Computed tomographic assessment of early changes of the mandible in bisphosphonate-treated patients

Abstract

To compare the computed tomography (CT) features of mandibular cancellous and cortical bones between patients with bisphosphonate (BP) administration and those without and to assess the early changes of the mandible in BP-treated patients. Twenty-four BP-treated patients suffering from medication-related osteonecrosis of the jaw (MRONJ) were enrolled in this study. For comparison, 20 patients suffering from osteomyelitis and 20 patients without pathology in the jaw were also enrolled, all of whom did not receive BP treatment. The CT values of the cancellous and cortical bone and the cortical bone widths were measured. In the MRONJ and osteomyelitis groups, there were significant differences in the CT values of cancellous and cortical bones between the affected and unaffected areas. In patients with stage 0 MRONJ, a significant difference was noted in the cancellous bone CT values between these areas. The cancellous bone CT values at the affected and unaffected areas in the BP-treated group were significantly higher than in the control groups. In patients with stage 0 MRONJ, the cancellous bone CT values at the affected area were also significantly higher than in the healthy patients. The cortical bone widths in the unaffected areas in the BP-treated patients were significantly larger than in healthy patients. The cancellous bone CT values were higher in the BP-treated group, including in patients with stage 0 MRONJ, and CT may provide useful quantitative information.