Computer programme to assess mandibular cortex morphology in cases of medication-related osteonecrosis of the jaw with osteoporosis or bone metastases

PURPOSE: The purpose of this study was to evaluate the morphology of the mandibular cortex in cases of medication-related osteonecrosis of the jaw (MRONJ) in patients with osteoporosis or bone metastases using a computer programme.MATERIALS AND METHODS: Fifty-four patients with MRONJ (35 with osteoporosis and 19 with bone metastases) were examined using panoramic radiography. The morphology of the mandibular cortex was evaluated using a computer programme that scanned the mandibular inferior cortex and automatically assessed the mandibular cortical index (MCI) according to the thickness and roughness of the mandibular cortex, as follows: normal (class 1), mildly to moderately eroded (class 2), or severely eroded (class 3). The MCI classifications of MRONJ patients with osteoporosis or bone metastases were evaluated with the Pearson chi-square test. In these analyses, a 5% significance level was used.RESULTS: The MCI of MRONJ patients with osteoporosis (class 1: 6, class 2: 15, class 3: 14) tended to be higher than that of patients with bone metastases (class 1: 14, class 2: 5, class 3: 0) (P=0.000).CONCLUSION: The use of a computer programme to assess mandibular cortex morphology may be an effective technique for the objective and quantitative evaluation of the MCI in MRONJ patients with osteoporosis or bone metastases.

Computed Tomographic Analysis of Inflammatory Spread in Adult Parotitis / Oral Science International

Adult parotitis exhibits various appearances on images. The purpose of this study was to investigate the imaging features of adult parotitis, focusing on the inflammatory spread in and around the parotid gland on CT images. We investigated 21 patients who were clinically and radiologically diagnosed with parotitis, including patients with concomitant occurrences of sialolith or Sjören's syndrome. Intra-glandular spread was divided into 13 diffuse types and 8 focal types. There was a significant difference in duration from the first onset of symptoms between the diffuse and focal types. Six of 8 patients showing focal type spread were associated with the concomitant occurrence of sialolith or Sjören's syndrome. Extra-glandular spread was observed in 13 (62%) patients. Of them, 12 (92%) showed subcutaneous fat tissue and/or masticator space involvement. Involvement of the parapharyngeal space and the superficial area just below the gland was observed in 4 and 7 patients, respectively. The appearance of extra-glandular spread was influenced by intra-glandular appearance and concomitant disease. The spread of adult parotitis possessed characteristic features in relation to clinical findings and concomitant disease. CT examination appeared to be effective for these diagnoses.