Oral Radiology

, Volume 29, Issue 2, pp 111–120

Role of magnetic resonance imaging in diagnosis of bisphosphonate-related osteonecrosis of the jaw

Original Article

DOI: 10.1007/s11282-013-0124-6

Cite this article as:
Ariji, Y. & Ariji, E. Oral Radiol (2013) 29: 111. doi:10.1007/s11282-013-0124-6



To clarify the magnetic resonance (MR) imaging features of bisphosphonate-related osteonecrosis of the jaw (BRONJ), particularly those in the early stage, through a literature review and case analysis.


Literature on MR imaging of BRONJ was collected, and the MR imaging features were summarized. On MR images of patients with BRONJ, the signal intensity of the bone marrow was evaluated quantitatively by means of the contrast-to-noise ratio (CNR). The relationships of the imaging features with the presence of exposed bone, types and administration routes of bisphosphonates (BP), and duration of symptoms were investigated.


Fifteen articles were identified. In the early stages, the region of osteonecrosis displayed decreased signal intensity on T1-weighted images and normal signal intensity on T2-weighted images. In the late stages, the signal intensity of the bone marrow on T2-weighted images was variable: the exposed diseased bone displayed decreased signal intensity, and the unexposed diseased bone displayed increased signal intensity. These changes were also seen in BRONJ cases. There was a significant difference in the CNR between the exposed and unexposed diseased bones on STIR images. There were no significant differences in the CNR among the three groups by types and administration routes of BP, both on T1-weighted and STIR images. Changes in the signal intensity of bone marrow were seen at the early duration of symptoms. In the early stage, the CNR on T1-weighted images had a significant correlation with duration of symptoms.


MR imaging may provide visualization of useful features in the early stage of BRONJ.


MRIBisphosphonate-related osteonecrosisJaw

Copyright information

© Japanese Society for Oral and Maxillofacial Radiology and Springer Japan 2013

Authors and Affiliations

  1. 1.Department of Oral and Maxillofacial RadiologyAichi-Gakuin University School of DentistryNagoyaJapan