CT imaging features of antiresorptive agent-related osteonecrosis of the jaw/medication-related osteonecrosis of the jaw.

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 30, 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, χ2 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.

CONCLUSIONS:

ARONJ/MRONJ has characteristic CT image findings which could be useful for its assessment.

• Authors: Akira Baba, Tazuko K Goto, Hiroya Ojiri, Mutsumi Takagiwa, Chiho Hiraga, Masahiro Okamura, Sho Hasegawa, Yumi Okuyama, Nobuhiro Ogino, Hideomi Yamauchi, Yuko Kobashi, Shinji Yamazoe, Yohei Munetomo, Takuji Mogami, Takeshi Nomura
• Journal: Dento maxillo facial radiology (Dentomaxillofac Radiol) Vol. 47 Issue 4 Pg. 20170323 (May 2018) ISSN: 0250-832X [Print] England
• PMID: 29365278 (Publication Type: Journal Article)

Chemical References

• Bone Density Conservation Agents
• Diphosphonates
• Denosumab

Topics

• Aged
• Bisphosphonate-Associated Osteonecrosis of the Jaw (diagnostic imaging)
• Bone Density Conservation Agents (adverse effects)
• Denosumab (adverse effects)
• Diphosphonates (adverse effects)
• Female
• Humans
• Japan
• Male
• Retrospective Studies
• Tomography, X-Ray Computed (methods)