Skip to main content

Advertisement

SpringerLink
Log in

Early imaging signs of the use of antiresorptive medication and MRONJ: a systematic review

  • Review
  • Published:
Clinical Oral Investigations Aims and scope Submit manuscript

Abstract

Objective

The main aim is to identify, by means of different imaging modalities, the early bone changes in patients “at risk” and in stage 0 MRONJ.

Materials and methods

A search of the literature was performed on PubMed, Embase, Web of Science, and Cochrane Library databases, until June 9, 2020. No language or year restrictions were applied. Screening of the articles, data collection, and qualitative analysis was done. The Newcastle-Ottawa Scale (NOS) was used for observational studies, and the Systematic Review Centre for Laboratory Animal Experimentation’s (SYRCLE) risk of bias tool for the animal studies.

Results

A total of 1188 articles were found, from which 47 were considered eligible, whereas 42 were suitable for the qualitative analysis. They correspond to 39 human studies and 8 animal studies. Radiographic findings such as bone sclerosis, osteolytic areas, thickening of lamina dura, persisting alveolar socket, periapical radiolucency, thicker mandibular cortex, widening of the periodontal ligament space, periodontal bone loss, and enhancement of the mandibular canal were identified as early bone changes due to antiresorptive therapy. All those findings were also reported later in Stage 0 patients.

Conclusion

The main limitations of these results are the lack of prospective data and comparisons groups; therefore, careful interpretation should be made. It is a fact that radiographic findings are present in antiresorptive-treated patients, but the precise timepoint of occurrence, their relation to the posology, and potential risk to develop MRONJ are not clear.

Clinical relevance

The importance of a baseline radiographic diagnosis for antiresorptive-treated patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Hamadeh IS, Ngwa BA, Gong Y (2015) Drug induced osteonecrosis of the jaw. Cancer Treat Rev 41:455–464. https://doi.org/10.1016/j.ctrv.2015.04.007

    Article  PubMed  Google Scholar 

  2. Matsuo A, Hamada H, Kaise H, Chikazu D, Yamada K, Kohno N (2014) Characteristics of the early stages of intravenous bisphosphonate-related osteonecrosis of the jaw in patients with breast cancer. Acta Odontol Scand 72:656–663. https://doi.org/10.3109/00016357.2014.887772

    Article  PubMed  Google Scholar 

  3. Hamada H, Matsuo A, Koizumi T, Satomi T, Chikazu D (2014) A simple evaluation method for early detection of bisphosphonate-related osteonecrosis of the mandible using computed tomography. J Cranio-Maxillofac Surg 42:924–929. https://doi.org/10.1016/j.jcms.2014.01.012

    Article  Google Scholar 

  4. Dutra KL, Haas LF, Zimmermann GS, Melo G, Minamisako MC, Flores-Mir C, Corrêa M (2019) Prevalence of radiographic findings on jaws exposed to antiresorptive therapy: a meta-analysis. Dentomaxillofac Radiol 48:20180112. https://doi.org/10.1259/dmfr.20180112

    Article  PubMed  Google Scholar 

  5. Sanna G, Preda L, Bruschini R, Cossu Rocca M, Ferretti S, Adamoli L, Verri E, Franceschelli L, Goldhirsch A, Nolè F (2006) Bisphosphonates and jaw osteonecrosis in patients with advanced breast cancer. Ann Oncol Off J Eur Soc Med Oncol 17:1512–1516. https://doi.org/10.1093/annonc/mdl163

    Article  Google Scholar 

  6. Ruggiero SL, Dodson TB, Fantasia J, Goodday R, Aghaloo T, Mehrotra B, O'Ryan F, American Association of Oral and Maxillofacial Surgeons (2014) American Association of Oral and Maxillofacial Surgeons position paper on medication-related osteonecrosis of the jaw--2014 update. J Oral Maxillofac Surg 72:1938–1956. https://doi.org/10.1016/j.joms.2014.04.031

    Article  PubMed  Google Scholar 

  7. Schiodt M, Otto S, Fedele S, Bedogni A, Nicolatou-Galitis O, Guggenberger R, Herlofson BB, Ristow O, Kofod T (2019) Workshop of European task force on medication-related osteonecrosis of the jaw-current challenges. Oral Dis 25:1815–1821. https://doi.org/10.1111/odi.13160

    Article  PubMed  Google Scholar 

  8. Devlin H, Greenwall-Cohen J, Benton J, Goodwin TL, Littlewood A, Horner K (2018) Detecting the earliest radiological signs of bisphosphonate-related osteonecrosis. Br Dent J 224:26–31. https://doi.org/10.1038/sj.bdj.2017.1001

    Article  PubMed  Google Scholar 

  9. Zaman MU, Nakamoto T, Tanimoto K (2013) A retrospective study of digital subtraction technique to detect sclerotic changes in alveolar bone on intraoral radiographs of bisphosphonate-treated patients. Dentomaxillofac Radiol 42:20130242. https://doi.org/10.1259/dmfr.20130242

    Article  PubMed  PubMed Central  Google Scholar 

  10. Olutayo J, Agbaje JO, Jacobs R, Verhaeghe V, Velde FV, Vinckier F (2010) Bisphosphonate-related osteonecrosis of the jaw bone: radiological pattern and the potential role of CBCT in early diagnosis. J Oral Maxillofac Res 1:e3. https://doi.org/10.5037/jomr.2010.1203

    Article  PubMed  PubMed Central  Google Scholar 

  11. Hutchinson M, O’Ryan F, Chavez V et al (2010) Radiographic findings in bisphosphonate-treated patients with stage 0 disease in the absence of bone exposure. J Oral Maxillofac Surg 68:2232–2240. https://doi.org/10.1016/j.joms.2010.05.003

    Article  PubMed  Google Scholar 

  12. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JPA, Clarke M, Devereaux PJ, Kleijnen J, Moher D (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med 6:e1000100. https://doi.org/10.1371/journal.pmed.1000100

    Article  PubMed  PubMed Central  Google Scholar 

  13. Zeng X, Zhang Y, Kwong JSW, Zhang C, Li S, Sun F, Niu Y, du L (2015) The methodological quality assessment tools for preclinical and clinical studies, systematic review and meta-analysis, and clinical practice guideline: a systematic review. J Evid Based Med 8:2–10. https://doi.org/10.1111/jebm.12141

    Article  PubMed  Google Scholar 

  14. Wells G, Shea B, O’Connell D, et al The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp. Accessed 6 Apr 2020

  15. Hooijmans CR, Rovers MM, De Vries RBM et al (2014) SYRCLE’s risk of bias tool for animal studies. BMC Med Res Methodol 14. https://doi.org/10.1186/1471-2288-14-43

  16. Rocha GCMA, Jaguar GC, Moreira CR, Neves EG, Fonseca FP, Pedreira EN (2012) Radiographic evaluation of maxillofacial region in oncology patients treated with bisphosphonates. Oral Surg Oral Med Oral Pathol Oral Radiol 114:S19–S25. https://doi.org/10.1016/j.tripleo.2011.08.016

    Article  PubMed  Google Scholar 

  17. Bagan L, Leopoldo-Rodado M, Poveda-Roda R, Murillo-Cortes J, Diaz-Fernández JM, Bagan J (2017) Grade of sclerosis in the contralateral mandibular area in osteonecrosis of the jaws. Int J Oral Maxillofac Surg 46:167–172. https://doi.org/10.1016/j.ijom.2016.09.025

    Article  PubMed  Google Scholar 

  18. Watanabe S, Nakajima K, Mizokami A, Yaegashi H, Noguchi N, Kawashiri S, Inokuchi M, Kinuya S (2017) Bone scan index of the jaw: a new approach for evaluating early-stage anti-resorptive agents-related osteonecrosis. Ann Nucl Med 31:201–210. https://doi.org/10.1007/s12149-016-1145-0

    Article  PubMed  Google Scholar 

  19. Faria KM, Ribeiro ACP, Brandão TB, Silva WG, Lopes MA, Pereira J, Alves MC, Gueiros LA, Shintaku WH, Migliorati CA, Santos-Silva AR (2018) Radiographic patterns of multiple myeloma in the jawbones of patients treated with intravenous bisphosphonates. J Am Dent Assoc 149:382–391. https://doi.org/10.1016/j.adaj.2017.12.028

    Article  PubMed  Google Scholar 

  20. Kubo R, Ariji Y, Taniguchi T, Nozawa M, Katsumata A, Ariji E (2018) Panoramic radiographic features that predict the development of bisphosphonate-related osteonecrosis of the jaw. Oral Radiol 34:151–160. https://doi.org/10.1007/s11282-017-0293-9

    Article  PubMed  Google Scholar 

  21. Wazzan T, Kashtwari D, Almaden WF, Gong Y, Chen Y, Moreb J, Katz J (2018) Radiographic bone loss and the risk of medication-related osteonecrosis of the jaw (MRONJ) in multiple myeloma patients-a retrospective case control study. Spec Care Dent 38:356–361. https://doi.org/10.1111/scd.12318

    Article  Google Scholar 

  22. Krishnan A, Arslanoglu A, Yildirm N, Silbergleit R, Aygun N (2009) Imaging findings of bisphosphonate-related osteonecrosis of the jaw with emphasis on early magnetic resonance imaging findings. J Comput Assist Tomogr 33:298–304. https://doi.org/10.1097/RCT.0b013e31817e4986

    Article  PubMed  Google Scholar 

  23. O’Ryan FS, Khoury S, Liao W et al (2009) Intravenous bisphosphonate-related osteonecrosis of the jaw: bone scintigraphy as an early Indicator. J Oral Maxillofac Surg 67:1363–1372. https://doi.org/10.1016/j.joms.2009.03.005

    Article  PubMed  Google Scholar 

  24. Suei Y (2013) Radiographic findings of bisphosphonate-related osteomyelitis of the jaw: investigation of the diagnostic points by comparison with radiation osteomyelitis, suppurative osteomyelitis, and diffuse sclerosing osteomyelitis. Oral Radiol 29:121–134. https://doi.org/10.1007/s11282-013-0135-3

    Article  Google Scholar 

  25. Imai Y, Hasegawa T, Takeda D, Kusumoto J, Akashi M, Ri S, Furudoi S, Komori T (2016) Evaluation and comparison of CT values in bisphosphonate-related osteonecrosis of the jaw. J Oral Maxillofac Surg Med Pathol 28:19–25. https://doi.org/10.1016/j.ajoms.2015.07.002

    Article  Google Scholar 

  26. Iwata E, Akashi M, Kishimoto M, Kusumoto J, Hasegawa T, Furudoi S, Komori T (2017) Meaning and limitation of cortical bone width measurement with DentaScan in medication-related osteonecrosis of the jaws. Kobe J Med Sci 62:E114–E119

    PubMed  PubMed Central  Google Scholar 

  27. Thomas C, Spanidis M, Engel C, Roos FC, Frees S, Neisius A, Hampel C, Rubenwolf P, Thüroff JW, Walter C, Miederer M (2016) Bone scintigraphy predicts bisphosphonate-induced osteonecrosis of the jaw (BRONJ) in patients with metastatic castration-resistant prostate cancer (mCRPC). Clin Oral Investig 20:753–758. https://doi.org/10.1007/s00784-015-1563-8

    Article  PubMed  Google Scholar 

  28. Koth VS, Figueiredo MA, Salum FG, Cherubini K (2017) Interrelationship of clinical, radiographic and haematological features in patients under bisphosphonate therapy. Dentomaxillofac Radiol 46:20160260. https://doi.org/10.1259/dmfr.20160260

    Article  PubMed  PubMed Central  Google Scholar 

  29. Torres SR, Chen CSK, Leroux BG, Lee PP, Hollender LG, Lloid M, Drew SP, Schubert MM (2015) Mandibular inferior cortical bone thickness on panoramic radiographs in patients using bisphosphonates. Oral Surg Oral Med Oral Pathol Oral Radiol 119:584–592. https://doi.org/10.1016/j.oooo.2015.02.005

    Article  PubMed  PubMed Central  Google Scholar 

  30. Diniz-Freitas M, Fernández-Montenegro P, Fernández-Feijoo J, Limeres-Posse J, González-Mosquera A, Vázquez-García E, Diz-Dios P (2016) Mandibular cortical indices on cone-beam computed tomography images in osteoporotic women on treatment with oral bisphosphonates. Gerodontology 33:155–160. https://doi.org/10.1111/ger.12121

    Article  PubMed  Google Scholar 

  31. Klingelhöffer C, Klingelhöffer M, Müller S, Ettl T, Wahlmann U (2016) Can dental panoramic radiographic findings serve as indicators for the development of medication-related osteonecrosis of the jaw? Dentomaxillofac Radiol 45:20160065. https://doi.org/10.1259/dmfr.20160065

    Article  PubMed  PubMed Central  Google Scholar 

  32. Barngkgei I, Halboub E, Almashraqi A (2019) Effect of bisphosphonate treatment on the jawbone: an exploratory study using periapical and panoramic radiographic evaluation. Oral Radiol 35:159–170. https://doi.org/10.1007/s11282-018-0358-4

    Article  PubMed  Google Scholar 

  33. Feitosa ÉF, Vasconcellos MM, Magalhães RJP, Domingos-Vieira AC, Visconti MA, Guedes FR, Maiolino A, Torres SR (2020) Bisphophonate alterations of the jaw bones in individuals with multiple myeloma. Dentomaxillofac Radiol 49:20190155. https://doi.org/10.1259/dmfr.20190155

    Article  PubMed  Google Scholar 

  34. Barngkgei I, Khattab R (2018) Detecting the effect of bisphosphonates during osteoporosis treatment on jawbones using multidetector computed tomography: the OSTEOSYR project. J Investig Clin Dent 9:e12332. https://doi.org/10.1111/jicd.12332

    Article  PubMed  Google Scholar 

  35. Lesclous P, Abi Najm S, Carrel J-P, Baroukh B, Lombardi T, Willi JP, Rizzoli R, Saffar JL, Samson J (2009) Bisphosphonate-associated osteonecrosis of the jaw: a key role of inflammation? Bone 45:843–852. https://doi.org/10.1016/j.bone.2009.07.011

    Article  PubMed  Google Scholar 

  36. Sanchez-Lopez J, Cariati P, Cambil-Martin J, Villegas-Calvo M, Moreno-Martin ML (2018) Use of bone scintigraphy in the early diagnosis of bisphosphonate related osteonecrosis of the jaw. Case report and review of the literature. J Clin Exp Dent 10:e1235–e1237. https://doi.org/10.4317/jced.55248

    Article  PubMed  PubMed Central  Google Scholar 

  37. Ariji Y, Ariji E (2013) Role of magnetic resonance imaging in diagnosis of bisphosphonate-related osteonecrosis of the jaw. Oral Radiol 29:111–120. https://doi.org/10.1007/s11282-013-0124-6

    Article  Google Scholar 

  38. Bedogni A, Fedele S, Bedogni G, Scoletta M, Favia G, Colella G, Agrillo A, Bettini G, di Fede O, Oteri G, Fusco V, Gabriele M, Ottolenghi L, Valsecchi S, Porter S, Petruzzi M, Arduino P, D’Amato S, Ungari C, Fung Polly PL, Saia G, Campisi G (2014) Staging of osteonecrosis of the jaw requires computed tomography for accurate definition of the extent of bony disease. Br J Oral Maxillofac Surg 52:603–608. https://doi.org/10.1016/j.bjoms.2014.04.009

    Article  PubMed  Google Scholar 

  39. Guo Y, Wang D, Wang Y, Peng X, Guo C (2016) Imaging features of medicine-related osteonecrosis of the jaws: comparison between panoramic radiography and computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol 122:e69–e76. https://doi.org/10.1016/j.oooo.2016.04.007

    Article  PubMed  Google Scholar 

  40. Taniguchi T, Ariji Y, Nozawa M, Naitoh M, Kuroiwa Y, Kurita K, Ariji E (2016) Computed tomographic assessment of early changes of the mandible in bisphosphonate-treated patients. Oral Surg Oral Med Oral Pathol Oral Radiol 122:362–372. https://doi.org/10.1016/j.oooo.2016.06.002

    Article  PubMed  Google Scholar 

  41. Cardoso CL, Barros CA, Curra C, Fernandes LMPSR, Franzolin SOB, Júnior JSF, de Antoni CC, Curi MM (2017) Radiographic findings in patients with medication-related osteonecrosis of the jaw. Int J Dent 2017:1–6. https://doi.org/10.1155/2017/3190301

    Article  Google Scholar 

  42. Soundia A, Hadaya D, Mallya SM, Aghaloo TL, Tetradis S (2018) Radiographic predictors of bone exposure in patients with stage 0 medication-related osteonecrosis of the jaws. Oral Surg Oral Med Oral Pathol Oral Radiol 126:537–544. https://doi.org/10.1016/j.oooo.2018.08.005

    Article  PubMed  PubMed Central  Google Scholar 

  43. Şahin O, Odabaşı O, Demiralp KÖ, Kurşun-Çakmak EŞ, Aliyev T (2019) Comparison of findings of radiographic and fractal dimension analyses on panoramic radiographs of patients with early-stage and advanced-stage medication-related osteonecrosis of the jaw. Oral Surg Oral Med Oral Pathol Oral Radiol 128:78–86. https://doi.org/10.1016/j.oooo.2019.03.002

    Article  PubMed  Google Scholar 

  44. Rugani P, Luschin G, Jakse N, Kirnbauer B, Lang U, Acham S (2014) Prevalence of bisphosphonate-associated osteonecrosis of the jaw after intravenous zoledronate infusions in patients with early breast cancer. Clin Oral Investig 18:401–407. https://doi.org/10.1007/s00784-013-1012-5

    Article  PubMed  Google Scholar 

  45. Bagan JV, Cibrian RM, Lopez J, Leopoldo-Rodado M, Carbonell E, Bagán L, Utrilla J, Scully C (2015) Sclerosis in bisphosphonate-related osteonecrosis of the jaws and its correlation with the clinical stages: study of 43 cases. Br J Oral Maxillofac Surg 53:257–262. https://doi.org/10.1016/j.bjoms.2014.12.004

    Article  PubMed  Google Scholar 

  46. Mawardi H, Treister N, Richardson P, Anderson K, Munshi N, Faiella RA, Woo SB (2009) Sinus tracts—an early sign of bisphosphonate-associated osteonecrosis of the jaws? J Oral Maxillofac Surg 67:593–601. https://doi.org/10.1016/j.joms.2008.09.031

    Article  PubMed  Google Scholar 

  47. Fedele S, Porter SR, D’Aiuto F et al (2010) Nonexposed variant of bisphosphonate-associated osteonecrosis of the jaw: a case series. Am J Med 123:1060–1064. https://doi.org/10.1016/j.amjmed.2010.04.033

    Article  PubMed  Google Scholar 

  48. Aghaloo TL, Dry SM, Mallya S, Tetradis S (2014) Stage 0 osteonecrosis of the jaw in a patient on denosumab. J Oral Maxillofac Surg 72:702–716. https://doi.org/10.1016/j.joms.2013.09.008

    Article  PubMed  PubMed Central  Google Scholar 

  49. Barba-Recreo P, Del Castillo Pardo de Vera JL, García-Arranz M et al (2014) Zoledronic acid - related osteonecrosis of the jaws. Experimental model with dental extractions in rats. J Craniomaxillofac Surg 42:744–750. https://doi.org/10.1016/j.jcms.2013.11.005

    Article  PubMed  Google Scholar 

  50. Kim Y, Lee H-Y, Yoon H-J, Kim BS (2016) Utility of 18F-fluorodeoxy glucose and 18F-sodium fluoride positron emission tomography/computed tomography in the diagnosis of medication-related osteonecrosis of the jaw: a preclinical study in a rat model. J Cranio-Maxillofac Surg 44:357–363. https://doi.org/10.1016/j.jcms.2016.01.009

    Article  Google Scholar 

  51. Martelli SJR, Damian MF, Gomes APN, Schinestsck AR, Silva AER, Vasconcelos ACU (2017) Comparison of effects of zoledronic acid and clodronate on the bone structure: imaginological and histomorphometrical study in vivo. J Oral Pathol Med 46:632–636. https://doi.org/10.1111/jop.12546

    Article  PubMed  Google Scholar 

  52. Vilarinho JLP, Ferrare N, Moreira AMR, Moura HF, Acevedo AC, Chaves SB, Melo NS, Leite AF, Macedo SB, de Souza MP, Guimarães ATB, Figueiredo PT (2017) Early bony changes associated with bisphosphonate-related osteonecrosis of the jaws in rats: a longitudinal in vivo study. Arch Oral Biol 82:79–85. https://doi.org/10.1016/j.archoralbio.2017.06.002

    Article  PubMed  Google Scholar 

  53. Soares MQS, Van Dessel J, Jacobs R et al (2018) Zoledronic acid induces site-specific structural changes and decreases vascular area in the alveolar bone. J Oral Maxillofac Surg 76:1893–1901. https://doi.org/10.1016/j.joms.2018.03.007

    Article  PubMed  Google Scholar 

  54. de Molon RS, Cheong S, Bezouglaia O, Dry SM, Pirih F, Cirelli JA, Aghaloo TL, Tetradis S (2014) Spontaneous osteonecrosis of the jaws in the maxilla of mice on antiresorptive treatment: a novel ONJ mouse model. Bone 68:11–19. https://doi.org/10.1016/j.bone.2014.07.027

    Article  PubMed  PubMed Central  Google Scholar 

  55. Soundia A, Hadaya D, Esfandi N, de Molon RS, Bezouglaia O, Dry SM, Pirih FQ, Aghaloo T, Tetradis S (2016) Osteonecrosis of the jaws (ONJ) in mice after extraction of teeth with periradicular disease. Bone 90:133–141. https://doi.org/10.1016/j.bone.2016.06.011

    Article  PubMed  PubMed Central  Google Scholar 

  56. Otto S, Pautke C, Martin Jurado O, Nehrbass D, Stoddart MJ, Ehrenfeld M, Zeiter S (2017) Further development of the MRONJ minipig large animal model. J Craniomaxillofac Surg 45:1503–1514. https://doi.org/10.1016/j.jcms.2017.07.002

    Article  PubMed  Google Scholar 

  57. Bianchi SD, Scoletta M, Cassione FB, Migliaretti G, Mozzati M (2007) Computerized tomographic findings in bisphosphonate-associated osteonecrosis of the jaw in patients with cancer. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 104:249–258. https://doi.org/10.1016/j.tripleo.2007.01.040

    Article  PubMed  Google Scholar 

  58. Arce K, Assael LA, Weissman JL, Markiewicz MR (2009) Imaging findings in bisphosphonate-related osteonecrosis of jaws. J Oral Maxillofac Surg 67:75–84. https://doi.org/10.1016/j.joms.2008.12.002

    Article  PubMed  Google Scholar 

Download references

Funding

The study was self-funded.

Author information

Authors and Affiliations

  1. OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, Leuven, Belgium

    Catalina Moreno-Rabié, Hugo Gaêta-Araujo, Constantinus Politis & Reinhilde Jacobs

  2. Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium

    Catalina Moreno-Rabié, Hugo Gaêta-Araujo, Constantinus Politis & Reinhilde Jacobs

  3. Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Sao Paulo, Brazil

    Hugo Gaêta-Araujo

  4. Department of Stomatology, Public Oral Health, Forensic Dentistry, Division of Oral Radiology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Sao Paulo, Brazil

    Christiano Oliveira-Santos

  5. Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden

    Reinhilde Jacobs

Authors
  1. Catalina Moreno-Rabié
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hugo Gaêta-Araujo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Christiano Oliveira-Santos
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Constantinus Politis
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Reinhilde Jacobs
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Catalina Moreno-Rabié.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

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

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

ESM 1

(DOCX 23.9 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Moreno-Rabié, C., Gaêta-Araujo, H., Oliveira-Santos, C. et al. Early imaging signs of the use of antiresorptive medication and MRONJ: a systematic review. Clin Oral Invest 24, 2973–2989 (2020). https://doi.org/10.1007/s00784-020-03423-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00784-020-03423-0

Keywords

Search

Navigation