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Bisphosphonate-related osteonecrosis of the jaw: clinical correlations with computerized tomography presentation
Authors:Sharon Elad  Moshe J Gomori  Noa Ben-Ami  Silvina Friedlander-Barenboim  Eran Regev  Towy S Lazarovici  Noam Yarom
Institution:1. Department of Oral Medicine, Hebrew University–Hadassah School of Dental Medicine, POB 12272, Jerusalem, 91120, Israel
2. Department of Clinical Radiology, Hadassah University Medical Center, Jerusalem, Israel
3. Department of Oral and Maxillofacial Surgery, The Hebrew University–Hadassah School of Dental Medicine, Jerusalem, Israel
4. Department of Oral and Maxillofacial Surgery, Sheba Medical Center, Tel-Hashomer, Israel
5. Department of Oral Pathology and Oral Medicine, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
Abstract:The aim of this study was to correlate clinical and computerized tomography (CT) features of bisphosphonate-related osteonecrosis of the jaws (BRONJ). All ONJ patients for whom there was complete CT scan imaging were eligible. Selected clinical parameters retrieved from their medical records were analyzed for correlation with CT parameters. The clinical presentation of BRONJ was supported by findings in CT imaging in 78.3%. The lesion’s size on CT correlated with the presence of purulent secretion (p?=?0.03). When sequestrum was present, the median lesion’s size on CT was relatively big (28 mm, range 21–43 mm). The mandibular canal cortex was never breached. CT has reasonable detection competence for diagnosing BRONJ. Purulent secretion indicates the likelihood that a more extensive involvement will be displayed on CT. A large lesion on CT should raise the index of suspicion for sequestrum. The CT appearance of a continuous cortex of the mandibular canal may serve as a differential parameter between BRONJ and metastasis to the jaw.
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