Abstract
<h3>Background</h3> <i>Medication-related osteonecrosis of the jaw</i> (MRONJ) refers to devitalization of bone caused by external insults. Radiographic features of sclerosis, osteolysis, periosteal reaction, and sequestration are seen in varying degrees of stages of MRONJ and may serve as a predictor for future morbidity. However, currently there are no protocols to guide the clinician for appropriate imaging in patients with MRONJ. <h3>Objectives</h3> The aim of this study was to provide an overview of the pathophysiology of MRONJ; to discuss the role of radiographic imaging during the assessment of patients with MRONJ; to review the recent literature on radiographic imaging of MRONJ; and to propose a guideline to aid in clinical decision making to perform imaging of MRONJ. <h3>Study Design</h3> The review included studies examining the contribution of imaging to MRONJ, a study by our own group. <h3>Results</h3> There are no current applicable results for this research presentation. <h3>Discussion</h3> The diagnosis and staging of MRONJ is currently based on patient history and clinical findings. Panoramic and intraoral radiographs help make an overall assessment. However, the presence or extent of necrotic changes may be underestimated on panoramic radiographs, complicating differentiation of MRONJ from dental disease. Although cone beam computed tomography (CBCT) provides improved visualization of the MRONJ lesion, criteria to identify patients who would benefit from this modality are lacking. Certain radiographic parameters seen in stage 0 MRONJ may predict progression to clinical bone exposure. Thus, imaging findings play an important role in evaluating the extent of disease, facilitating staging, and determining subsequent management. This report provides a review of the literature pertaining to the value of CBCT imaging in MRONJ management. Guided by these data, we propose an imaging protocol to facilitate clinical decision making and appropriate application of CBCT imaging.
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