Change in the Magnetic Resonance Imaging Signal of the Mandibular Condyle Due to Bisphosphonate-Related Osteonecrosis of the Jaw

Abstract

Marx was the first to report osteonecrosis of the jaw due to administration of BPs in 2003. Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is the result of an adverse drug reaction. Moreover, many studies worldwide have reported an association between a range of serious dental diseases and the use of bisphosphonates (BPs). Few studies, however, have evaluated BRONJ based on an abnormal signal detected by MRI in the bone marrow of the mandibular condyle. The aim of this study was to assess changes in the magnetic resonance imaging (MRI) signal from the mandibular condyle that could be due to BRONJ. In particular, we focused on the presence of an abnormal MRI signal emanating from mandibular condyle bone marrow. Twenty-eight patients (11 men, 17 women; 56 temporomandibular joints) with BRONJ were evaluated for jaw pain. The patients, whose mean age was 72.9 ± 9.4 years (range 48 -88 years), underwent MRI examination of the jawbone at our hospital from August 2006 to December 2015 and were included in the study. Overall, 80.0% of the patients diagnosed with BRONJ exhibited an abnormal bone marrow signal in the mandibular condyle on the same side of the face that suffered jaw pain. This abnormal signal was present significantly more frequently on the side of the face with the jaw symptoms than on the side without symptoms. Patients with BRONJ displayed an abnormal MRI signal in the mandibular condyle on the side of the face with jaw symptoms, suggesting that MRI findings could be useful clinically for detecting BRONJ in the mandibular condyle.