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Oral and Maxillofacial Surgery

, Volume 23, Issue 4, pp 465–472 | Cite as

Volumetric analysis of MRONJ lesions by semiautomatic segmentation of CBCT images

  • Matthias ZirkEmail author
  • Johannes Buller
  • Joachim E. Zöller
  • Carola Heneweer
  • Norbert Kübler
  • Max-Philipp Lentzen
Original Article
  • 47 Downloads

Abstract

Purpose

The purpose of this study was to evaluate potential differences in volumes of areas of osteolysis caused by medication-related osteonecrosis of the jaw (MRONJ) between the upper and lower jaw. We aim to analyze the clinical relevance of volumetric measurement of osteolytic lesions for surgical planning of MRONJ patients.

Methods

Sixty-seven patients who were clinically and histopathologically diagnosed with MRONJ were retrospectively included in this study. Cone beam computed tomography (CBCT) images were evaluated according to localization, affected anatomical structures, and volumetric measurement of osteolytic lesions caused by MRONJ in appliance of CBCT datasets by using ITK-SNAP.

Results

The most frequently affected localization is the mandible, whereas female patients show significantly more often lesions of the maxilla. The cortical bone was predominantly affected. Furthermore, the affection of teeth, sinus floor, inferior alveolar nerve canal, or even a pathological fracture of the mandible are infrequently existing. The volumetric measurements revealed a statistically significant greater absolute osteolysis volume in males.

Conclusions

Image analysis and volumetric measurements of osteolytic lesions of MRONJ patients is a helpful tool to further understand the clinical appearance and identify compromised anatomic landmarks. Volumetric analysis aids in pre-surgical planning and visualizes the individual extent of the disease for each patient.

Keywords:

MRONJ Osteonecrosis of the jaws Volumetric parameters Pre-surgical planning Jaw’s anatomy 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

For this type of study (retrospective study), formal consent is not required.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department for Oral and Craniomaxillofacial and Plastic SurgeryUniversity Hospital of CologneCologneGermany
  2. 2.Department for Oral and Maxillofacial SurgeryUniversity Hospital DuesseldorfDuesseldorfGermany
  3. 3.Institute of Diagnostic and Interventional RadiologyUniversity Hospital of CologneCologneGermany

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