RESUMO
Pathological fracture is one of the most serious complications in medication-related osteonecrosis of the jaw (MRONJ). This case is a report of an 87-year-old woman who had been diagnosed with pathological fracture due to MRONJ. The authors performed minimally invasive and conservative treatment, such as intraoral dressing, antibiotic therapy, and simple debridement, for patients with pathologic fractures due to MRONJ. After 1 year, the inflammatory symptoms disappeared and pathological fractures spontaneously recovered.
Assuntos
Osteonecrose da Arcada Osseodentária Associada a Difosfonatos , Conservadores da Densidade Óssea , Fraturas Espontâneas , Feminino , Humanos , Idoso de 80 Anos ou mais , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/diagnóstico por imagem , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/etiologia , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/terapia , Antibacterianos/uso terapêutico , DifosfonatosRESUMO
BACKGROUND: In this study, we investigated whether deep learning-based prediction of osseointegration of dental implants using plain radiography is possible. METHODS: Panoramic and periapical radiographs of 580 patients (1,206 dental implants) were used to train and test a deep learning model. Group 1 (338 patients, 591 dental implants) included implants that were radiographed immediately after implant placement, that is, when osseointegration had not yet occurred. Group 2 (242 patients, 615 dental implants) included implants radiographed after confirming successful osseointegration. A dataset was extracted using random sampling and was composed of training, validation, and test sets. For osseointegration prediction, we employed seven different deep learning models. Each deep-learning model was built by performing the experiment 10 times. For each experiment, the dataset was randomly separated in a 60:20:20 ratio. For model evaluation, the specificity, sensitivity, accuracy, and AUROC (Area under the receiver operating characteristic curve) of the models was calculated. RESULTS: The mean specificity, sensitivity, and accuracy of the deep learning models were 0.780-0.857, 0.811-0.833, and 0.799-0.836, respectively. Furthermore, the mean AUROC values ranged from to 0.890-0.922. The best model yields an accuracy of 0.896, and the worst model yields an accuracy of 0.702. CONCLUSION: This study found that osseointegration of dental implants can be predicted to some extent through deep learning using plain radiography. This is expected to complement the evaluation methods of dental implant osseointegration that are currently widely used.