Cone-beam Computed Tomography Imaging Findings of Bisphosphonate-related Osteonecrosis of the Jaws (BRONJ): A Review Article

Abstract

Bisphosphonates are potent synthetic analogs of pyrophosphates that act to inhibit osteoclasts and reduce bone metabolism. These drugs have become important in the treatment of bone lesions of multiple myeloma, Paget’s disease, hypercalcemia of malignancy, metastatic bone tumors, and osteoporosis. The most common complication in patients on bisphosphonate therapy is osteonecrosis of jaw (ONJ) which can occur after any surgical dental procedure such as extraction, periodontal or endodontic surgery, or implant placement. Imaging may play an important role in determining the extent of the disease; the considerable number of studies investigating CT and/or MRI for bisphosphonate-related osteonecrosis (BRONJ) imaging, there are significantly fewer papers in the literature that study the use of cone-beam computed tomography (CBCT) as a modality for imaging of BRONJ lesions. The purpose of this article is to investigate the radiological signs of BRONJ in CBCT scans and review of the literature.