CBCT imaging and histopathological characteristics of osteoradionecrosis and medication-related osteonecrosis of the jaw

Ogura, Ichiro; Minami, Yoshiyuki; Ono, Junya; Kanri, Yoriaki; Okada, Yasuo; Igarashi, Kensuke; Haga‐Tsujimura, Maiko; Nakahara, Ken; Kobayashi, Eizaburo

doi:10.5624/isd.20200230

Cited by 22 publications

(11 citation statements)

References 21 publications

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“…According to Simpione et al (2020) and Kim et al (2020), the most frequent alterations are bony sequestrum, bone exposure, and osteosclerosis. In the study by Ogura et al (2021), in addition to CBCT images, histopathology was also used to identify the main microscopic features of MRONJ, including necrotic bone, granulation tissue surrounded by bone and inflammatory cells; osteoclasts are rarely found around the necrotic bone, but were seen on its surface, in contact with the granulation tissue.…”

Section: Discussionmentioning

confidence: 99%

Medication-related osteonecrosis of the jaw and the role of the doctor of dental surgery: a literature review

Cabral

Santiago

Silva

et al. 2023

RSD

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Introduction: Medication-related Osteonecrosis of the Jaw (MRONJ) is a condition that may affect patients undergoing oral surgery procedures that use antiresorptive drugs. It is essential that the Doctor of Dental Surgery (DDS) is familiar with the pathology and how to diagnose, prevent and approach it. Objectives: To perform a literature review on MRONJ and to guide the DDS on how to manage the affected patients. Methodology: a systematized search was conducted on the PubMed virtual database using the terms: "diphosphonates", "dentist's practice pattern", "dentists", "dentist's role" and "Bisphosphonate-Associated Osteonecrosis of the Jaw". 29 articles in English, published in the last 5 years, were included. Results and discussion: MRONJ is characterized by exposed and necrotic bone that persists for more than 8 weeks and happens in patients taking antiresorptive agents. It is multifactorial and its severity depends on the dosage, route of administration, and treatment duration. Its management must be multidisciplinary to improve the patient's quality of life. The DDS must focus on prevention. Every patient should have their oral health evaluated before starting antiresorptive therapy and be informed of its risks and benefits. Most DDSs do not feel confident to adequately manage these cases, even though information on MRONJ is more widespread among younger DDSs and recent graduates. Conclusion: MRONJ is a harmful condition for the patient and it is the DDS's responsibility to know how to treat and prevent it, by having adequate knowledge of this pathology and making decisions based on the latest scientific evidence.

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Section: Discussionmentioning

confidence: 99%

Medication-related osteonecrosis of the jaw and the role of the doctor of dental surgery: a literature review

Cabral

Santiago

Silva

et al. 2023

RSD

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“…The CBCT parameters at our hospital were as follows: standard mode (tube voltage, 90.0 kV; tube current, 4.00 mA; rotation time, 16.8 s; field of view, 81 mm × 81 mm; thickness, 0.144 mm), high-density mode (tube voltage, 90.0 kV; tube current, 4.00 mA; rotation time, 33.5 s; field of view, 81 mm × 81 mm; thickness, 0.144 mm), and high-resolution mode (tube voltage, 90.0 kV; tube current, 4.00 mA; rotation time, 16.8 s; field of view, 56 mm × 56 mm; thickness, 0.099 mm) [ 25 ]. High-resolution mode was sharper than both standard mode and high-density mode for the analysis of surgical specimens in segmental mandibulectomy [ 26 ]. However, standard mode was used for patients as the oral and maxillofacial protocols at our hospital because evaluation of another dentomaxillofacial lesion was necessary for diagnosis and treatment planning in dental practice [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of Vertical Root Fractures in Endodontically Treated Teeth by Cone-Beam Computed Tomography

2022

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The purpose of this study was to investigate the characteristics and the detection ability of vertical root fractures in endodontically treated teeth by intraoral radiography and cone-beam computed tomography (CBCT). CBCT images of 50 patients with root fractures in endodontically treated teeth were reviewed, and 36 vertical root fractures were taken in this study. The cause of fracture, core construction, kind of teeth, and fracture direction (bucco-lingual and mesio-distal fractures) were investigated. Detection ability of vertical root fractures by intraoral radiography and CBCT was also examined. Statistical analyses concerning the characteristics were performed by χ2 test, and the detection ability was analyzed by cross-tabulation. All of the fractured teeth were nontraumatized teeth. The vertical root fracture occurrence was not differed by core construction. The vertical root fracture number was largest at the premolar teeth (p = 0.005), and the number of the bucco-lingual fracture was larger than the mesio-distal fracture (p = 0.046). Vertical root fractures were detectable using CBCT, while undetectable by intraoral radiography (p < 0.001). Vertical root fractures occurred easily in premolar teeth with bucco-lingual direction, and CBCT is an adequate radiographic method to diagnose vertical root fracture.

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“…Furthermore, Ogura et al . [ 20 ] showed that surgical specimens from segmental mandibulectomy of MRONJ were analysed using cone-beam computed tomography (CBCT), and CBCT could be useful for the post-surgical evaluation of MRONJ. Miyashita et al .…”

Section: Discussionmentioning

confidence: 99%

“…In this study, maximum SUVs for MRONJ (n = 4, 25.4 ± 4.9) and chronic osteomyelitis (n = 3, 14.6 ± 3.1) in mandible were higher than those of the opposite side as normal mandible (3.8 ± 0.7 and 4.6 ± 1.8, respectively). Furthermore, Ogura et al [20] showed that surgical specimens from segmental mandibulectomy of MRONJ were analysed using cone-beam computed tomography (CBCT), and CBCT could be useful for the post-surgical evaluation of MRONJ. Miyashita et al [5] indicated that 3D SPECT/CT is useful not only for detecting jaw bone invasion of oral cancer but also for surgical planning.…”

Section: Discussionmentioning

confidence: 99%

Volumetric analysis of mandibular lesions with SPECT/CT: a pilot clinical study of maximum standardized uptake value

Minami¹,

Ogawa²,

Ogura³

2022

Pol J Radiol

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Purpose This study was designed to investigate mandibular lesions using volumetric analysis with bone single-photon emission computed tomography/computed tomography (SPECT/CT). Material and methods Eight patients with mandibular lesions underwent SPECT/CT scan acquisition 4 hours after injection of Tc-99m hydroxymethylene diphosphonate (HMDP). Regarding volumetric analysis, maximum standar-dized uptake value (SUV) was obtained using software and a workstation (Q.Volumetrix MI and GEniE-Xeleris 4 DR, respectively). The localization and size of the volume of interest (VOI) can be drawn over the lesion, mesial, distal, and opposite side as normal using the CT, SPECT, and SPECT/CT transaxials, coronals, and sagittals as the anatomical reference. Q.Volumetrix MI can analyse SUV of lesions by organ segmentation using optional pan and zoom imaging. Then, the dosimetry software provided multiple quantitative data for a given VOI. Statistical analyses for the maximum SUV were performed by Mann-Whitney U test. A p -value lower than 0.05 was considered as statistically significant. Results Maximum SUVs for medication-related osteonecrosis of the jaw ( n = 4, 25.4 ± 4.9), chronic osteomyelitis ( n = 3, 14.6 ± 3.1), and squamous cell carcinoma ( n = 1, 31.7) were significantly higher than those of the opposite side as normal mandible (3.8 ± 0.7, 4.6 ± 1.8, and 7.4, respectively; p = 0.000). Conclusions Volumetric analysis with SPECT/CT could be useful for the evaluation of mandibular lesions, such as detecting and surgical planning.

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CBCT imaging and histopathological characteristics of osteoradionecrosis and medication-related osteonecrosis of the jaw

Cited by 22 publications

References 21 publications

Medication-related osteonecrosis of the jaw and the role of the doctor of dental surgery: a literature review

Medication-related osteonecrosis of the jaw and the role of the doctor of dental surgery: a literature review

Diagnosis of Vertical Root Fractures in Endodontically Treated Teeth by Cone-Beam Computed Tomography

Volumetric analysis of mandibular lesions with SPECT/CT: a pilot clinical study of maximum standardized uptake value

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