Antiresorptiva-assoziierte Kiefernekrosen

Smielowski, Maximilian; Hoffmann, Jürgen; Ristow, Oliver

doi:10.1007/s12614-023-1119-2

Cited by 2 publications

(5 citation statements)

References 15 publications

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“…Furthermore, radiation protection is an issue when it comes to determining which modality is necessary when and how often progress controls are useful. As a result of this discussion, many international guidelines do not give clear recommendations but leave the decision open to the practitioner (Di Fede et al, 2018; Schiegnitz et al, 2018; Schiodt et al, 2019; Svejda et al, 2016; Yoneda et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

“…Vital bone was defined as osteocytes in lacunae with only focal non‐vital areas ±osseous infection signs (Kassolis et al, 2010). All surgical tooth extractions were performed by the same surgeons following the standardized and published protocol (Ristow et al, 2020) and in compliance with the following risk‐reduction measures for patients while and after undergoing AR treatment (Schiegnitz et al, 2018): (1) adjunctive antibiotic therapy, (2) in an atraumatic manner, succeeded by (3) alveoplasty, and (4) thorough primary wound closure. After surgery, all patients received routine postoperative instructions and follow‐up consultation, as published in the PRISM protocol (Ristow et al, 2020).…”

Section: Methodsmentioning

confidence: 99%

“…Vital bone was defined as osteocytes in lacunae with only focal non-vital areas ±osseous infection signs (Kassolis et al, 2010). All surgical tooth extractions were performed by the same surgeons following the standardized and published protocol (Ristow et al, 2020) and in compliance with the following risk-reduction measures for patients while and after undergoing AR treatment (Schiegnitz et al, 2018): (1) adjunctive antibiotic therapy,…”

Section: Reference Standard Testmentioning

confidence: 99%

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Diagnostic accuracy comparing OPT and CBCT in the detection of non‐vital bone changes before tooth extractions in patients with antiresorptive intake

et al. 2021

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Objectives: To compare the diagnostic accuracy in detecting early non-vital bone changes between orthopantomography (OPT) and cone-beam computed tomography (CBCT) in correlation with histopathological findings before tooth extractions in patients with antiresorptive (AR) intake. Subjects:Patients with an indication tooth extraction who had received OPT and CBCT preoperatively while or after undergoing AR treatment were prospectively enrolled over a 24-month period in the progesterone in spontaneous miscarriage (PRISM) trial. Imaging studies were randomly analyzed by three examiners for early non-vital bone changes using specific predefined characteristics and a 5-level scale (1 definite absence of criteria to 5 definite presence of criteria). Sensitivity and specificity values were calculated in correlation with the histopathologically evaluated bone samples at the time point of tooth extraction. Results:One hundred thirty patients with 237 treated extraction sites met the inclusion criteria. For all images evaluated by all examiners, CBCT (430/492; 87.4%; receiver operating characteristic [ROC]: area under the curve [AUC] = 0.88; p < 0.001) was more likely to detect histopathologically confirmed non-vital bone than the OPT (132/492; 26.8%; ROC: AUC = 0.562; p = 0.115). Conclusions:In the detection of non-vital bone changes, CBCT is superior to OPT in both sensitivity and specificity. Specific imaging characteristics allow for the prediction of early non-vital bone changes already at the time before tooth extractions.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Reference Standard Testmentioning

confidence: 99%

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Diagnostic accuracy comparing OPT and CBCT in the detection of non‐vital bone changes before tooth extractions in patients with antiresorptive intake

et al. 2021

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“…Patients suffering from ARONJ in an advanced stage underwent surgery, according to treatment guidelines (Schiegnitz et al, 2018). In close consultation with the attending surgeon and after anatomical orientation, Raman spectra were collected from the central aspect of ARONJ lesions, which were subsequently confirmed histologically.…”

Section: Study Collective and Sample Preparationmentioning

confidence: 99%

“…Adequate diagnosis and treatment require close interdisciplinary cooperation between oncologists, orthopedic surgeons, endocrinologists, oral and maxillofacial surgeons, dentists, other medical specialists, as well as general practitioners (Ruggiero et al, 2022;Schiegnitz et al, 2018;Spanou et al, 2015). Based on the extent and severity, ARONJ is classified in four different grades and stages, ranging from merely at risk to mucosal irritation and lastly painful, suppurative fistula formation or even pathologic fractures with consecutive limitations in speech, masticatory, gustatory and swallowing function, as well as social integrity (Durie et al, 2005;Weitzman et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

Raman spectroscopy and U‐Net deep neural network in antiresorptive drug‐related osteonecrosis of the jaw

Matthies,

Gebrekidan,

Braeuer

et al. 2023

Oral Diseases

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ObjectiveApplication of an optical method for the identification of antiresorptive drug‐related osteonecrosis of the jaw (ARONJ).MethodsWe introduce shifted‐excitation Raman difference spectroscopy followed by U‐Net deep neural network refinement to determine bone tissue viability. The obtained results are validated through established histological methods.ResultsDiscrimination of osteonecrosis from physiological tissues was evaluated at 119 distinct measurement loci in 40 surgical specimens from 28 patients. Mean Raman spectra were refined from 11,900 raw spectra, and characteristic peaks were assigned to their respective molecular origin. Then, following principal component and linear discriminant analyses, osteonecrotic lesions were distinguished from physiological tissue entities, such as viable bone, with a sensitivity, specificity, and overall accuracy of 100%. Moreover, bone mineral content, quality, maturity, and crystallinity were quantified, revealing an increased mineral‐to‐matrix ratio and decreased carbonate‐to‐phosphate ratio in ARONJ lesions compared to physiological bone.ConclusionThe results demonstrate feasibility with high classification accuracy in this collective. The differentiation was determined by the spectral features of the organic and mineral composition of bone. This merely optical, noninvasive technique is a promising candidate to ameliorate both the diagnosis and treatment of ARONJ in the future.

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Antiresorptiva-assoziierte Kiefernekrosen

Cited by 2 publications

References 15 publications

Diagnostic accuracy comparing OPT and CBCT in the detection of non‐vital bone changes before tooth extractions in patients with antiresorptive intake

Diagnostic accuracy comparing OPT and CBCT in the detection of non‐vital bone changes before tooth extractions in patients with antiresorptive intake

Raman spectroscopy and U‐Net deep neural network in antiresorptive drug‐related osteonecrosis of the jaw

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