Are there any differences in mandibular morphology of patients with bisphosphonate-related osteonecrosis of jaws?: a case-control study

Abstract

Objectives: The aim of this study was to compare the morphological differences in the mandible between patients with bisphosphonate-related osteonecrosis of the jaw (BRONJ) and healthy individuals and to detect the correlation between these parameters on panoramic radiography and CBCT. Methods: The CBCT and panoramic images of patients with BRONJ (n 5 32) and control groups (n 5 32) were included in the study. All the comparisons were analyzed between the osteonecrosed and healthy sides of patients with BRONJ and control group. The panoramic radiographs were used to measure the values of the condyle angle, gonial angle, antegonial angle, antegonial depth, condylar height and ramal height. The mandibular cortical index (MCI) and bone quality index (BQI) were also examined on cross-sectional scans of CBCT images. Results: There were significant differences in the MCI (p 5 0.014) and BQI (p 5 0.021) between the left and right side of the BRONJ group and also between the osteonecrosed side of the BRONJ and control group (p , 0.0001). No significant difference was found in other comparisons. Conclusions:The outcomes of the present study indicate that bisphosphonates influenced some internal morphological changes in the mandible. These changes may be a reason of BRONJ. But, these changes are not reflective of the measured values obtained using panoramic radiographs on the external morphology of the mandible.

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

“…This finding is reported only with assessment using cone beam CT (CBCT). 23,24 CBCT is known to be more useful for measuring the mandibular cortical bone 23 and other characteristic findings of BRONJ than PR. 23,25,26 We used only conventional CT in our study, and so we were unable to include thickness of cortical bone and degree of bone marrow sclerosis for findings of CT. CBCT has possibility to give additional information to conventional CT or PR.…”

Evaluation of Mandibular Morphometry in the Bisphosphonate Users

“…This could be due to the MCT showing differences according to sex. Ozcan et al (2016) studied the morphological differences of the mandible in 32 healthy individuals and 32 individuals with BRONJ on their panoramic radiographs and CBCT images. In their study, they evaluated CA, GA, AGA, AGD and condyle and ramus height using panoramic radiography and used CBCT to evaluate MCI and bone quality index.…”

Characteristic Multimodal Imaging of Medication- Related Osteonecrosis of the Jaw: Comparison Between Oral and Parenteral Routes of Medication Administration

“…Regarding panoramic radiography of MRONJ, Klingelhöffer et al [ 11 ] indicated that panoramic radiographs of patients undergoing antiresorptive therapy with manifested osteonecrosis more frequently showed changes in the bone structure. Ozcan et al [ 12 ] suggested that the osseous changes associated with BRONJ in the mandible, which includes the cortical and spongious bones, do not reflect the external morphology of the mandible on panoramic images. Torres et al [ 13 ] suggested that mandibular inferior cortical bone thickness in patients using bisphosphonates was detected on panoramic radiographs, and represented a potentially useful tool for the detection of dimensional changes associated with bisphosphonate therapy.…”