Radiographic Evaluation of Medication-Related Osteonecrosis of the Jaw (MRONJ) With Different Primary Cancers and Medication Therapies

Background: Medication-related osteonecrosis of the jaw (MRONJ) is a condition that affects jaws and characterized by exposed bone in oral cavity persists for more than eight weeks despite treatment. Additional criteria include patient should have current or past history antiresorptive drugs and/or combination with antiangiogenic drugs, absence metastasis, no previous radiotherapy to affected area. The radiographic features MRONJ most instances do not any specific features. This because standard radiographs usually show stark abnormalities early stages disease. Objective: study aimed evaluate if patterns are associated primary cancers between medications. Materials methods: an observational case series. A total 50 cases possible from June 2010 2013 archives Department Oral Maxillofacial Radiology were assessed. Based on history, 12 had medication use could lead medication-related selected. Cone beam computed tomography (CBCT) scans these evaluated using CBCT reconstruction program InVivo Dental version 6 (Anatomage Inc., San Jose, CA, USA). number areas showing sequestration, pattern osteonecrosis, extent Primary cancer type also assessed identify certain showed distinctive osteonecrosis. Reconstructed panoramic images true three-dimensional (3D) multi-planar condition. An maxillofacial radiology resident training board-certified radiologist images. Results: Radiographic findings varied among included generalized sclerosis, osteosclerosis widened periodontal ligament (PDL) space, bony sequestra, necrosis. However, observed cases, regardless used. Conclusion: It challenging radiographically distinguish different medication. Future directions: studies evaluating larger samples varying medications drug therapies. Cases advanced stage due extensive destruction superimposed infection; it may be valuable patients better understand distinguishing