CT Imaging Features of Antiresorptive agent-Related Osteonecrosis of the Jaw/ Medication-Related Osteonecrosis of the Jaws.

CT Imaging Features of Antiresorptive agent-Related Osteonecrosis of the Jaw/ Medication-Related Osteonecrosis of the Jaws.

Dentomaxillofac Radiol. 2018 Jan 24;:20170323

Authors: Baba A, Goto TK, Ojiri H, Takagiwa M, Hiraga C, Okamura M, Hasegawa S, Okuyama Y, Ogino N, Yamauchi H, Kobashi Y, Yamazoe S, Munetomo Y, Mogami T, Nomura T

Abstract
OBJECTIVES: Antiresorptive agent-related osteonecrosis of the jaw (ARONJ)/medication-related osteonecrosis of the jaw (MRONJ) include both bisphosphonate-related osteonecrosis of jaw (BRONJ) and denosumab-related osteonecrosis of jaw (DRONJ). The purpose of this study is to study radiological characteristics of ARONJ/MRONJ.　These imaging features may serve as one useful aid for assessing ARONJ/MRONJ.
METHODS: CT scans of 74 Japanese patients, who were clinically diagnosed by inclusion criteria of ARONJ/MRONJ, obtained between April 1, 2011 and September 31, 2016, were evaluated. We investigated the CT imaging features of ARONJ/MRONJ, and clarified radiological differentiation between BRONJ and DRONJ, BRONJ due to oral bisphosphonate administration and due to intravenous bisphosphonate administration, BRONJ with respective kinds of medication, BRONJ with long-term administration and short-term administration, BRONJ with each clinical staging respectively.　Fisher's exact test, chi-square test, Student's t-test and analysis of variance were performed in the statistical analyses.
RESULTS: Unilateral maxillary sinusitis was detected in all patients with upper ARONJ/MRONJ (100%). DRONJ showed large sequestrum more frequently than BRONJ (3/4, 75 % vs. 3/35, 8.6 %, p<0.05). DRONJ showed periosteal reaction more frequently than BRONJ (4/10, 40 % vs. 7/65, 10.1 %, p < 0.05). Patients of BRONJ resulting from intravenous bisphosphonate administration showed larger and more frequent buccolingual cortical bone perforations than BRONJ resulting from oral bisphosphonate administration (7/8, 87.5 % vs. 11/30, 36.7 %, p < 0.05). There was no significant correlation between CT findings and respective kinds of medication, long/short-term administration, clinical stages of BRONJ.
CONCLUSION: ARONJ/MRONJ has characteristic CT image findings which could be useful for its assessment.

PMID: 29365278 [PubMed - as supplied by publisher]

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