Imaging Findings of Bisphosphonate-Related Osteonecrosis of the Jaws: A Critical Review of the Quantitative Studies
Identifieur interne : 001425 ( Pmc/Checkpoint ); précédent : 001424; suivant : 001426Imaging Findings of Bisphosphonate-Related Osteonecrosis of the Jaws: A Critical Review of the Quantitative Studies
Auteurs : André Ferreira Leite [Brésil] ; Fernanda Dos Santos Ogata [Brésil] ; Nilce Santos De Melo [Brésil] ; Paulo Tadeu De Souza Figueiredo [Brésil]Source :
- International Journal of Dentistry [ 1687-8728 ] ; 2014.
Abstract
Url:
DOI: 10.1155/2014/784348
PubMed: 25018769
PubMed Central: 4075086
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Imaging Findings of Bisphosphonate-Related Osteonecrosis of the Jaws: A Critical Review of the Quantitative Studies</title><author><name sortKey="Leite, Andre Ferreira" sort="Leite, Andre Ferreira" uniqKey="Leite A" first="André Ferreira" last="Leite">André Ferreira Leite</name><affiliation wicri:level="2"><nlm:aff id="I1">Oral Radiology, Department of Dentistry, Faculty of Health Science, University of Brasília, Campus Universitario Darcy Ribeiro, Asa Norte, 70910-900 Brasília, DF, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Oral Radiology, Department of Dentistry, Faculty of Health Science, University of Brasília, Campus Universitario Darcy Ribeiro, Asa Norte, 70910-900 Brasília, DF</wicri:regionArea><placeName><region type="state">District fédéral (Brésil)</region></placeName></affiliation></author><author><name sortKey="Ogata, Fernanda Dos Santos" sort="Ogata, Fernanda Dos Santos" uniqKey="Ogata F" first="Fernanda Dos Santos" last="Ogata">Fernanda Dos Santos Ogata</name><affiliation wicri:level="2"><nlm:aff id="I2">University of Brasília, Campus Universitario Darcy Ribeiro, Asa Norte, 70910-900 Brasília, DF, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>University of Brasília, Campus Universitario Darcy Ribeiro, Asa Norte, 70910-900 Brasília, DF</wicri:regionArea><placeName><region type="state">District fédéral (Brésil)</region></placeName></affiliation></author><author><name sortKey="De Melo, Nilce Santos" sort="De Melo, Nilce Santos" uniqKey="De Melo N" first="Nilce Santos" last="De Melo">Nilce Santos De Melo</name><affiliation wicri:level="2"><nlm:aff id="I3">Oral Pathology, Department of Dentistry, Faculty of Health Science, University of Brasília, Campus Universitario Darcy Ribeiro, Asa Norte, 70910-900 Brasília, DF, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Oral Pathology, Department of Dentistry, Faculty of Health Science, University of Brasília, Campus Universitario Darcy Ribeiro, Asa Norte, 70910-900 Brasília, DF</wicri:regionArea><placeName><region type="state">District fédéral (Brésil)</region></placeName></affiliation></author><author><name sortKey="Figueiredo, Paulo Tadeu De Souza" sort="Figueiredo, Paulo Tadeu De Souza" uniqKey="Figueiredo P" first="Paulo Tadeu De Souza" last="Figueiredo">Paulo Tadeu De Souza Figueiredo</name><affiliation wicri:level="2"><nlm:aff id="I1">Oral Radiology, Department of Dentistry, Faculty of Health Science, University of Brasília, Campus Universitario Darcy Ribeiro, Asa Norte, 70910-900 Brasília, DF, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Oral Radiology, Department of Dentistry, Faculty of Health Science, University of Brasília, Campus Universitario Darcy Ribeiro, Asa Norte, 70910-900 Brasília, DF</wicri:regionArea><placeName><region type="state">District fédéral (Brésil)</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25018769</idno><idno type="pmc">4075086</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4075086</idno><idno type="RBID">PMC:4075086</idno><idno type="doi">10.1155/2014/784348</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">002D78</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002D78</idno><idno type="wicri:Area/Pmc/Curation">002D78</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">002D78</idno><idno type="wicri:Area/Pmc/Checkpoint">001425</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">001425</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Imaging Findings of Bisphosphonate-Related Osteonecrosis of the Jaws: A Critical Review of the Quantitative Studies</title><author><name sortKey="Leite, Andre Ferreira" sort="Leite, Andre Ferreira" uniqKey="Leite A" first="André Ferreira" last="Leite">André Ferreira Leite</name><affiliation wicri:level="2"><nlm:aff id="I1">Oral Radiology, Department of Dentistry, Faculty of Health Science, University of Brasília, Campus Universitario Darcy Ribeiro, Asa Norte, 70910-900 Brasília, DF, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Oral Radiology, Department of Dentistry, Faculty of Health Science, University of Brasília, Campus Universitario Darcy Ribeiro, Asa Norte, 70910-900 Brasília, DF</wicri:regionArea><placeName><region type="state">District fédéral (Brésil)</region></placeName></affiliation></author><author><name sortKey="Ogata, Fernanda Dos Santos" sort="Ogata, Fernanda Dos Santos" uniqKey="Ogata F" first="Fernanda Dos Santos" last="Ogata">Fernanda Dos Santos Ogata</name><affiliation wicri:level="2"><nlm:aff id="I2">University of Brasília, Campus Universitario Darcy Ribeiro, Asa Norte, 70910-900 Brasília, DF, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>University of Brasília, Campus Universitario Darcy Ribeiro, Asa Norte, 70910-900 Brasília, DF</wicri:regionArea><placeName><region type="state">District fédéral (Brésil)</region></placeName></affiliation></author><author><name sortKey="De Melo, Nilce Santos" sort="De Melo, Nilce Santos" uniqKey="De Melo N" first="Nilce Santos" last="De Melo">Nilce Santos De Melo</name><affiliation wicri:level="2"><nlm:aff id="I3">Oral Pathology, Department of Dentistry, Faculty of Health Science, University of Brasília, Campus Universitario Darcy Ribeiro, Asa Norte, 70910-900 Brasília, DF, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Oral Pathology, Department of Dentistry, Faculty of Health Science, University of Brasília, Campus Universitario Darcy Ribeiro, Asa Norte, 70910-900 Brasília, DF</wicri:regionArea><placeName><region type="state">District fédéral (Brésil)</region></placeName></affiliation></author><author><name sortKey="Figueiredo, Paulo Tadeu De Souza" sort="Figueiredo, Paulo Tadeu De Souza" uniqKey="Figueiredo P" first="Paulo Tadeu De Souza" last="Figueiredo">Paulo Tadeu De Souza Figueiredo</name><affiliation wicri:level="2"><nlm:aff id="I1">Oral Radiology, Department of Dentistry, Faculty of Health Science, University of Brasília, Campus Universitario Darcy Ribeiro, Asa Norte, 70910-900 Brasília, DF, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Oral Radiology, Department of Dentistry, Faculty of Health Science, University of Brasília, Campus Universitario Darcy Ribeiro, Asa Norte, 70910-900 Brasília, DF</wicri:regionArea><placeName><region type="state">District fédéral (Brésil)</region></placeName></affiliation></author></analytic><series><title level="j">International Journal of Dentistry</title><idno type="ISSN">1687-8728</idno><idno type="eISSN">1687-8736</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><italic>Objectives</italic>. This paper offers a critical review of published information on the imaging strategies used for diagnosing bisphosphonate-associated osteonecrosis of the jaw (BRONJ) in patients taking intravenous bisphosphonates, pointing at the different methodologies and results of existing literature. <italic>Methods</italic>. Electronic literature search was performed in order to identify as many quantitative studies that discussed the imaging findings of BRONJ up to February 2014. Initially, the search for articles was based on the following four types of imaging modalities for evaluating BRONJ: computed tomography, plain film radiographs, magnetic resonance imaging, and nuclear bone scanning. <italic>Results</italic>. Eleven out of the 79 initially selected articles met the inclusion criteria. Most of the selected articles were cross-sectional studies. Regarding the selected studies, 54.5% have used plain films radiographs and 54.5% were based on computed tomography findings. All of the selected studies showed a small number of patients and none of the selected studies have tested the accuracy of the imaging examination for evaluating BRONJ. <italic>Conclusions</italic>. This critical review showed a scarcity of quantitative studies that analyzed the typical imaging findings related to BRONJ. Further studies are necessary in order to analyze the role of different imaging techniques in the assessment of BRONJ.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Marx, Re" uniqKey="Marx R">RE Marx</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ruggiero, Sl" uniqKey="Ruggiero S">SL Ruggiero</name></author><author><name sortKey="Dodson, Tb" uniqKey="Dodson T">TB Dodson</name></author><author><name sortKey="Assael, La" uniqKey="Assael L">LA Assael</name></author><author><name sortKey="Landesberg, R" uniqKey="Landesberg R">R Landesberg</name></author><author><name sortKey="Marx, Re" uniqKey="Marx R">RE Marx</name></author><author><name sortKey="Mehrotra, B" uniqKey="Mehrotra B">B Mehrotra</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Silverman, Sl" uniqKey="Silverman S">SL Silverman</name></author><author><name sortKey="Landesberg, R" uniqKey="Landesberg 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Int J Dent</journal-id><journal-id journal-id-type="iso-abbrev">Int J Dent</journal-id><journal-id journal-id-type="publisher-id">IJD</journal-id><journal-title-group><journal-title>International Journal of Dentistry</journal-title></journal-title-group><issn pub-type="ppub">1687-8728</issn><issn pub-type="epub">1687-8736</issn><publisher><publisher-name>Hindawi Publishing Corporation</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">25018769</article-id><article-id pub-id-type="pmc">4075086</article-id><article-id pub-id-type="doi">10.1155/2014/784348</article-id><article-categories><subj-group subj-group-type="heading"><subject>Review Article</subject></subj-group></article-categories><title-group><article-title>Imaging Findings of Bisphosphonate-Related Osteonecrosis of the Jaws: A Critical Review of the Quantitative Studies</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Leite</surname><given-names>André Ferreira</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref><xref ref-type="corresp" rid="cor1">*</xref></contrib><contrib contrib-type="author"><name><surname>Ogata</surname><given-names>Fernanda dos Santos</given-names></name><xref ref-type="aff" rid="I2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>de Melo</surname><given-names>Nilce Santos</given-names></name><xref ref-type="aff" rid="I3"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Figueiredo</surname><given-names>Paulo Tadeu de Souza</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref></contrib></contrib-group><aff id="I1"><sup>1</sup>Oral Radiology, Department of Dentistry, Faculty of Health Science, University of Brasília, Campus Universitario Darcy Ribeiro, Asa Norte, 70910-900 Brasília, DF, Brazil</aff><aff id="I2"><sup>2</sup>University of Brasília, Campus Universitario Darcy Ribeiro, Asa Norte, 70910-900 Brasília, DF, Brazil</aff><aff id="I3"><sup>3</sup>Oral Pathology, Department of Dentistry, Faculty of Health Science, University of Brasília, Campus Universitario Darcy Ribeiro, Asa Norte, 70910-900 Brasília, DF, Brazil</aff><author-notes><corresp id="cor1">*André Ferreira Leite: <email>andreleite@unb.br</email></corresp><fn fn-type="other"><p>Academic Editor: Giuliano Ascani</p></fn></author-notes><pub-date pub-type="ppub"><year>2014</year></pub-date><pub-date pub-type="epub"><day>11</day><month>6</month><year>2014</year></pub-date><volume>2014</volume><elocation-id>784348</elocation-id><history><date date-type="received"><day>26</day><month>3</month><year>2014</year></date><date date-type="accepted"><day>9</day><month>5</month><year>2014</year></date></history><permissions><copyright-statement>Copyright © 2014 André Ferreira Leite et al.</copyright-statement><copyright-year>2014</copyright-year><license xlink:href="https://creativecommons.org/licenses/by/3.0/"><license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><p><italic>Objectives</italic>. This paper offers a critical review of published information on the imaging strategies used for diagnosing bisphosphonate-associated osteonecrosis of the jaw (BRONJ) in patients taking intravenous bisphosphonates, pointing at the different methodologies and results of existing literature. <italic>Methods</italic>. Electronic literature search was performed in order to identify as many quantitative studies that discussed the imaging findings of BRONJ up to February 2014. Initially, the search for articles was based on the following four types of imaging modalities for evaluating BRONJ: computed tomography, plain film radiographs, magnetic resonance imaging, and nuclear bone scanning. <italic>Results</italic>. Eleven out of the 79 initially selected articles met the inclusion criteria. Most of the selected articles were cross-sectional studies. Regarding the selected studies, 54.5% have used plain films radiographs and 54.5% were based on computed tomography findings. All of the selected studies showed a small number of patients and none of the selected studies have tested the accuracy of the imaging examination for evaluating BRONJ. <italic>Conclusions</italic>. This critical review showed a scarcity of quantitative studies that analyzed the typical imaging findings related to BRONJ. Further studies are necessary in order to analyze the role of different imaging techniques in the assessment of BRONJ.</p></abstract><funding-group><award-group><funding-source>University of Brasília</funding-source></award-group></funding-group></article-meta></front><floats-group><fig id="fig1" orientation="portrait" position="float"><label>Figure 1</label><caption><p>Flow chart of the study selection procedure.</p></caption><graphic xlink:href="IJD2014-784348.001"></graphic></fig><fig id="fig2" orientation="portrait" position="float"><label>Figure 2</label><caption><p>Imaging findings of a 57-year-old woman with metastatic breast carcinoma receiving intravenous zoledronic acid. (a) Panoramic radiograph showing maxillary involvement with radiographic evidence of osteolysis (gray arrow). (b) and (c) axial and cross-sectional CBCT views, respectively, showing the necrotic area with bone sequestrum in the left maxilla (gray arrow). (d) Axial CBCT image showing the extent of mandible bone involvement with periosteal bone reaction. The periosteal bone reaction changed the mandibular morphology, as it can be seen in the two-dimensional multiplanar reconstruction image ((e), white arrow) and in the 3D images (frontal view (f) and sagittal view (g)).</p></caption><graphic xlink:href="IJD2014-784348.002"></graphic></fig><fig id="fig3" orientation="portrait" position="float"><label>Figure 3</label><caption><p>Imaging findings of a 65-year-old woman with metastatic breast carcinoma receiving intravenous zoledronic acid. (a) Panoramic radiograph showing an osteolytic lesion in the anterior mandible (gray arrow) and areas of osteosclerosis in the posterior regions (black arrows). (b) Axial CBCT image reveals areas of osteolysis (gray arrows), areas of osteosclerosis (black arrows), and a periosteal bone reaction in the left mandible (white arrow). (c) Sagittal CBCT image demonstrates a nonhealing extraction socket in the anterior mandible.</p></caption><graphic xlink:href="IJD2014-784348.003"></graphic></fig><table-wrap id="tab1" orientation="portrait" position="float"><label>Table 1</label><caption><p>Study design, population characteristics, imaging methods, equipment, and set conditions of each selected study. </p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Authors (year)</th><th align="center" rowspan="1" colspan="1">Study design</th><th align="left" rowspan="1" colspan="1">Population characteristics</th><th align="center" rowspan="1" colspan="1">Imaging method</th><th align="left" rowspan="1" colspan="1">Equipment, contrast medium or radionucleotide, and set conditions</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">Bianchi et al., 2007 [<xref rid="B13" ref-type="bibr">13</xref>]</td><td align="center" rowspan="1" colspan="1">Cross-sectional</td><td align="left" rowspan="1" colspan="1">32 subjects (20 women; range: 48–84 years)</td><td align="center" rowspan="1" colspan="1">MDCT + PAN</td><td align="left" rowspan="1" colspan="1">PAN: Orthophos (Sirona, Bensheim, Germany; at 69–71 kV and 15 mA for 14.2 s)/MDCT: Lightspeed Pro 16 and Lightspeed QX/i (GE, Milwaukee, WI; at 120 kV and 80–120 mA, 0.6 mm slice thickness, 0.9 pitch, and 12.8 cm FOV)</td></tr><tr><td align="left" colspan="5" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Fleisher et al., 2010 [<xref rid="B14" ref-type="bibr">14</xref>]</td><td align="center" rowspan="1" colspan="1">Case-control</td><td align="left" rowspan="1" colspan="1">68 subjects (gender and year's range: N/E)</td><td align="center" rowspan="1" colspan="1">PER + PAN</td><td align="left" rowspan="1" colspan="1">N/S</td></tr><tr><td align="left" colspan="5" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Guggenberger et al., 2013 [<xref rid="B15" ref-type="bibr">15</xref>]</td><td align="center" rowspan="1" colspan="1">Cross-sectional</td><td align="left" rowspan="1" colspan="1">10 subjects (9 women; mean age 69,6; range: 53–88 years)</td><td align="center" rowspan="1" colspan="1">MRI + PET/CT + CBCT </td><td align="left" rowspan="1" colspan="1">MRI: 1.5 T scanner (Signa Excite HDxt; GE Healthcare; Milwaukee, WI). An 8-channel transmit-receive head coil was used. PET/CT: (Discovery RX or Discovery STE; GE Healthcare). CBCT: KaVo 3D eXam (KaVo, Biberach, Germany) with an amorphous silicium flat panel detector (20 × 25 cm). Exposure volume: 102 mm. Voxel size: 0.4 mm. The scan was set at a high-frequency constant potential of 120 kV (peak)</td></tr><tr><td align="left" colspan="5" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Rocha et al., 2012 [<xref rid="B11" ref-type="bibr">11</xref>]</td><td align="center" rowspan="1" colspan="1">Cohort</td><td align="left" rowspan="1" colspan="1">60 subjects; 30 cases and 30 controls (case: 18 women; range: 41–91 years/control: 22 women; range: 50–64 years)</td><td align="center" rowspan="1" colspan="1">PAN</td><td align="left" rowspan="1" colspan="1">Planmeca machine (Proline XC Digital model, 78 kV and 10 mA/18 s)</td></tr><tr><td align="left" colspan="5" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Stockmann et al., 2010 [<xref rid="B16" ref-type="bibr">16</xref>]</td><td align="center" rowspan="1" colspan="1">Cross-sectional</td><td align="left" rowspan="1" colspan="1">28 subjects (16 women; range: 57–78 years)</td><td align="center" rowspan="1" colspan="1">PAN + MRI + MDCT</td><td align="left" rowspan="1" colspan="1">PAN: Orthophos TM, Sirona, Bensheim, Germany, ×1.2 magnification; with gender specific settings (female patients, 69 kV and 15 mA; male patients, 66 kV and 8 mA)/MRI: 1.5 T (Magnetom Symphony TM, Siemens, Erlangen, Germany)/MDCT: 64-slice MDCT-Scanner (Somatom Sensation 64TM, Siemens, Forchheim, Germany). Scan settings were 120 kV, 110 mAs eff., 64 × 0.6 slice acquisition, 0.9 pitch, 1 s rotation time, 1 mm reconstructed slice thickness, 0.8 mm reconstruction increment, and sharp kernel (B70s)</td></tr><tr><td align="left" colspan="5" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Takaishi et al., 2010 [<xref rid="B17" ref-type="bibr">17</xref>]</td><td align="center" rowspan="1" colspan="1">Cross-sectional</td><td align="left" rowspan="1" colspan="1">48 subjects; 6 cases and 42 controls; age-matched (case: gender N/E; range: 47–75; control: gender N/E; range: 45–76 years)</td><td align="center" rowspan="1" colspan="1">PER</td><td align="left" rowspan="1" colspan="1">N/S</td></tr><tr><td align="left" colspan="5" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Torres et al., 2011 [<xref rid="B18" ref-type="bibr">18</xref>]</td><td align="center" rowspan="1" colspan="1">Cross-sectional</td><td align="left" rowspan="1" colspan="1">36 subjects; 9 cases and 27 controls; gender- and age-matched (case: gender N/E; range: 43–83 years; control: gender N/E; 43–84 years)</td><td align="center" rowspan="1" colspan="1">CBCT</td><td align="left" rowspan="1" colspan="1">MercuRay<bold>©</bold> CBCT System (Hitachi Medical Corporation, Tokyo, Japan)</td></tr><tr><td align="left" colspan="5" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Torres et al., 2012 [<xref rid="B19" ref-type="bibr">19</xref>]</td><td align="center" rowspan="1" colspan="1">Cross-sectional</td><td align="left" rowspan="1" colspan="1">58 subjects; 10 cases and 48 controls; gender- and age-matched (case: 7 women; range: 49–77 years; control: 34 women; range: 49–76 years)</td><td align="center" rowspan="1" colspan="1">CBCT</td><td align="left" rowspan="1" colspan="1">CB MercuRay equipment (Hitachi Medical Corporation, Tokyo, Japan)</td></tr><tr><td align="left" colspan="5" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Treister et al., 2009 [<xref rid="B20" ref-type="bibr">20</xref>]</td><td align="center" rowspan="1" colspan="1">Cross-sectional</td><td align="left" rowspan="1" colspan="1">39 subjects (15 women; range: 40–83 years)</td><td align="center" rowspan="1" colspan="1">PAN</td><td align="left" rowspan="1" colspan="1">N/S</td></tr><tr><td align="left" colspan="5" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Van den Wyngaert et al., 2011 [<xref rid="B21" ref-type="bibr">21</xref>]</td><td align="center" rowspan="1" colspan="1">Cohort</td><td align="left" rowspan="1" colspan="1">22 subjects (19 women; range 48–78 years)</td><td align="center" rowspan="1" colspan="1">SCI + SPECT</td><td align="left" rowspan="1" colspan="1">SCI: intravenous administration of medronate (methylene diphosphonate (MDP)) labeled with 740 MBq (20 mCi) Tc-99 m (Amerscan Medronate II Agent, GE Healthcare Limited, UK)/SPECT: step-and-shoot mode was used to obtain 64 projections with a zoom of 1.3, an angular range of 360° in 5.6° increments, and a duration of 30 seconds per frame. All studies were performed on a large-field-of-view dual-head whole-body camera (DST-XL or DST-Xli, General Electric/Sopha Medical Vision International, Buc, France)</td></tr><tr><td align="left" colspan="5" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Wilde et al., 2012 [<xref rid="B6" ref-type="bibr">6</xref>]</td><td align="center" rowspan="1" colspan="1">Cross-sectional</td><td align="left" rowspan="1" colspan="1">20 subjects (14 women; age N/E) </td><td align="center" rowspan="1" colspan="1">CBCT</td><td align="left" rowspan="1" colspan="1">Accuitomo (J. Morita MFG Corp., Kyoto, Japan) with the following parameters: 77 kV, 4 mA, scanning time 18 seconds, basis image 184, with a volume of 6 × 6 cm<sup>3</sup></td></tr></tbody></table><table-wrap-foot><fn><p>MDCT: multidetector computed tomography; PAN: panoramic radiography; PER: periapical radiography; CBCT: cone beam computed tomography; SCI: planar scintigraphy; SPECT: single photon emission computed tomography; PET: positron emission tomography; N/S: not specified.</p></fn></table-wrap-foot></table-wrap><table-wrap id="tab2" orientation="portrait" position="float"><label>Table 2</label><caption><p>Objectives, main results, and main conclusions of each selected study. </p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Authors</th><th align="left" rowspan="1" colspan="1">Objectives</th><th align="left" rowspan="1" colspan="1">Main results</th><th align="left" rowspan="1" colspan="1">Main conclusions</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">Bianchi et al., 2007 [<xref rid="B13" ref-type="bibr">13</xref>]</td><td align="left" rowspan="1" colspan="1">To verify the radiographic, demographic, and clinical features of BRONJ</td><td align="left" rowspan="1" colspan="1">MDCT was far superior to PAN in detecting all the radiologic signs. Dental panoramic radiograph may miss the correct diagnosis of sequestration. Intense reaction was often found</td><td align="left" rowspan="1" colspan="1">PAN was found to be of limited use in assessing BRONJ in patients for whom CT imaging was subsequently ordered</td></tr><tr><td align="left" colspan="4" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Fleisher et al., 2010 [<xref rid="B14" ref-type="bibr">14</xref>]</td><td align="left" rowspan="1" colspan="1">To verify radiographic changes that develop BRONJ after extraction and the correlation between BRONJ and reduced <italic>serum</italic> CTX values</td><td align="left" rowspan="1" colspan="1">All patients who had serum CTX levels <150 pg/mL healed successfully after dentoalveolar surgery or after treatment for BRONJ. 83% of patients who had BRONJ exhibited periodontal ligament (PDL) widening associated with extracted teeth, while only 11% who healed normally demonstrated PDL widening</td><td align="left" rowspan="1" colspan="1">The radiographic PDL widening may be a more sensitive indicator than CTX testing in predicting risk of BRONJ. Minimal surgical intervention may need to be revised to include alternative strategies for the elimination or management of this pathology</td></tr><tr><td align="left" colspan="4" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Guggenberger et al., 2013 [<xref rid="B15" ref-type="bibr">15</xref>]</td><td align="left" rowspan="1" colspan="1">To compare the extent of changes compatible with BRONJ on MRI, PET/CT, and CBCT of the jaw with clinical preoperative and intraoperative examinations</td><td align="left" rowspan="1" colspan="1">There were significant differences in BRONJ extent among modalities and examinations (<italic>P</italic> < 0.001).The highest median rank was seen in PET/CT and MRI imaging, followed by intraoperative examinations, CBCT, and preoperative examinations. Preoperative examinations showed significantly less extensive disease than all other modalities/examinations (all <italic>P</italic> < 0.05)</td><td align="left" rowspan="1" colspan="1">PET/CT and MRI imaging revealed more extensive involvement of BRONJ compared with panoramic views from CBCT and clinical examinations </td></tr><tr><td align="left" colspan="4" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Rocha et al., 2012 [<xref rid="B11" ref-type="bibr">11</xref>]</td><td align="left" rowspan="1" colspan="1">To compare radiographic alterations in patients taking bisphosphonate with a control group that would permit early diagnosis of BRONJ</td><td align="left" rowspan="1" colspan="1">Patients treated with zoledronate presented a statistically significant increase in the number of radiographic abnormalities compared with the control group. Female patients presented significantly more alterations than male patients, and the posterior region of the mandible was the most affected region</td><td align="left" rowspan="1" colspan="1">The use of panoramic radiographs facilitates early identification of bone alterations, which can improve early diagnosis of BRONJ</td></tr><tr><td align="left" colspan="4" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Stockmann et al., 2010 [<xref rid="B16" ref-type="bibr">16</xref>]</td><td align="left" rowspan="1" colspan="1">To find out the adequate imaging techniques to assess the extent of BRONJ</td><td align="left" rowspan="1" colspan="1">The detectability of BRONJ was 54% in PAN, 92% for MRI, and 96% for MDCT</td><td align="left" rowspan="1" colspan="1">MRI and MDCT have a higher detectability than PAN. The relevance of MRI and MDCT for the preoperative assessment of the extent of BRONJ is limited</td></tr><tr><td align="left" colspan="4" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Takaishi et al., 2010 [<xref rid="B17" ref-type="bibr">17</xref>]</td><td align="left" rowspan="1" colspan="1">To characterize alveolar bone under imminent danger for BRONJ by a radiogrammetric method on the alveolar bone mineral density</td><td align="left" rowspan="1" colspan="1">The bone mineral density surrounding the osteonecrosis lesions showed distinctly higher density in BRONJ cases compared with age-matched controls. In one subject on bisphosphonate treatment in which two extractions were simultaneously carried out, BRONJ occurred only at the location with extremely high alveolar bone density, but not at the other site with normal density</td><td align="left" rowspan="1" colspan="1">This method may be useful in detecting a rise of alveolar bone mineral density frequently occurring near the necrotic lesion in subjects with impending risk for BRONJ </td></tr><tr><td align="left" colspan="4" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Torres et al., 2011 [<xref rid="B18" ref-type="bibr">18</xref>]</td><td align="left" rowspan="1" colspan="1">To compare fractal dimensions (FD) in CBCT exams of patients with BRONJ with a control group and select the best region of interest for detecting bone alterations</td><td align="left" rowspan="1" colspan="1">The value of the FD in the area of exposed bone was the highest. The odds of being a BRONJ patient versus being a control were six times as high for individuals with a higher FD score at a region of interest in the alveolar process, although the confidence interval was quite wide owing to the small sample size</td><td align="left" rowspan="1" colspan="1">BRONJ patients had higher FD values than controls at regions close to the alveolar process. FD is a promising tool for detection of bone alterations associated with BRONJ</td></tr><tr><td align="left" colspan="4" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Torres et al., 2012 [<xref rid="B19" ref-type="bibr">19</xref>]</td><td align="left" rowspan="1" colspan="1">To compare cortical bone measures in CBCT exams of patients with BRONJ with a control group</td><td align="left" rowspan="1" colspan="1">The cortical bone measurements were significantly higher in cases than in controls. The bone measurements were strongly associated with BRONJ case status</td><td align="left" rowspan="1" colspan="1">Mandibular cortical bone measurement is a potentially useful tool in the detection of bone dimensional changes caused by bisphosphonates</td></tr><tr><td align="left" colspan="4" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Treister et al., 2009 [<xref rid="B20" ref-type="bibr">20</xref>]</td><td align="left" rowspan="1" colspan="1">To determine the extent to which clinical and radiographic features of BRONJ are correlated</td><td align="left" rowspan="1" colspan="1">There was agreement between clinical and radiographic detection. There was equivalency between BRONJ diagnosis and both sclerosis and surface irregularity. The correlation between the number of clinical sites and any radiographic finding was significant in the maxilla (<italic>P</italic> < 0.001) but not in the mandible (<italic>P</italic> = 0.178). The total number of radiographic signs per patient increased with BRONJ stage</td><td align="left" rowspan="1" colspan="1">Focal panoramic radiographic findings of sclerosis and surface irregularity correlate with clinical sites of BRONJ. This may be a useful and reliable tool to detect early changes of BRONJ or to confirm a clinical diagnosis</td></tr><tr><td align="left" colspan="4" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Van den Wyngaert et al., 2011 [<xref rid="B21" ref-type="bibr">21</xref>]</td><td align="left" rowspan="1" colspan="1">To identify images that predict the healing of BRONJ</td><td align="left" rowspan="1" colspan="1">SPECT acquisitions were proved superior over planar images in detecting BRONJ lesions. Quantification of tracer uptake in the BRONJ lesion relative to the unaffected side showed increasing uptake with higher stages of ONJ. The relative ratio of uptake was found to be an independent predictor of BRONJ healing BRONJ stage and relative ratio of uptake were not predictors of the occurrence of BRONJ relapses</td><td align="left" rowspan="1" colspan="1">Bone scintigraphy in patients with BRONJ is feasible. SPECT acquisitions are preferred over planar images. Relative quantification of tracer uptake provides prognostic information independent of clinical stage that may assist in identifying patients with a poor prognosis</td></tr><tr><td align="left" colspan="4" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Wilde et al., 2012 [<xref rid="B6" ref-type="bibr">6</xref>]</td><td align="left" rowspan="1" colspan="1">To investigate the prevalence of typical radiological findings of BRONJ in CBCT and the relationship of the imaging findings with the severity of BRONJ sites</td><td align="left" rowspan="1" colspan="1">The most common imaging findings were cancellous bone destruction and cortical bone erosion and can often be seen in all stages of the disease, including low stages. The prevalence of typical findings such as bone destruction, sequestration, and osteosclerosis seems to decrease with decreasing severity of BRONJ. The occurrence of periosteal new bone formation seems to start in high-stage BRONJ</td><td align="left" rowspan="1" colspan="1">With the exception of formation of new periosteal bone, all investigated radiological signs can be seen across all stages of BRONJ, and occurrence seems to decrease with decreasing severity of the disease. The radiological signs destruction of the cancellous bone and erosion of the cortical bone were the two most frequent and typical findings for BRONJ in CBCT scans</td></tr></tbody></table><table-wrap-foot><fn><p>MDCT: multidetector computed tomography; PAN: panoramic radiography; PER: periapical radiography; CBCT: cone beam computed tomography; SCI: planar scintigraphy; SPECT: single photon emission computed tomography; PET: positron emission tomography.</p></fn></table-wrap-foot></table-wrap></floats-group></pmc><affiliations><list><country><li>Brésil</li></country><region><li>District fédéral (Brésil)</li></region></list><tree><country name="Brésil"><region name="District fédéral (Brésil)"><name sortKey="Leite, Andre Ferreira" sort="Leite, Andre Ferreira" uniqKey="Leite A" first="André Ferreira" last="Leite">André Ferreira Leite</name></region><name sortKey="De Melo, Nilce Santos" sort="De Melo, Nilce Santos" uniqKey="De Melo N" first="Nilce Santos" last="De Melo">Nilce Santos De Melo</name><name sortKey="Figueiredo, Paulo Tadeu De Souza" sort="Figueiredo, Paulo Tadeu De Souza" uniqKey="Figueiredo P" first="Paulo Tadeu De Souza" last="Figueiredo">Paulo Tadeu De Souza Figueiredo</name><name sortKey="Ogata, Fernanda Dos Santos" sort="Ogata, Fernanda Dos Santos" uniqKey="Ogata F" first="Fernanda Dos Santos" last="Ogata">Fernanda Dos Santos Ogata</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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