Changes in dimension of neurovascular canals in the mandible and maxilla: A radiographic finding in patients diagnosed with MRONJ.

D Goller-Bulut,G Ozcan,F Avci

doi:10.4317/medoral.22274

Abstract

BackgroundThe aim of this retrospective study was to compare the morphological features of neurovascular canals and foramina of patients with medication-related osteonecrosis of the jaws (MRONJ) and healthy individuals by using cone beam computed tomography (CBCT).Material and MethodsThe CBCT images of 58 patients under bisphosphonate therapy diagnosed with MRONJ and age gender- matched controls were retrospectively evaluated. The diameter of mandibular and nasopalatine canal and mandibular, mental and lingual foramina were measured on several sections of CBCT. The value of mental index (MI) and panoramic mandibular index (PMI) were also assessed.ResultsThe mean value of diametric measurements for all neurovascular canals and foramina in MRONJ patients were narrower than controls. Left mandibular foramen was the most affected area (p<0.001). There were significantly difference in all measurements of mental foramen, lingual foramen and mandibular incisive canal between two groups (p<0.05). PMI of MRONJ subjects were also significantly differences in both sides (p<0.05).ConclusionsIn MRONJ patient, neurovascular canals and foramina are affected due to the alterations in bone remodeling. Therefore, the diametric measurement of neurovascular canals and assessment of MI and PMI on CBCT, is a potentially useful method for detection of early changes associated with bisphosphonate therapy and for predict areas where new necrosis may occur. Key words:Bisphosphonate, MRONJ, CBCT, neurovascular canals, PMI.

Highlights

Medication-related osteonecrosis of the jaw (MRONJ) is a quite serious drug reaction, consisting of bone destruction in the maxillofacial region of patients
This study was aimed to investigate the changing in dimension of neurovascular canals, mental index (MI) and panoramic mandibular ındex (PMI) by using cone beam computed tomography (CBCT) that may help to understand whether it is a diagnostic value in early diagnosis of medication-related osteonecrosis of the jaws (MRONJ)
The present study suggested that these diametric measurements and indexes are useful tools for MRONJ risk evaluaion in BPs-exposed patients

Summary

Introduction

Medication-related osteonecrosis of the jaw (MRONJ) is a quite serious drug reaction, consisting of bone destruction in the maxillofacial region of patients. MRONJ is described by the presence of exposed bone in the maxillofacial area more than 8 weeks, an anamnesis of present or prior treatment with BPs and the exception of a radiation therapy history to the maxillofacial region It may remain asymptomatic for months, Stage 0 was defined as a level of potentially emerging MRONJ in line with the clinical guideline [5]. This study was aimed to investigate the changing in dimension of neurovascular canals, mental index (MI) and panoramic mandibular ındex (PMI) by using CBCT that may help to understand whether it is a diagnostic value in early diagnosis of MRONJ The aim of this retrospective study was to compare the morphological features of neurovascular canals and foramina of patients with medication-related osteonecrosis of the jaws (MRONJ) and healthy individuals by using cone beam computed tomography (CBCT). The diametric measurement of neurovascular canals and assessment of MI and PMI on CBCT, is a potentially useful method for detection of early changes associated with bisphosphonate therapy and for predict areas where new necrosis may occur

Objectives

Findings

Discussion

Conclusion