Abstract
Osteonecrosis of the jaw is a severe bone disease that occurs as a result of reduced local blood supply. Bisphosphonate-associated osteonecrosis of the jaw usually occurs following dental procedures. We report clinical and radiological findings in a case of mandibular osteonecrosis associated with the use of bisphosphonate; the mandibular osteonecrosis was undiagnosed prior to cross-sectional imaging with computed tomography. The radiological correlation to the underlying pathological process and a correlative assessment of history, clinical, and imaging findings enabled the diagnosis. A discussion of differential diagnoses is provided to alert the oral radiologist to the presence of this condition in cases with typical imaging findings. The literature on indications for advanced imaging is reviewed to simplify the selection of the appropriate imaging modality for mandibular osteonecrosis.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Carneiro E, Vibhute P, Montazem A, Som PM. Bisphosphonate-associated mandibular osteonecrosis. AJNR. 2006;27:1096–9.
Chiandussi S, Biasatto M, Dore F, Cavalli F, Cova MA, Di Lenarda R. Clinical and diagnostic imaging of bisphosphonate-associated osteonecrosis of the jaw. Dentomaxillofac Radiol. 2006;35:236–43.
Hess LM, Jeter JM, Hutchins MB, Alberts DS. Factors associated with osteonecrosis of the jaw among bisphosphonate users. Am J Med. 2008;121(6):475–83.
Hughes DE, MacDonald BR, Russell RG, Gowen M. Inhibition of osteoclast-like cell formation by bisphosphonates in long-term cultures of human bone marrow. J Clin Invest. 1989;83:1930–5.
Fleisch H. Bisphosphonates: mechanisms of action. Endocr Rev. 1998;19:80–100.
Ruggiero SL, Fantasia J, Carlson E. Bisphosphonate-related osteonecrosis of the jaw: background and guidelines for diagnosis, staging and management. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;102:433–41.
Cossío PI, Macián AC, Ceballos JLP, Nicas JP, Pérez JLG. Bisphosphonate-related osteonecrosis of the jaw in patients with multiple myeloma. Med Oral Patol Oral Cir Bucal. 2008;13(1):E52–7.
Clarke BM, Boyette J, Vural E, Suen JY, Anaissie EJ, Stack BC Jr. Bisphosphonates and jaw osteonecrosis: the UAMS experience. Otolaryngol Head Neck Surg. 2007;136(3):396–400.
Advisory Task Force on Bisphosphonate-Related Osteonecrosis of the Jaws, American Association of Oral and Maxillofacial Surgeons. American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaws. J Oral Maxillofac Surg. 2007;65(3):369–76.
Bedoni A, Blandamura S, Lokmic Z, Palumba C, Ragazzo M, Ferrari F, et al. Bisphosphonate-associated jawbone osteonecrosis: a correlation between imaging techniques and histopathology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;105(3):358–64.
Khosla S, Burr D, Cauley J, Dempster DW, Ebeling PR, Felsenberg D, et al. Bisphosphonate-associated osteonecrosis of the jaw: report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res. 2007;22:1479–91.
Erkan M, Bilgi O, Mutluoğlu M, Uzun G. Bisphosphonate-related osteonecrosis of the jaw in cancer patients and hyperbaric oxygen therapy. JOP. 2009;10(5):579–80.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Sahai, S., Arora, H. & Aggarwal, B. CT imaging in bisphosphonate-associated mandibular osteonecrosis: case report, pathological correlates, and review of literature. Oral Radiol 27, 64–67 (2011). https://doi.org/10.1007/s11282-011-0059-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11282-011-0059-8