Tomographic study of Jaw bone changes in patients with bisphosphonate-related osteonecrosis.

Autor:	Simpione G; Master student, Bauru School of Dentistry, University of Sao Paulo, Brazil., Caldas RJ; PhD, Bauru School of Dentistry, University of Sao Paulo, Brazil., Soares MQS; Post-doctoral student Bauru School of Dentistry, University of Sao Paulo, Brazil., Rubira-Bullen IRF; Associate Professor, Department of Surgery, Stomatology, Radiology and Pathology, Faculty of Dentistry of Bauru - USP., Santos PSS; Associate Professor, Department of Surgery, Stomatology, Radiology and Pathology, Faculty of Dentistry of Bauru - USP.
Jazyk:	angličtina
Zdroj:	Journal of clinical and experimental dentistry [J Clin Exp Dent] 2020 Mar 01; Vol. 12 (3), pp. e285-e290. Date of Electronic Publication: 2020 Mar 01 (Print Publication: 2020).
DOI:	10.4317/jced.56265
Abstrakt:	Background: Bisphosphonates (BP) are synthetic pyrophosphate-like substances with antiresorptive properties and specifically affect osteoclastic activity. In 2007, the American Association of Oral and Maxillofacial Surgeons (AAOMS) defined diagnostic criteria for Osteonecrosis of the Jaws Associated with Bisphosponates (BRONJ). BRONJ is mainly diagnosed by clinical features, but the detection of early bone changes by imaging may help prevent and better understand the disease. The objective of this study was to evaluate maxillary changes in CBCT in patients using BP. Material and Methods: All included patients were diagnosed with osteonecrosis and received bisphosphonate drugs in the last ten years. All imaging examinations were obtained by I-CAT and 3D Accuitomo. The multiplanar reconstructions were analyzed by an examiner without knowledge of the clinical aspects and location of the lesions. Results: The study sample consisted of 21 patients, the majority of the sample represented patients with cancer (76.2%), the other patients had osteoporosis (23.8%). Only four patients (19.04%) received alendronate, while intravenous bisphosphonates, such as zoledronate and pamidronate, represented the treatment of most of our sample. Most of our patients presented stage 1 and 2 MRONJ (85.7%), whose lesions were mainly observed in the mandible (52.4%). Fifty-seven percent of the patients had at least one bone change. Conclusions: In BRONJ, bone changes vary between exposed and non-exposed areas and one aspect of the study was: persistent extraction cavities in the BRONJ lesion region and high frequency of periodontal ligament space widening in areas that are not involved in BRONJ lesions. This reflects the very important role of dental and periodontal diseases in the pathophysiology of BRONJ. Thus, preventive measures should be prioritized for patients exposed to anti-resorptive drugs. Key words: Cone-Beam computed tomography, osteonecrosis, bisphosphonate-associated osteonecrosis of the jaw. Competing Interests: Conflicts of interest The authors have declared that no conflict of interest exist. (Copyright: © 2020 Medicina Oral S.L.)
Databáze:	MEDLINE
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