TY - JOUR
T1 - Do various imaging modalities provide potential early detection and diagnosis of medication-related osteonecrosis of the jaw? A review
AU - Wongratwanich, Pongsapak
AU - Shimabukuro, Kiichi
AU - Konishi, Masaru
AU - Nagasaki, Toshikazu
AU - Ohtsuka, Masahiko
AU - Suei, Yoshikazu
AU - Nakamoto, Takashi
AU - Verdonschot, Rinus G.
AU - Kanesaki, Tomohiko
AU - Sutthiprapaporn, Pipop
AU - Kakimoto, Naoya
PY - 2021
Y1 - 2021
N2 - textlessbrtextgreaterObjective: Patients with medication-related osteonecrosis of the jaw (MRONJ) often visit their dentists at advanced stages and subsequently require treatments that greatly affect quality of life. Currently, no clear diagnostic criteria exist to assess MRONJ, and the definitive diagnosis solely relies on clinical bone exposure. This ambiguity leads to a diagnostic delay, complications, and unnecessary burden. This article aims to identify imaging modalitiestextquotesingle usage and findings of MRONJ to provide possible approaches for early detection.textlessbrtextgreatertextlessbrtextgreaterMethods: Literature searches were conducted using PubMed, Web of Science, Scopus, and Cochrane Library to review all diagnostic imaging modalities for MRONJ.textlessbrtextgreatertextlessbrtextgreaterResults: Panoramic radiography offers a fundamental understanding of the lesions. Imaging findings were comparable between non-exposed and exposed MRONJ, showing osteolysis, osteosclerosis, and thickened lamina dura. Mandibular cortex index Class II could be a potential early MRONJ indicator. While three-dimensional modalities, CT and CBCT, were able to show more features unique to MRONJ such as a solid type periosteal reaction, buccal predominance of cortical perforation, and bone-within-bone appearance. MRI signal intensities of vital bones are hypointense on T1WI and hyperintense on T2WI and STIR when necrotic bone shows hypointensity on all T1WI, T2WI, and STIR. Functional imaging is the most sensitive method but is usually performed in metastasis detection rather than being a diagnostic tool for early MRONJ.textlessbrtextgreatertextlessbrtextgreaterConclusion: Currently, MRONJ-specific imaging features cannot be firmly established. However, the current data are valuable as it may lead to a more efficient diagnostic procedure along with a more suitable selection of imaging modalities.textlessbrtextgreater
AB - textlessbrtextgreaterObjective: Patients with medication-related osteonecrosis of the jaw (MRONJ) often visit their dentists at advanced stages and subsequently require treatments that greatly affect quality of life. Currently, no clear diagnostic criteria exist to assess MRONJ, and the definitive diagnosis solely relies on clinical bone exposure. This ambiguity leads to a diagnostic delay, complications, and unnecessary burden. This article aims to identify imaging modalitiestextquotesingle usage and findings of MRONJ to provide possible approaches for early detection.textlessbrtextgreatertextlessbrtextgreaterMethods: Literature searches were conducted using PubMed, Web of Science, Scopus, and Cochrane Library to review all diagnostic imaging modalities for MRONJ.textlessbrtextgreatertextlessbrtextgreaterResults: Panoramic radiography offers a fundamental understanding of the lesions. Imaging findings were comparable between non-exposed and exposed MRONJ, showing osteolysis, osteosclerosis, and thickened lamina dura. Mandibular cortex index Class II could be a potential early MRONJ indicator. While three-dimensional modalities, CT and CBCT, were able to show more features unique to MRONJ such as a solid type periosteal reaction, buccal predominance of cortical perforation, and bone-within-bone appearance. MRI signal intensities of vital bones are hypointense on T1WI and hyperintense on T2WI and STIR when necrotic bone shows hypointensity on all T1WI, T2WI, and STIR. Functional imaging is the most sensitive method but is usually performed in metastasis detection rather than being a diagnostic tool for early MRONJ.textlessbrtextgreatertextlessbrtextgreaterConclusion: Currently, MRONJ-specific imaging features cannot be firmly established. However, the current data are valuable as it may lead to a more efficient diagnostic procedure along with a more suitable selection of imaging modalities.textlessbrtextgreater
U2 - 10.1259/dmfr.20200417
DO - 10.1259/dmfr.20200417
M3 - Article
SN - 0250-832X
VL - 50
JO - Dentomaxillofacial Radiology
JF - Dentomaxillofacial Radiology
IS - 6
ER -