Quantitative ultrasound at the hand phalanges in patients with bisphosphonate-related osteonecrosis of the jaws

Motta, Ana Carolina Fragoso; Macedo, Leandro Dorigan de; Santos, Gisele Guimarães; Guerreiro, Carlos Tostes; Ferrari, Tatiane Cristina; Oliveira, Thaís Feitosa Leitão de; Santos, Paulo Sérgio da Silva; Oliveira‐Santos, Christiano; Ricz, Hilton Marcos Alves; Xavier, Samuel Porfírio; Iannetta, Odilon

doi:10.1590/1807-3107bor-2015.vol29.0106

Cited by 3 publications

(2 citation statements)

References 28 publications

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“…This leads us to believe the qualitative bone aspects in both groups were similar, and, if anything, never worse in patients with ONJ than in those taking bisphosphonates. Some authors have described low values of ultrasound parameters in patients with ONJ 41 , but as with densitometry in ONJ, there are very few studies similar to ours with which to make comparisons. If we take into account that the control patients took bisphosphonates for a long time and considering that bisphosphonates improve bone quantity and quality 42,43 , the higher values of BMD, TBS, SOS and QUI in patients with ONJ could indicate that the general bone health of these patients is adequate.…”

Section: Discussionmentioning

confidence: 65%

Estado cualitativo y cuantitativo óseo generalizado en la osteonecrosis de maxilares. Efecto de los bifosfonatos

Quintana-González

Quintana-Montesdeoca

Tejada-Romero

et al. 2019

Rev Osteoporos Metab Miner

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Objetive: Osteonecrosis of the jaw (ONJ) is a recently reported disease whose origin and development are unknown, although prolonged bisphosphonate treatment has been attributed, among other causes. While ONJ is a localized condition, the action of bisphosphonates is widespread and affects all bones. No studies show the general bone status of patients with ONJ. Our study examines the general condition in patients with ONJ using quantitative measurements and qualitative estimates of bone by means of bone mineral density (BMD) and trabecular bone score (TBS) and ultrasound parameters in the calcaneus (QUS), along with other diseases and the taking of drugs (especially bisphosphonates) in patients with ONJ who may be involved in the pathogenesis. Material and method: Observational and cross-sectional study of cases and controls, conducted in 304 patients of both sexes, in which the case group (group I) was formed by 24 patients who had suffered ONJ. The control group (group II) contained 280 patients who did not present ONJ and who received bisphosphonates over at least 5 years for various reasons. All of them underwent bone densitometry (DXA, Hologic 4500 Discovery ®) in the lumbar spine and proximal femur. In addition, TBS measurements were made in the lumbar spine, as well as ultrasound parameters in the calcaneus (Hologic, Sahara ®) in the dominant foot (QUS). Results: Patients suffering ONJ presented greater comorbidity than controls, with a higher prevalence of diabetes mellitus, cancer, rheumatoid arthritis, hyperthyroidism, heart disease, arrhythmias, heart failure and hypercholesterolemia. Therefore, the consumption of corticosteroids, (oral and inhaled), anticoagulants, hypnotics, bisphosphonates i.v. (zoledronate), and antineoplastic chemotherapy was also higher among patients with ONJ than control patients. However, among the patients with ONJ the percentage taking oral bisphosphonates was lower. Densitometric values (BMD measured in lumbar spine L2-L4, femoral neck and total hip) were higher in patients with ONJ compared to those in controls. The TBS showed no statistically significant differences between the two groups, and the ultrasound showed higher values of QUI and SOS in patients with ONJ than in controls. The prevalence of fragility fractures was similar in both groups. Conclusions: Patients with ONJ in our study presented greater comorbidity and a higher consumption of drugs than the patients in the control group, except for oral bisphosphonates. On the other hand, both BMD and ultrasound showed higher values in patients with ONJ than in controls. If we consider DXA as a technique for measuring the amount of bone mass, and TBS and calcaneal ultrasound estimating qualitative aspects of bone, we could assume that neither bone quantity nor quality in general seems to be affected in ONJ, and that its etiopathogenic mechanism is probably another. Oral bisphosphonates do not appear to be among the drugs involved in ONJ's origin and development, but the most potent and intravenously administered bisph...

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Section: Discussionmentioning

confidence: 65%

Estado cualitativo y cuantitativo óseo generalizado en la osteonecrosis de maxilares. Efecto de los bifosfonatos

Quintana-González

Quintana-Montesdeoca

Tejada-Romero

et al. 2019

Rev Osteoporos Metab Miner

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“…9,19 PR has also been used in the assessment of increased trabecular bone density, thickening of the mandibular canal cortices and osteosclerosis of the sinus floor caused by medications. 12,20 Some studies correlate the increase in the lamina…”

Section: Medication-related Osteonecrosis Of the Jaw (Mronj)mentioning

confidence: 99%

Imaging modalities in medication-related osteonecrosis of the jaw

et al. 2020

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Osteonecrosis occurs by cellular death of the bone tissue due to an irreversible external factor. This disorder may be clinically unidentified in the early stages and result in degradation of the bone architectural structure, leading to pain, bone destruction, and loss of function. Thus, imaging exams become relevant to the recognition and definition of the bone necroses. The aim of this study was to review the literature on imaging exams frequently used for the diagnosis and evaluation of patients undergoing drug therapies associated with osteonecrosis of the jaw, such as panoramic radiography, computed tomography, magnetic resonance imaging and bone scintigraphy.

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Panoramic radiographs and quantitative ultrasound of the radius and phalanx III to assess bone mineral status in postmenopausal women

Grocholewicz¹,

Janiszewska‐Olszowska²,

Aniko-Włodarczyk³

et al. 2018

BMC Oral Health

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BackgroundVarious mandibular indices have been developed to detect osteoporosis on panoramic radiographs. Quantitative ultrasound (QUS) is a low-cost, radiation-free method to assess bone status. The aim of this study was to compare mandibular morphometric analysis and QUS at the radius and proximal phalanx III finger.MethodsThe study involved 97 postmenopausal women, aged 48.5–71.5y (mean: 55.4). Mandibular morphometric analysis comprised: distance between upper and lower mandibular borders just behind the mental foramen (H), distance: mental foramen - inferior mandibular cortex (IM) and mandibular cortical width at the mental region (MCW). Then, ratios were calculated: MCW/IM = PMI (panoramic mandibular index), H/IM = MR (mandibular ratio). Mandibular cortical index (MCI) was used to classify the morphology of the mandibular cortex.Bone mineral status assessed using QUS at the radius and proximal phalanx III finger was compared to population mean apical bone mass (T-score).Linear regression analysis was used for correlations between continuous variables, Pearson’s correlation coefficient r - for variables of normal distribution. Student’s t-test was used to compare variables of normal distribution and for the latter - Mann-Whitney U-test. The level of significance was p < 0.05.ResultsMandibular height was 13.42–34.42 mm. The mean mandibular cortical width was 3.31 mm. Mean values of PMI and MR were 0.33 and 2.57, respectively. Higher mean value of Ad-SoS was found in the radius than in the III finger. Phalanx T-score values were lower than those of the radius. T-score of the radius was < − 1.0 in 22 patients, indicating osteopenia. Basing on phalanx T-score, osteopenia was found in 39 patients. Category C1 of Mandibular Cortical Index was found in 48 women, C2 - in 37 women and C3 - in 12 women. Higher scores of Mandibular Cortical Index were recorded in older women. MCI significantly correlated with the skeletal status (p = 0.01) as well as with H, MCW and MR. Phalanx T-score was not correlated to PMI, MR or MCW.Conclusions1. Mandibular Cortical Index can be used as a screening tool for detecting osteoporosis.2. Quantitative ultrasound at the phalanx III constitutes a reliable way of assessing bone status.Electronic supplementary materialThe online version of this article (10.1186/s12903-018-0593-4) contains supplementary material, which is available to authorized users.

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Quantitative ultrasound at the hand phalanges in patients with bisphosphonate-related osteonecrosis of the jaws

Cited by 3 publications

References 28 publications

Estado cualitativo y cuantitativo óseo generalizado en la osteonecrosis de maxilares. Efecto de los bifosfonatos

Estado cualitativo y cuantitativo óseo generalizado en la osteonecrosis de maxilares. Efecto de los bifosfonatos

Imaging modalities in medication-related osteonecrosis of the jaw

Panoramic radiographs and quantitative ultrasound of the radius and phalanx III to assess bone mineral status in postmenopausal women

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