of the Jaw Bone: Radiological Pattern and the Potential Role of CBCT in Early Diagnosis eJournal of Oral Maxillofacial Research bisphosphonates jaw osteonecrosis cone-beam CT early diagnosis |
| title | Bisphosphonate-Related Osteonecrosis of the Jaw Bone: Radiological Pattern and the Potential Role of CBCT in Early Diagnosis |
| title_full | Bisphosphonate-Related Osteonecrosis of the Jaw Bone: Radiological Pattern and the Potential Role of CBCT in Early Diagnosis |
| title_fullStr | Bisphosphonate-Related Osteonecrosis of the Jaw Bone: Radiological Pattern and the Potential Role of CBCT in Early Diagnosis |
| title_full_unstemmed | Bisphosphonate-Related Osteonecrosis of the Jaw Bone: Radiological Pattern and the Potential Role of CBCT in Early Diagnosis |
| title_short | Bisphosphonate-Related Osteonecrosis of the Jaw Bone: Radiological Pattern and the Potential Role of CBCT in Early Diagnosis |
| title_sort | bisphosphonate related osteonecrosis of the jaw bone radiological pattern and the potential role of cbct in early diagnosis |
| topic | bisphosphonates jaw osteonecrosis cone-beam CT early diagnosis |
| url | http://www.ejomr.org/JOMR/archives/2010/2/e3/e3ht.pdf |
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