ASSESSMENT OF OSSEOUS DENSITY CHANGES IN PATIENTS WITH MEDICATION-RELATED OSTEONECROSIS OF THE JAWS USING CONE-BEAM CT: A CASE CONTROL STUDY

Abstract

Objective: In this study, the aim was to analyze density differences in prearranged region of patients with medication-related osteonecrosis of the jaws (MRONJ) and to evaluate potential effected sides in jaws by using cone beam computed tomography (CBCT)Material and Methods: The records of 29 patients diagnosed with MRONJ and under bisphosphonates therapy and examined by CBCT were retrospectively evaluated with age- and gender-matched controls. The gray values (voxel value (VV)) were detected in the maxillary tuberosity (MTs), anterior supporting bone of nasopalatine canal (NPCs), mental foramen regions (MFs), center of symphysis and the bone surrounding the MRONJ area.Results: According to the results, the mostly affected area was the bone under the mental foramen. There were significant differences between MRONJ and controls for right and left MFs (p=0.03, p=0.006 respectively). The mean gray value of right MTs were: 165.04 for controls and 212.4 for patients (p=0.13); left MTs were 208.6 for controls and 268.0 for patients (p=0.32); NPCs were 575.1 for controls and 572.6 for patients (p=0.96); and MSs were 679.2 for controls and 828.2 for patients (p=0.1). The gray value in the inferior peripheral bone of exposed region was the highest.Conclusion: The present study shows that bisphosphonates cause internal morphological changes in jaws. Morphological changes are more frequent in certain parts of the jawbone such as the mental foramen. Gray values obtained by CBCT for quantitative measurements of density differences, can help achieve useful data for prediction of hazardous conditions where MRONJ can occur and how it will progress.