Clinical Oral Investigations

, Volume 14, Issue 1, pp 43–50

Bisphosphonate-related osteonecrosis of the jaw: clinical correlations with computerized tomography presentation

  • Sharon Elad
  • Moshe J. Gomori
  • Noa Ben-Ami
  • Silvina Friedlander-Barenboim
  • Eran Regev
  • Towy S. Lazarovici
  • Noam Yarom
Original Article

DOI: 10.1007/s00784-009-0311-3

Cite this article as:
Elad, S., Gomori, M.J., Ben-Ami, N. et al. Clin Oral Invest (2010) 14: 43. doi:10.1007/s00784-009-0311-3

Abstract

The aim of this study was to correlate clinical and computerized tomography (CT) features of bisphosphonate-related osteonecrosis of the jaws (BRONJ). All ONJ patients for whom there was complete CT scan imaging were eligible. Selected clinical parameters retrieved from their medical records were analyzed for correlation with CT parameters. The clinical presentation of BRONJ was supported by findings in CT imaging in 78.3%. The lesion’s size on CT correlated with the presence of purulent secretion (p = 0.03). When sequestrum was present, the median lesion’s size on CT was relatively big (28 mm, range 21–43 mm). The mandibular canal cortex was never breached. CT has reasonable detection competence for diagnosing BRONJ. Purulent secretion indicates the likelihood that a more extensive involvement will be displayed on CT. A large lesion on CT should raise the index of suspicion for sequestrum. The CT appearance of a continuous cortex of the mandibular canal may serve as a differential parameter between BRONJ and metastasis to the jaw.

Keywords

OsteonecrosisBisphosphonateComputerized tomographyCortexMandibular canalDiagnosisImaging

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Sharon Elad
    • 1
  • Moshe J. Gomori
    • 2
  • Noa Ben-Ami
    • 1
  • Silvina Friedlander-Barenboim
    • 1
  • Eran Regev
    • 3
  • Towy S. Lazarovici
    • 4
  • Noam Yarom
    • 4
    • 5
  1. 1.Department of Oral MedicineHebrew University–Hadassah School of Dental MedicineJerusalemIsrael
  2. 2.Department of Clinical RadiologyHadassah University Medical CenterJerusalemIsrael
  3. 3.Department of Oral and Maxillofacial SurgeryThe Hebrew University–Hadassah School of Dental MedicineJerusalemIsrael
  4. 4.Department of Oral and Maxillofacial SurgerySheba Medical CenterTel-HashomerIsrael
  5. 5.Department of Oral Pathology and Oral Medicine, The Maurice and Gabriela Goldschleger School of Dental MedicineTel Aviv UniversityTel AvivIsrael