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Volumetric analysis of MRONJ lesions by semiautomatic segmentation of CBCT images

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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.

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Author notes

  1. Matthias Zirk and Johannes Buller contributed equally to this work.

Authors and Affiliations

  1. Department for Oral and Craniomaxillofacial and Plastic Surgery, University Hospital of Cologne, Kerpener Strasse 62, 50931, Cologne, Germany

    Matthias Zirk, Johannes Buller & Joachim E. Zöller

  2. Department for Oral and Maxillofacial Surgery, University Hospital Duesseldorf, Duesseldorf, Germany

    Norbert Kübler & Max-Philipp Lentzen

  3. Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Cologne, Germany

    Carola Heneweer

Authors
  1. Matthias Zirk
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Correspondence to Matthias Zirk.

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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.

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Zirk, M., Buller, J., Zöller, J.E. et al. Volumetric analysis of MRONJ lesions by semiautomatic segmentation of CBCT images. Oral Maxillofac Surg 23, 465–472 (2019). https://doi.org/10.1007/s10006-019-00805-x

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  • DOI: https://doi.org/10.1007/s10006-019-00805-x

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