ABSTRACT
The objective of this study was to compare the grade of radiographic sclerosis between the area of osteonecrosis and the at-risk contralateral mandibular area without osteonecrosis. Three groups were studied: group 1 comprised 30 cases of medication-related osteonecrosis of the jaws (MRONJ); group 2 was the healthy contralateral area without osteonecrosis of the group 1 cases; group 3 comprised 30 healthy controls. ImageJ software was used to analyze the computed tomography images, and the grade of bone sclerosis was compared between the three groups. The grade of sclerosis was significantly higher in group 1 than in the other groups (P<0.05); the difference between groups 2 and 3 was not significant. Sclerosis was significantly greater in the area of bone necrosis than in the contralateral mandibular area in patients with MRONJ. No significant differences were found in the grade of sclerosis between the contralateral non-affected mandibular area of patients with MRONJ and the control patients.
Subject(s)
Bisphosphonate-Associated Osteonecrosis of the Jaw/pathology , Mandibular Diseases/pathology , Aged , Bisphosphonate-Associated Osteonecrosis of the Jaw/diagnostic imaging , Case-Control Studies , Female , Humans , Male , Mandibular Diseases/diagnostic imaging , SclerosisABSTRACT
We analysed the degree of sclerosis in the different stages of bisphosphonate-related osteonecrosis of the jaws (BRONJ) and studied the relation between the grade of sclerosis, the clinical symptoms, and the depth of lucency. We compared 43 patients with mandibular BRONJ with a control group of 40 cases with no bony lesions. The presence of sclerotic bone, cortical irregularities, radiolucency, fragmentation or sequestration, periostitis, and narrowing of the mandibular canal were studied from computed tomographic (CT) scans using the program ImageJ 1.47v (National Institute of Health, Bethesda, USA) to measure the radiolucency, width of the cortices, and degree of sclerosis. Patients with BRONJ had more severe sclerosis than controls (p<0.01). There was also a significant difference among the different stages of BRONJ, with the highest values found in stage III (p=0.02). The degree of sclerosis differed according to sex, type of bisphosphonate, and the clinical characteristics such as pain, or suppuration, but not significantly so (p>0.05). We conclude that the degree of sclerosis increases with the clinical stage of BRONJ, and is correlated with the depth of lucency.
