Surgical evaluation of panoramic radiography and cone beam computed tomography for therapy planning of bisphosphonate-related osteonecrosis of the jaws

Kämmerer, Peer W.; Thiem, Daniel G. E.; Eisenbeiß, Christoph; Dau, Michael; Schulze, Ralf; Draenert, Florian G.

doi:10.1016/j.oooo.2015.11.012

Cited by 31 publications

(28 citation statements)

References 29 publications

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“…5 In addition, no further training using PAN and CBCT next to their prior experience was provided. This decision was based on the objective of the study to examine differences between the groups with different medical education.…”

Section: Questionnairementioning

confidence: 99%

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Presurgical evaluation of bony implant sites using panoramic radiography and cone beam computed tomography—influence of medical education

Dau

Edalatpour

Schulze

et al. 2017

Dentomaxillofacial Radiology

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Objectives: The aim of this study was to compare the subjective quality rating of panoramic radiography (PAN) and CBCT in the planning of dental implant procedures by clinicians with different educational backgrounds. Methods: Radiographic images (PAN and CBCT) of 42 patients were examined as follows: the maxillary (MX) anterior region of patients, the MX posterior region of 16 patients and the mandibular (MD) posterior region of 16 patients. These sites were used for planning of dental implant insertion. Data sets were analyzed by examiners with different training backgrounds: three general practitioners (GP), three oral surgeons (OS) and three maxillofacial surgeons (MS). A standardized questionnaire in a standardized setting was answered by participants. Results: The majority of participants rated an additional CBCT as "required" (14.0%) or "reasonable" (56.1%). These ratings depended strongly on the area of interest (MX anterior region: 31.1 and 58.9%; MX posterior region: 14.6 and 62.5%; and MD posterior region: 2.8% and 47.9%). MS classified CBCT as required more often than GP and OS (23.8 vs 10.3 and 7.9%; p , 0.001). With the additional information of CBCT, "therapy affecting" ratings were stated high in all groups. Conclusions: Especially in the anterior and posterior MX, significant subjective benefits for an additional CBCT were seen for planning of dental implant procedures. Participants with fundamental medical education asked for CBCT more often. The results indicate that an improved education in three-dimensional dental radiology is necessary.

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Section: Questionnairementioning

confidence: 99%

“…It also became an important element in dental implantology. 4,5 However, 3D radiography involves higher radiation doses to be applied. For certain indications, CBCT offers an alternative to conventional CT with about 10-50% less radiation exposure.…”

Section: Introductionmentioning

confidence: 99%

Presurgical evaluation of bony implant sites using panoramic radiography and cone beam computed tomography—influence of medical education

Dau

Edalatpour

Schulze

et al. 2017

Dentomaxillofacial Radiology

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“…Watanabe et al (2017) reported that the bone scan index of the jaw was significantly higher in patients who developed ONJ than in those who did not, 3 months before the diagnosis of ONJ, underlining its value as a new prognostic index. More advanced imaging procedures like computed tomography (which can evaluate the radiodensity of necrotic bone) (Hamada, Matsuo, Koizumi, Satomi, & Chikazu, 2014), and cone beam computed tomography, are considered superior to established panoramic radiography, and represent a potential additional tool to assist surgical management of ONJ (Guggenberger et al, 2014;Kammerer et al, 2016). More advanced imaging procedures like computed tomography (which can evaluate the radiodensity of necrotic bone) (Hamada, Matsuo, Koizumi, Satomi, & Chikazu, 2014), and cone beam computed tomography, are considered superior to established panoramic radiography, and represent a potential additional tool to assist surgical management of ONJ (Guggenberger et al, 2014;Kammerer et al, 2016).…”

Section: Predictive and Prognostic Factorsmentioning

confidence: 99%

Antiresorptive treatment-associated ONJ

Eleutherakis‐Papaiakovou

Bamias

2017

Eur J Cancer Care

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Osteonecrosis of the jaw (ONJ) is a severe complication of therapy with antiresorptive agents (e.g. bisphosphonates and denosumab), which are used to manage bone metastases from cancer, to reduce the incidence of skeletal-related events. Available data indicate that 0-27, 5% of patients exposed to antiresorptive agents may develop ONJ, depending on the number of infusions and the duration of therapy. Besides antiresorptive therapy, a number of risk factors for osteonecrosis have been identified. Oral surgical procedures, tooth extractions and infection to the jawbones are considered the main risk factors for developing ONJ, when receiving antiresorptive therapy. However, a growing number of patients develop ONJ without apparent risk factors, raising concern for other predisposing factors. Jaw bone necrosis may be irreversible, resulting in a chronic disease with negative impact on the quality of patients' lives. The role of risk reduction strategies like meticulous dental screening and optimal oral hygiene is fundamental for preventing development of ONJ. ONJ is usually treated conservatively to relieve the symptoms and manage jaw bone necrosis. In certain cases, surgical intervention is required. Future research should emphasize individual predisposition to ONJ, more effective preventive measures and more efficient therapeutic procedures.

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“…48 These disadvantages have been overcome by CBCT, which provides a three-dimensional image, but with lower radiation dose, easier accessibility and lower cost than CT. 44,48,49 The applied radiation dose in CBCT, depending on the equipment used and the area scanned, is between 3 and 20% of a CT scan, but it is still high compared with conventional dental radiography techniques. 49,50 Compared with panoramic radiography, CBCT provides an equivalent patient radiation dose of 5-74 times that of a single film-based panoramic X-ray. However, modifications in patient positioning and additional personal protection can reduce the dose by up to 40%.…”

Section: Imaging Findingsmentioning

confidence: 99%

Bisphosphonate-related osteonecrosis of the jaw: from the sine qua non condition of bone exposure to a non-exposed BRONJ entity

Koth¹,

Figueiredo²,

Salum³

et al. 2016

Dentomaxillofacial Radiology

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Surgical evaluation of panoramic radiography and cone beam computed tomography for therapy planning of bisphosphonate-related osteonecrosis of the jaws

Cited by 31 publications

References 29 publications

Presurgical evaluation of bony implant sites using panoramic radiography and cone beam computed tomography—influence of medical education

Presurgical evaluation of bony implant sites using panoramic radiography and cone beam computed tomography—influence of medical education

Antiresorptive treatment-associated ONJ

Bisphosphonate-related osteonecrosis of the jaw: from the sine qua non condition of bone exposure to a non-exposed BRONJ entity

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