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Radiological manifestations and clinical findings of patients with oncologic and osteoporotic medication-related osteonecrosis of the jaw.
Shin, Jeong Won; Kim, Jo-Eun; Huh, Kyung-Hoe; Yi, Won-Jin; Heo, Min-Suk; Lee, Sam-Sun; Choi, Soon-Chul.
Afiliación
  • Shin JW; Department of Orthodontics, Institute of Oral Health Science, Ajou University School of Medicine, Suwon, Republic of Korea.
  • Kim JE; Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea. noel1st@snu.ac.kr.
  • Huh KH; Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea.
  • Yi WJ; Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea.
  • Heo MS; Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea.
  • Lee SS; Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea.
  • Choi SC; Department of Oral and Maxillofacial Radiology, School of Dentistry, Seoul National University, Seoul, Republic of Korea.
Sci Rep ; 14(1): 8744, 2024 04 16.
Article en En | MEDLINE | ID: mdl-38627515
ABSTRACT
Medication-related osteonecrosis of the jaw (MRONJ) poses a challenging form of osteomyelitis in patients undergoing antiresorptive therapies in contrast to conventional osteomyelitis. This study aimed to compare the clinical and radiological features of MRONJ between patients receiving low-dose medications for osteoporosis and those receiving high-dose medications for oncologic purposes. The clinical, panoramic radiographic, and computed tomography data of 159 patients with MRONJ (osteoporotic group, n = 120; oncologic group, n = 39) who developed the condition after using antiresorptive medications for the management of osteoporosis or bone malignancy were analyzed. The osteoporotic group was older (75.8 vs. 60.4 years, p < 0.01) and had a longer duration of medication usage than the oncologic group (58.1 vs. 28.0 months, p < 0.01). Pus discharge and swelling were more common in the osteoporotic group (p < 0.05), whereas bone exposure was more frequent in the oncologic group (p < 0.01). The mandibular cortical index (MCI) in panoramic radiographs was higher in the osteoporotic group (p < 0.01). The mean sequestra size was larger in the oncologic group than in the osteoporotic group (15.3 vs. 10.6 mm, p < 0.05). The cured rate was significantly higher in the osteoporotic group (66.3% vs. 33.3%, p < 0.01). Oncologic MRONJ exhibited distinct clinical findings including rapid disease onset, fewer purulent signs, and lower cure rates than osteoporotic MRONJ. Radiological features such as sequestrum size on CT scan, and MCI values on panoramic radiographs, may aid in differentiating MRONJ in osteoporotic and oncologic patients.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Osteomielitis / Osteoporosis / Conservadores de la Densidad Ósea / Osteonecrosis de los Maxilares Asociada a Difosfonatos Límite: Humans Idioma: En Revista: Sci Rep Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Osteomielitis / Osteoporosis / Conservadores de la Densidad Ósea / Osteonecrosis de los Maxilares Asociada a Difosfonatos Límite: Humans Idioma: En Revista: Sci Rep Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido