Prevalence of radiographic findings on jaws exposed to antiresorptive therapy: a meta-analysis

Abstract

Objectives: Determine the prevalence of radiographic findings (RF) on both jaws among patients receiving antiresorptive bone therapy. methods: Six electronic databases and partial grey literature were searched. Data was collected based on predetermined criteria. The key features from the included studies were extracted. The MAStARI tool assessed the potential risk of bias (RoB) among the studies, while the GRADE approach determined the level of evidence. Results: 29 studies were identified and included in the qualitative analysis, totalling 1133 patients. 27 studies had sufficient data to be included in a series of meta-analysis reporting 12 types of radiographic findings, and were split in two groups based on their study design. G1 comprised descriptive observational studies and G2 analytical cross-sectional studies. Two studies presented a high RoB, 16 had a moderate RoB, and 11 had low RoB. The overall level of evidence identified was very low. The most frequent RF were mixed lytic-sclerotic areas (73.88%), followed by osteolytic changes (66.18%), osteosclerosis (65.75%), cortical bone erosion (50.83%), persisting alveolar socket (45.77%), periodontal ligament (PDL) widening (44.69%), and inferior alveolar canal (IAC) involvement (43.40%). Less frequent, but equally important, were the periosteal reaction (34.27%), lamina dura thickening (32.97%), sequestrum (29.94%), pathologic fracture (20.90%), and density confluence of cortical and cancellous bone (16.61%). 20 patients reported no signs. conclusions: RF prevalence was high and mainly included mixed lytic-sclerotic areas, osteolysis, osteosclerosis, cortical bone erosion, persisting alveolar socket, PDL-widening, IAC-involvement. Due to the very low level of evidence (GRADE) caution should be exercised when considering these findings.

A critical assessment of the medication-related osteonecrosis of the jaw classification in stage I patients: a retrospective analysis

“…Unfortunately, no consensus has been reached on the efficacy of different radiological imaging modalities in assessing the extent of a necrotic osseous lesion 39 . The latest meta-analysis to examine the prevalence of radiographic findings on jaws exposed to antiresorptive therapy, including jaws with MRONJ, identified only 29 studies with a total of 1,133 patients.…”

“…The latest meta-analysis to examine the prevalence of radiographic findings on jaws exposed to antiresorptive therapy, including jaws with MRONJ, identified only 29 studies with a total of 1,133 patients. The most frequent radiological findings were mixed lytic-sclerotic areas (73.88%), osteolytic changes (66.18%), osteosclerosis (65.75%), cortical bone erosion (50.83%), and persisting alveolar socket (45.77%) 39 . Those authors emphasized that the overall level of evidence in the studies identified was very low.…”

“…Those authors emphasized that the overall level of evidence in the studies identified was very low. They also pointed out that no imaging modality currently allows clear differentiation between necrotic and vital bone 39 . That is why we assessed the extent of MRONJ in this study using an intraoperative measurement technique.…”

“…Nonetheless, further efforts must be made to find radiographic modalities that can clearly differentiate between necrotic and vital bone. Such modalities could enable early diagnosis, significantly affecting the management of the underlying disease and enabling better treatment and the prevention of new potential cases 39 , 40 . By assessing the real extent of the lesion and detecting asymptomatic necrotic areas, high-resolution imaging could be helpful in individualized treatment planning 41 .…”

Mandibular canal vs. inferior alveolar canal: Evidence‐based terminology analysis

“…The most recent, consecutive 50 articles containing “inferior alveolar canal” or “inferior alveolar nerve canal” were included (defined as the IAC/IANC group) (Adibi, Shahidi, Nikanjam, Paknahad, & Ranjbar, 2017; Afsa & Rahmati, 2017; Al‐Ekrish et al, 2018; Al‐Ekrish et al, 2020; Ali, Mosleh, & Shawky, 2018; Aljarbou, Aldosimani, Althumairy, Alhezam, & Aldawsari, 2019; Arbel et al, 2019; Atef & Mounir, 2018; Česaitienė, Česaitis, Junevičius, & Venskutonis, 2017; Y. Chen, Liu, Pei, Liu, & Pan, 2018; Clark, Barbu, Lorean, Mijiritsky, & Levin, 2017; Demirel & Akbulut, 2020; Dutra et al, 2019; Elkhateeb & Awad, 2018; Ghai & Choudhury, 2018; Goller Bulut & Köse, 2018; Gumusok, Alkurt, Museyibov, & Ucok, 2016; He, Wang, Hu, & Liu, 2019; Ishii, Abe, Moro, Yokomizo, & Kobayashi, 2017; Kablan, Abu‐Sobeh, Lorean, & Levin, 2020; Khojastepour, Khaghaninejad, Hasanshahi, Forghani, & Ahrari, 2019; Kubota, Imai, Nakazawa, & Uzawa, 2020; S. Lee, Lee, Kim, & Nam, 2019; Liu, Sidell, Huon, & Torre, 2018; Luangchana, Pornprasertsuk‐Damrongsri, Kitisubkanchana, & Wongchuensoontorn, 2019; Mortazavi, Baharvand, & Rezaeifar, 2018; Mortazavi, Baharvand, Safi, & Behnaz, 2019; Mortazavi, Baharvand, Safi, Dalaie, et al, 2019; Patil, Pai, Vineetha, Rajagopal, & Dkhar, 2019; Patrick, Birur, Gurushanth, Raghavan, & Gurudath, 2017; Pour, Sedaghati, & Shamshiri, 2020; Prakash et al, 2018; Qi et al, 2019; Rytkönen & Ventä, 2018; Saha, Kedarnath, & Singh, 2019; Şahin, Odabaşı, Demiralp, Kurşun‐Çakmak, & Aliyev, 2019; Sharifi, Beshkar, Mobayeni, & Hasheminasab, 2018; Shokry et al, 2019; Sirin, Yildirimturk, Horasan, & Guven, 2020; Tabrizi et al, 2019; Tachinami, Tomihara, Fujiwara, Nakamori, & Noguchi, 2017; Tudtiam et al, 2019; Uchida, Motoyoshi, Namura, & Shimizu, 2017; Uzun, Sumer, & Sumer,…”