Tomography Features Research Articles

Lymphadenopathy Secondary to Metastatic Squamous Cell Carcinoma Mistaken for Malignant Lymphoma.

It is difficult to identify disease entities underlying lymphadenopathy in the head and neck region based solely on imaging. This often results in metastatic squamous cell carcinoma (Sqcc)-induced lymphadenopathy being mistaken for lymphoma. This study aimed to analyze clinical characteristics and computed tomographic features that aid in distinguishing between metastatic Sqcc and lymphoma when lymphadenopathy resembles a large solitary lymphoma. The authors retrospectively enrolled 5 patients, managed between 2010 and 2024, with metastatic Sqcc mistaken for lymphoma and 9 patients with lymphadenopathy of 2cm or larger due to lymphoma. Among the 5 patients, 3 exhibited a homogeneous lymphadenopathy phenotype, whereas the remaining 2 displayed heterogeneous enhancement with multiple small necrotic areas within the affected masses. Measurement of the Hounsfield units (HU) for lymphadenopathy, the sternocleidomastoid muscle, and the submandibular gland (SMG) was conducted for each patient. The ratio of lymphadenopathy HU to the average HU of the sternocleidomastoid muscle and the SMG was significantly higher in patients diagnosed with metastatic Sqcc compared with those with lymphoma (P = 0.01). In computed tomography scans, heterogeneous lymphadenopathy or enhancement levels that approach or exceed those of the SMG may indicate the likelihood of Sqcc rather than lymphoma.

Dentigerous cysts in horses: A retrospective study

SummaryBackgroundDentigerous cysts are well‐known congenital defects in horses, and the literature on this condition is extensive. Recently, a third type of dentigerous cyst, associated with an exostosis arising from the temporal bone, has been described. Today, computed tomography (CT) is often available and provides detailed information about the exact location and extent of dentigerous cysts, allowing for the description of new findings.Study designThis is a case series outlining the clinical, radiographic and computed tomographic features of dentigerous cysts in seven horses presented to the Equine Clinic at the Vetsuisse Faculty, University of Zurich, Switzerland.ObjectivesThe aim of this case series was to describe the radiographic and computed tomographic findings, and the occurrence of exostoses arising from the temporal bone, in horses with dentigerous cysts.MethodsThe medical records of the Equine Hospital at the University of Zurich were reviewed for horses admitted with dentigerous cysts between 2007 and 2023. Data collected and analysed included patient signalment, clinical history, clinical signs and their duration prior to referral, diagnostic imaging results, treatment and outcomes.ResultsThe most common location for the cysts was the base of the ear, although in one case, the maxillary sinus was involved. Of the seven cases, four were Icelandic horses. CT proved superior to standard radiography for determining the extent and precise location of the cysts, as well as for identifying dental material and exostoses in the temporal region. CT also facilitated detailed surgical planning. All cysts were surgically removed with good long‐term outcomes.Main limitationsOverall, the incidence of dentigerous cysts in horses was low. The relatively high occurrence of dentigerous cysts in Icelandic horses in this study is an interesting finding, though the small sample size calls for further research.ConclusionsTwo of the cases in this series were similar to a recently described variant of a ‘temporal dentigerous cyst associated with an exostosis in the temporal region’ and were closely connected to the bony structure and draining tract.

Late corneal ectasia after penetrating and deep anterior lamellar keratoplasty for keratoconus.

To investigate tomographic features of late corneal ectasia after keratoplasty for keratoconus and compare penetrating keratoplasty (PK) and deep anterior lamellar keratoplasty (DALK) in terms of incidence, time of onset and risk factors of corneal ectasia. Sixty eyes with PK and 30 eyes with DALK operated between 1999 and 2021 were analyzed. Final Pentacam scans were evaluated together with vision and previous topographies. Main outcome measures were vision, K values, apparent thinning on graft-host cornea and the difference between opposing quadrants in the thinnest point measurements. Anterior segment optic coherence tomography was performed for further evaluation. Mean follow-up was 127.2mo (24-282mo) in PK, and 64.3mo (24-144mo) in DALK. K max was higher in DALK (60.6 vs 56.7 D, P=0.012). Inferior recipient was thinner (595.9 µm) in PK than DALK (662.2 µm, P=0.021), due to longer follow-up. Overall corneal ectasia rate was 20.0% within 24y. Ectasia rate was the same (6.7%) in DALK 2/30 and in PK 4/60 in 10y and 13.3% in 12y (4/30 and 8/60, respectively). It increased to 23.3% (14/60) in PK over 24y. While ectasia was not seen before 7y in PK, it could be seen in DALK starting from the 5th year. The intervals between keratoplasty and ectasia were 144.5mo in PK and 99mo in DALK. Inferior recipient was significantly thinner in 18 eyes with ectasia (502.7 µm) compared to 76 non-ectasia (649.1 µm, P=0.000). Inferior graft was thinner (561.0 vs 620.4 µm, P=0.006), K max (63.3 vs 56.5 D, P=0.000), and anterior elevation was higher in ectasia (89.1 vs 48.6 µm, P=0.002). Accelerated crosslinking was performed on 5 eyes. Inferior-superior recipient and inferior graft thinning on tomography, with high K max and anterior elevation emerge as the most reliable criteria for the diagnosis of late ectasia. The incidence of corneal ectasia increases with the time.

Analysis of factors influencing refractive error in Fuchs eyes undergoing Descemet membrane endothelial keratoplasty triple procedure

PurposeTo evaluate the accuracy of current intraocular lens (IOL) formulas and identify factors influencing mean error in eyes undergoing Descemet membrane endothelial keratoplasty (DMEK) triple procedure, that is, DMEK combined...

Computed tomographic features of pulmonary and extrapulmonary lesions can be useful in prioritizing the diagnosis of hemangiosarcoma metastases in dogs.

The aim of this study was to evaluate the CT features of pulmonary metastases in dogs with hemangiosarcoma (HSA) at various sites. Additionally, the CT characteristics of extrapulmonary metastases in the same population were assessed. Retrospective, observational, and descriptive study conducted from April 2013 to January 2024. Dogs with histologically confirmed HSA and suspected or cytologically/histologically confirmed lung metastases were included. Dogs were excluded if they had a second primary tumor or only 1 unsampled pulmonary nodule. 33 dogs were included, with 26/33 [78.8%] having more than 10 metastatic pulmonary nodules. Most nodules were generalized (24/33 [72.7%]), miliary (29/33 [87.9%]) to subcentimetric (32/33 [97%]) in size, well-defined margins (29/33 [87.9%]), or a perilesional halo sign (24/33 [72.7%]). When more than 10 nodules were present, a generalized distribution was prevalent, while a peripheral location was more common when 2 to 10 nodules were present (P < .0001). In 32/33 (97%) cases, a pulmonary vessel was directly connected to the nodule (feeding vessel). After contrast administration, most lung metastases appeared homogenous (26/33 [78.8%]), although some showed areas of intense enhancement (5/33 [15.1%]) a feature also observed in extrapulmonary metastases with varying frequency (0% to 85.7%). Pulmonary HSA metastases were characterized by generalized, small (miliary/subcentimetric), well-defined nodules, commonly associated with a halo sign and feeding vessel. Intralesional areas of spotty postcontrast linear or amorphous strong hyperdensity were frequently observed especially in extrapulmonary metastases. These features may help radiologists and clinicians orient their diagnosis toward metastatic HSA.

Computed tomographic features of Morel-Lavallée lesions in 3 cats.

To describe the CT features of Morel-Lavallée lesions (MLLs) and their association with trauma in cats. This study aimed to investigate whether MLL fluid in cats accumulates between the dermis and deep fascia near superficial trauma, exhibits a vertical attenuation gradient, and shows no or only mild contrast enhancement on CT images. 3 young cats: a 1-year-old neutered male domestic shorthair cat, a 2-year-old neutered male domestic shorthair cat, and a 3-year-old neutered female British Shorthair cat. The clinical presentation of the 3 cats in the study involved recurrent swelling and fluid accumulation affecting at least 1 pelvic limb following trauma. In all cases, there was a fluid-filled space deep to the skin and superficial subcutaneous layer but superficial to the deep fascial plane overlying the muscular component of the pelvic limbs. The MLL fluid had a vertical attenuation gradient and no or only mild contrast enhancement. Morel-Lavallée lesions are often initially overlooked, likely due to distraction by concomitant significant bone injuries, and can be mistaken for hematomas, seromas, subcutaneous edema, contusions, or cellulitis, leading to less aggressive treatment. If left untreated, MLLs present a significant risk of extensive skin necrosis compared to other types of subcutaneous swelling.

Evaluación tomográfica del mixoma odontogénico en maxilar superior. Reporte de caso y revisión de la literatura

Odontogenic myxoma (OM) is a slow-growing, painless, aggressive and non-metastatic central jaw tumor of mesenchymal origin. Radiographically, it can vary from a unilocular radiolucent lesion to a multilocular lesion with well-defined or diffuse margins. The aim of this paper is to recognize the radiographic and tomographic characteristics of OM in a patient who attended the Dental Clinic of the Faculty of Dentistry of the Universidad Nacional Mayor de San Marcos in Lima-Peru. Case presentation: 86 year old male patient, who in the panoramic radiography indicated for his oral rehabilitation, a unilocular radiolucent image was found in the anterosuperior area with partially defined limits, corticalized edges and oval shape. In the volumetric tomography there was evidence of thinning and erosion of both bone tables, thinning of the floor of the nasal cavity. The radiolucent image seems to havean extension close to the alveolar ridge. In adition, there was an effacement of the cortices of the nasopalatine duct. The lesion was enucleated and an anatomopathological examination was performed. Diagnosis was odontogenic myxoma. The patient was evaluated at one year and six months with satisfactory results. The wide variety of radiographic characteristics of odontogenic myxoma leads us to think of a large number of differential diagnoses, being the histological evaluation together with the imaging analysis the ones that provide a definitive diagnosis. Although the anterosuperior area is the least common for its presentation, radiolucent images in this area should be considered as possible odontogenic myxomas, since this condition is more frequent in latín race.

Computed tomographic characteristics of craniomandibular osteopathy in 20 dogs.

Craniomandibular osteopathy (CMO) is a proliferative, self-limiting, non-neoplastic disease of growing dogs characterised by excessive new bone formation on the skull and mandible. The radiographic findings of CMO are well described; however, limited reports of the computed tomographic (CT) appearance are available. This paper aims to characterise the spectrum of CT findings that can occur with CMO. The study is retrospective, descriptive, multicenter, and includes 20 cases. Age at presentation ranged from 6 weeks to 12 months, with no sex predisposition. Scottish terriers were overrepresented (65%); other breeds included Cairn terrier, Jack Russell terrier, Staffordshire bull terrier, labrador retriever, golden retriever, akita and Slovakian rough-haired pointer (one of each breed). Terrier breeds represented 80% (16/20) of the patient cohort. Mandibular osteoproliferation was present in all patients (marked in 80%, bilateral in 95%), affecting the rostral mandible in 25%, body in 85%, and ramus in 80%. Tympanic bulla osteoproliferation was present in 60% (12/20) of patients (all marked, bilateral in 75%). Cranial osteoproliferation (frontal, parietal, temporal, occipital bones or maxilla, or combinations of them) was present in 90% (18/20) of patients (40% marked, 27% moderate, 33% mild). Nasopharyngeal narrowing was seen in all 12 patients with tympanic bulla osteoproliferation (67% marked, 27% moderate) and caused nearly complete occlusion in two of them. External ear canal stenosis was seen in 55% (11/20) of patients (63% marked, 37% moderate, all bilateral). Temporomandibular joint (TMJ) impingement was suspected in 83% (10/12) of patients with marked tympanic bulla osteoproliferation (75% bilateral). Osteolysis with a moth-eaten pattern was seen in the mandible of 10/20 dogs, the calvarium of 5/20 dogs, and the maxilla of 1/20 dogs (5%). Lymphadenomegaly (mandibular and medial retropharyngeal) was found in 15/20 patients (70% mild, 30% moderate). The most severe CT changes were seen in Scottish terriers. CT allows for detailed characterisation of the bony changes associated with CMO, including the effects occurring secondary to osteoproliferation surrounding the tympanic bullae such as TMJ impingement, external ear canal stenosis, and nasopharyngeal narrowing. Osteoproliferation affecting the cranium and the presence of osteolysis were seen more frequently in this study than previously reported in CMO.

Association between Tomographic Characteristics of Pterygium and Preoperative Anterior and Posterior Topography Measured by Anterior Segment Optical Coherence Tomography.

Background: The utilities of anterior segment optical coherence tomography (AS-OCT) for characterization, differential diagnosis, postoperative monitoring, and evaluation/comparison of surgical techniques in pterygium are described. Through AS-OCT, it is also possible to study the corneal astigmatic effect of pterygium. Our purpose is to study the associations between the anatomical characteristics of pterygium and the corneal topography through AS-OCT. Methods: Fifty eyes with primary pterygium in a tertiary hospital were evaluated before surgery by measuring 10 anatomical variables of pterygium and 13 topographic variables using AS-OCT (Casia 2; Tomey Corp., Nagoya, Japan). Statistical analysis was used to study the association between them. Results: Pterygium classified as flat pattern exhibited lower preoperative values of flat keratometry (K1), real flat keratometry (K1r), average keratometry (AvgK), and real average keratometry (AvgKr) compared to nodular ones. The flat pattern showed greater cylinder (CYL) and real cylinder (CLYr) values. The horizontal corneal invasion proportionally increased CYL and CYLr. Overall, larger anatomical pterygium measurements (limbus thickness (LimbusT), central pterygium thickness (CentreT), head pterygium thickness (HeadT), epithelial thickness at 1 mm (EpitT1mm), stromal thickness at 1 mm (stromT1mm), total thickness at 1 mm (TotalT1mm), total thickness at 2 mm (TotalT2mm), and total thickness at 3 mm (TotalT3mm)) resulted in lower anterior K1, K1r, AvgK, and AvgKr, and posterior K1 and AvgK values. CentreT was greater in astigmatisms against the rule than in oblique ones. Conclusions: This study demonstrates associations between preoperative topography and the NF (nodular or flat) classification of pterygium and its anatomical measurements assessed by AS-OCT.

Computed tomographic characteristics of testicular teratoma in a cat.

A 5-year-old intact male mixed-breed cat weighing 4.5kg was referred to our hospital with a left testicular mass. CT revealed mild heterogeneous contrast enhancement and calcification in the testicular mass. A well-defined, contrast-enhancing, multiloculated mass with fluid-filled areas was extended from the testicular mass in the scrotum to the caudal aspect of the left kidney. The abdominal mass extended to the right crus of the diaphragm, and the gastrointestinal tract was compressed dorsally. Histopathology was consistent with teratoma. Characteristic CT findings in a feline testicular teratoma may include calcification and cystic areas.

Ultrasonographic and Computed Tomographic Features of Dermoid Cyst of the Neck in a Dog: A Case Report

Ultrasonographic and Computed Tomographic Features of Dermoid Cyst of the Neck in a Dog: A Case Report

Computed tomographic features of suspected arterial pseudoaneurysm in the head and neck of four dogs.

Computed tomography is a valuable diagnostic technique in the clinical work-up of dogs with oropharyngeal trauma and bleeding. Traumatic extravasation can manifest as a pseudoaneurysm. A pseudoaneurysm is an extraluminal accumulation of blood that is contained by the adventitia layer or neighboring tissues. The purpose of this retrospective, multicenter, observational case series study was to describe the CT features in dogs with presumed oropharyngeal arterial pseudoaneurysm and its potential association with trauma. Imaging archives were searched for canine patients with head and neck CT studies showing visible extravasation of contrast-enhanced blood contained by soft tissue structures. Medical records of these patients were reviewed for oropharyngeal bleeding or trauma and reported. Four dogs met the inclusion criteria. CT findings included a well-defined, confined area of vascular contrast enhancement adjacent to the common carotid artery or its branches. The mean contrast enhancement in the corresponding artery and pseudoaneurysm lesion was similar, suggesting that these lesions represent active arterial extravasation. Four-dimensional CT was performed in one case and demonstrated contrast medium leaking from an artery and being contained by adjacent soft tissue structures. All dogs had a history and imaging findings consistent with oropharyngeal bleeding and trauma. Arterial pseudoaneurysm should be considered as a differential diagnosis in dogs with oral trauma and CT features of a well-defined, periarterial, strongly contrast-enhancing lesion.

Computed tomographic characteristics of anatomical variations of external and internal jugular veins in dogs.

The external jugular vein (EJV) has been commonly used for clinical procedures in veterinary medicine, while the internal jugular vein (IJV) has been used mainly for research. Limited literature regarding anatomical variants in both EJV and IJV is available. The objectives of this descriptive retrospective study were to identify the number of dogs with variations of the jugular veins in canine patients undergoing CT of the head and neck and characterize these variations. Of 1000 dogs, 193 dogs (19.3%) had anatomical variations. Six types of anatomical variations were identified. The most common Type I was the absence of the linguofacial vein (72.0%, n=139), with the lingual, facial, and maxillary veins entering the EJV at a common branching point. Type II described a variable course of the EJV and IJV, which in some dogs resulted in the absence of the EJV (14.0%, n=27). Type III was a variable anastomotic loop formed by the linguofacial or maxillary vein cranial or at the junction of the EJV (4.2%, n=8). In Type IV, the EJV was either suspected to be aplastic or markedly reduced in diameter compared with the contralateral side just distal to its formation (3.6%, n=7). Type V was found in only six dogs (3.1%) with unilateral differences in the diameter of the IJV. Six of 193 dogs had a combination of more than one variation (Type VI, 3.1%). Type I was significantly observed more frequently in meso- and dolichocephalic breeds. Type II was significantly observed more frequently in brachycephalic breeds.

Comparison of Scheimpflug Imaging (Pentacam HR) and Swept-Source Optical Coherence Tomography (CASIA2) in Eyes With Macular Corneal Dystrophy.

Assessment of tomographic characteristics and interdevice comparability between Scheimpflug imaging (Pentacam HR, Oculus Optikgeräte GmbH, Wetzlar, Germany) and swept-source optical coherence tomography (CASIA2, Tomey Corp., Nagoya, Japan) in eyes with macular corneal dystrophy (MCD). Eyes with MCD were examined by Pentacam HR and CASIA2. Interdevice comparison was performed using a Wilcoxon matched pairs test and Bland-Altman plots with 95% limit of agreement. A Spearman rank correlation coefficient was used for correlating indices of both devices. This retrospective study included 31 eyes of 18 patients (mean age: 32.1 ± 10.7 years). Eyes with MCD demonstrated a moderate astigmatism with a Cylinder anterior of 2.56 ± 1.50 D (Pentacam HR) and 2.52 ± 1.57 D (CASIA2) without a difference between both devices. CASIA2 (0.34 ± 0.14 D) measured lower values of Cylinder posterior compared with Pentacam HR (0.96 ± 0.66 D) (P < 0.0001). Comparison of pachymetry (Pentacam HR vs. CASIA2) showed higher values of the central corneal thickness (619 ± 227 μm vs. 445 ± 67 μm, P = 0.0001) and the thinnest corneal thickness (499 ± 165 μm vs. 430 ± 60 μm, P = 0.0167) for Pentacam HR. Corneal densitometry measurement revealed that increasing gray scale units caused a greater interdevice difference for pachymetry values, as Pentacam HR measured higher than CASIA2 for more opaque corneas. Eyes with MCD tend to have thinner corneas and a higher amount of corneal astigmatism than healthy eyes. In advanced MCD, Scheimpflug technology may mistakenly overestimate corneal thickness. The pachymetry measurement of the optical coherence tomography should be used when planning corneal surgery such as excimer laser-assisted phototherapeutic keratectomy to determine the ablation depth.

Change in Visual Acuity of Patients With Fuchs Endothelial Corneal Dystrophy Over 1 Year.

To determine whether the clinical and paraclinical course of Fuchs endothelial corneal dystrophy (FECD) over 1 year is related to the extent of triplet repetition in the transcription factor 4 (TCF4) gene. A prospective study with a 1-year follow-up was conducted. A total of 104 patients (160 eyes) with FECD and an equivalent number of age- and sex-matched control subjects without FECD were included. At inclusion, the corneas were graded using the modified Krachmer grade (KG) and patients were genotyped for the number of trinucleotide repeats (TNRs) in the TCF4 gene by the short tandem repeat assay. Visual acuity, Scheimpflug tomographic features, and the Visual Function and Corneal Health Status using a visual disability instrument were measured on 2 visits at 1-year intervals. KGs ranged from 1 to 6, and 46% of eyes had grades 1 to 4. 71% of the patients harbored TNR expansion (>40) versus 13% in control subjects ( P < 0.001). Severity at inclusion was higher in the presence of TNR expansion when considering eyes independently (mean grade ±SD, 4.08 ± 1.42) without TNR expansion and 4.66 ± 1.27 with TNR expansion ( P = 0.024). In 1 year, the ETDRS score significantly decreased by -2.97 (95% confidence interval -4.69 to -1.26, P = 0.001) and the ETDRS score with glare by -4.25 (95% confidence interval -6.22 to -2.27, P < 10 -5 ). There was no relationship between the rate of decline and TNR expansion or KG. Central corneal thickness and Visual Function and Corneal Health Status scores did not significantly vary. It is possible to measure a subtle progression of FECD over a period as short as 1 year. We did not find a relationship between the presence of TNR expansion and the speed of deterioration over 1 year. This work should facilitate the design of future clinical trials on FECD.

Complex morphological and computed tomographic characteristics of vascularization of monochorionic diamniotic placentas with discordant weight of newborns

Complex morphological and computed tomographic characteristics of vascularization of monochorionic diamniotic placentas with discordant weight of newborns

Black adenoma a rare tumor of the adrenal glands: case report and systematic review

Introduction: black adrenal adenomas (ASNs) are tumors of the adrenal cortex with black or dark brown pigment. They are made of lipofuscin, it is a rare tumor and there are only case series and reports in the literature. Material and methods: a detailed systematic review was carried out following the PRISMA guide, of a total of 231 articles submitted to screening, 38 patients can be included. Results: the mean age of presentation was 46.47 years, with a predominance of females in 76.3% of the patients, with no predilection for laterality of the affected adrenal, with a mean size of 2.9cm, 89.5% were hypersecretors, the Cushing's disease occurred in 76.5% of patients, 7.9% of patients had a pheochromocytoma, and 13.2% of patients had primary hyperaldosteronism. Discussion: ASN is a rare tumor that presents clinically as a hormone-producing tumor in young women, or in other cases, in a tomography as an incidentaloma, with tomographic characteristics that suspect malignant pathology, for which surgical treatment is granted.

A High-Resolution Measurement Method for Inner and Outer 3D Surface Profiles of Laser Fusion Targets Using a Laser Differential Confocal–Atomic Force Probe Technique

The high-resolution and nondestructive co-reference measurement of the inner and outer three-dimensional (3D) surface profiles of laser fusion targets is difficult to achieve. In this study, we propose a laser differential confocal (LDC)–atomic force probe (AFP) method to measure the inner and outer 3D surface profiles of laser fusion targets at a high resolution. This method utilizes the LDC method to detect the deflection of the AFP and exploits the high spatial resolution of the AFP to enhance the spatial resolution of the outer profile measurement. Nondestructive and co-reference measurements of the inner profile of a target were achieved using the tomographic characteristics of the LDC method. Furthermore, by combining multiple repositionings of the target using a horizontal slewing shaft, the inner and outer 3D surface profiles of the target were obtained, along with a power spectrum assessment of the entire surface. The experimental results revealed that the respective axial and lateral resolutions of the outer profile measurement were 0.5 and 1.3 nm, while the respective axial and lateral resolutions of the inner profile measurement were 2.0 nm and approximately 400.0 nm. The repeatabilities of the root-mean-square deviation measurements for the outer and inner profiles of the target were 2.6 and 2.4 nm, respectively. We believe our study provides a promising method for the high-resolution and nondestructive co-reference measurement of the inner and outer 3D profiles of laser fusion targets.

Foveal atrophy in patients with active central serous chorioretinopathy at first presentation: characteristics and treatment outcomes

Background/aimsThis study aimed to investigate the clinical characteristics and treatment outcomes of patients with active central serous chorioretinopathy (CSC) and foveal atrophy.MethodsPatients diagnosed with active idiopathic CSC using multimodal imaging...

Key insights into antiresorptive drug use and osteonecrosis in osteoporotic patients undergoing tooth extractions: A clinical and CBCT assessment

SummaryThis study investigates the effects of antiresorptive drugs and risk factors for medication-related osteonecrosis of the jaws in osteoporotic patients undergoing tooth extraction. Among the findings, antiresorptive-treated patients had thicker lamina dura and longer healing times. Additionally, corticosteroid intake and multi-rooted teeth carried a higher osteonecrosis risk. Bone sequestrum indicated osteonecrosis.PurposeTo describe the effects of antiresorptive drugs (ARD) in the maxilla and mandible and risk factors for medication-related osteonecrosis of the jaws (MRONJ) in osteoporotic patients undergoing tooth extractions using clinical data and cone beam computed tomography (CBCT).MethodsThis retrospective cohort study collected clinical and CBCT data from 176 patients. The study group (n = 78; 224 extractions) received ARD treatment, underwent tooth extraction, and had a pre-operative CBCT. Additionally, age-, sex-, and tooth-matched controls were selected (n = 98; 227 extractions). Radiographic examinations were performed independently by three calibrated examiners. Statistical analysis included Chi-square, Fisher’s exact, Mann–Whitney U, and t-tests to contrast clinical and radiographic data between study and control, MRONJ + and MRONJ − , and bisphosphonate and denosumab patients/sites. Significance was set at p ≤ 0.05.ResultsFrom the study group, 4 patients (5%) and 5 sites (2%) developed MRONJ after tooth extraction. ARD-treated patients exhibited significantly more thickening of the lamina dura and a longer average mucosal healing time (4.4 weeks) than controls (2.6 weeks). In the study group, MRONJ risk significantly increased with corticosteroid intake and in multi-rooted teeth. No significant differences between bisphosphonates and denosumab use were seen in the tomographic features (p > 0.05). Lastly, bone sequestrum was exclusively observed in osteoporotic patients, who exhibited post-operative exposed bone or histological evidence of osteonecrosis.ConclusionOsteoporotic patients under ARD may exhibit thickening of the lamina dura and prolonged post-operative healing. Among these patients, multi-rooted teeth are at higher risk for MRONJ than single-rooted teeth. Sequester formation is a radiographic indicator of osteonecrosis.