Detecting the effect of bisphosphonates during osteoporosis treatment on jawbones using multidetector computed tomography: The <scp>OSTEOSYR</scp> project

Barngkgei, Imad; Khattab, Razan

doi:10.1111/jicd.12332

Cited by 7 publications

(8 citation statements)

References 56 publications

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“…As the corresponding average symptom durations were 4.5 and 3.2 months, respectively, MRONJ might have occurred 54 and 24 months after low-dose and high-dose antiresorptive therapy. This result was quite similar to the findings of previous studies, which reported that this condition developed 12 months after intravenous BP injection and > 3 years after oral BP therapy 20 , 21 . In another study, the prevalence of MRONJ was greater among patients with > 4 years of exposure to oral BPs than in those with shorter durations of exposure (0.21% vs. 0.04%).…”

Section: Discussionsupporting

confidence: 92%

Radiological manifestations and clinical findings of patients with oncologic and osteoporotic medication-related osteonecrosis of the jaw

Shin,

Kim,

Huh

et al. 2024

Sci Rep

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Medication-related osteonecrosis of the jaw (MRONJ) poses a challenging form of osteomyelitis in patients undergoing antiresorptive therapies in contrast to conventional osteomyelitis. This study aimed to compare the clinical and radiological features of MRONJ between patients receiving low-dose medications for osteoporosis and those receiving high-dose medications for oncologic purposes. The clinical, panoramic radiographic, and computed tomography data of 159 patients with MRONJ (osteoporotic group, n = 120; oncologic group, n = 39) who developed the condition after using antiresorptive medications for the management of osteoporosis or bone malignancy were analyzed. The osteoporotic group was older (75.8 vs. 60.4 years, p < 0.01) and had a longer duration of medication usage than the oncologic group (58.1 vs. 28.0 months, p < 0.01). Pus discharge and swelling were more common in the osteoporotic group (p < 0.05), whereas bone exposure was more frequent in the oncologic group (p < 0.01). The mandibular cortical index (MCI) in panoramic radiographs was higher in the osteoporotic group (p < 0.01). The mean sequestra size was larger in the oncologic group than in the osteoporotic group (15.3 vs. 10.6 mm, p < 0.05). The cured rate was significantly higher in the osteoporotic group (66.3% vs. 33.3%, p < 0.01). Oncologic MRONJ exhibited distinct clinical findings including rapid disease onset, fewer purulent signs, and lower cure rates than osteoporotic MRONJ. Radiological features such as sequestrum size on CT scan, and MCI values on panoramic radiographs, may aid in differentiating MRONJ in osteoporotic and oncologic patients.

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Section: Discussionsupporting

confidence: 92%

Radiological manifestations and clinical findings of patients with oncologic and osteoporotic medication-related osteonecrosis of the jaw

Shin,

Kim,

Huh

et al. 2024

Sci Rep

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“…Most of these studies reported that the cortical bone thickness of patients taking antiresorptive drugs was significantly greater than that of the control group. 5 7 10 11 12 13 However, other studies showed no significant difference between the 2 groups, 8 14 and 1 study 4 even reported that the cortical bone thickness of patients taking antiresorptive drugs was significantly smaller than that of the control group. However, because these studies were conducted in patients with osteoporosis, it is not clear whether the findings of thin cortical bone were due to osteoporosis or antiresorptive drugs.…”

Section: Are There Any Imaging Signs That Predict Mronj In Patients Tmentioning

confidence: 96%

“…Yajima et al 6 reported no significant difference between the cancellous bone mineral density (BMD) of a BP group and a non-BP group. They measured trabecular BMD using quantitative CT. Barngkgei and Khattab 7 investigated the effects of BP on the jaw bones using multidetector CT. They concluded that BP treatment for osteoporosis for 5 years showed no influence on the trabecular parts of the jaw bones.…”

Section: Are There Any Imaging Signs That Predict Mronj In Patients Tmentioning

confidence: 99%

Several issues regarding the diagnostic imaging of medication-related osteonecrosis of the jaw

2020

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“…While some investigations have utilized panoramic radiographs [12,14], the utilization of cone beam computed tomography (CBCT) images for this purpose in osteoporotic patients has been relatively uncommon. Existing CBCT studies have primarily focused on the mandibular cortical area [15,16], resulting in a gap in the comprehensive evaluation of broad-spectrum changes in this patient population. Therefore, the objective of this retrospective cohort study is to characterize the effects of ARDs on the maxilla and mandible and to identify risk factors for osteonecrosis development in osteoporotic patients undergoing tooth extractions, utilizing clinical data and CBCT assessment.…”

Section: Introductionmentioning

confidence: 99%

Key insights into antiresorptive drug use and osteonecrosis in osteoporotic patients undergoing tooth extractions: A clinical and CBCT assessment

Moreno-Rabié,

Fontenele,

Oliveira-Santos

et al. 2024

Osteoporos Int

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This study investigates the effects of antiresorptive drugs and risk factors for medication-related osteonecrosis of the jaws in osteoporotic patients undergoing tooth extraction. Among the findings, antiresorptive-treated patients had thicker lamina dura and longer healing times. Additionally, corticosteroid intake and multi-rooted teeth carried a higher osteonecrosis risk. Bone sequestrum indicated osteonecrosis. Purpose To describe the effects of antiresorptive drugs (ARD) in the maxilla and mandible and risk factors for medicationrelated osteonecrosis of the jaws (MRONJ) in osteoporotic patients undergoing tooth extractions using clinical data and cone beam computed tomography (CBCT). Methods This retrospective cohort study collected clinical and CBCT data from 176 patients. The study group (n = 78; 224 extractions) received ARD treatment, underwent tooth extraction, and had a pre-operative CBCT. Additionally, age-, sex-, and tooth-matched controls were selected (n = 98; 227 extractions). Radiographic examinations were performed independently by three calibrated examiners. Statistical analysis included Chi-square, Fisher's exact, Mann-Whitney U, and t-tests to contrast clinical and radiographic data between study and control, MRONJ + and MRONJ − , and bisphosphonate and denosumab patients/sites. Significance was set at p ≤ 0.05. Results From the study group, 4 patients (5%) and 5 sites (2%) developed MRONJ after tooth extraction. ARD-treated patients exhibited significantly more thickening of the lamina dura and a longer average mucosal healing time (4.4 weeks) than controls (2.6 weeks). In the study group, MRONJ risk significantly increased with corticosteroid intake and in multirooted teeth. No significant differences between bisphosphonates and denosumab use were seen in the tomographic features (p > 0.05). Lastly, bone sequestrum was exclusively observed in osteoporotic patients, who exhibited post-operative exposed bone or histological evidence of osteonecrosis. Conclusion Osteoporotic patients under ARD may exhibit thickening of the lamina dura and prolonged post-operative healing. Among these patients, multi-rooted teeth are at higher risk for MRONJ than single-rooted teeth. Sequester formation is a radiographic indicator of osteonecrosis.

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Detecting the effect of bisphosphonates during osteoporosis treatment on jawbones using multidetector computed tomography: The OSTEOSYR project

Cited by 7 publications

References 56 publications

Radiological manifestations and clinical findings of patients with oncologic and osteoporotic medication-related osteonecrosis of the jaw

Radiological manifestations and clinical findings of patients with oncologic and osteoporotic medication-related osteonecrosis of the jaw

Several issues regarding the diagnostic imaging of medication-related osteonecrosis of the jaw

Key insights into antiresorptive drug use and osteonecrosis in osteoporotic patients undergoing tooth extractions: A clinical and CBCT assessment

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