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Bisphosphonate-associated jawbone osteonecrosis: a correlation between imaging techniques and histopathology
Alberto Bedogni1, Stella Blandamura, Zerina Lokmic
1Unit of Dentistry and Maxillofacial Surgery, University of Verona, Verona, Italy.
Summary
Bisphosphonate-associated jawbone osteonecrosis presents distinct histopathologic and radiologic features. Advanced imaging like CT and MRI accurately evaluate this condition, guiding treatment decisions.
Area of Science:
- Oral pathology
- Radiology
- Oncology
Background:
- Bisphosphonates are commonly used to treat osteoporosis and other bone diseases.
- Jawbone osteonecrosis is a rare but serious adverse effect associated with bisphosphonate therapy.
- Understanding the histopathologic and radiologic characteristics is crucial for diagnosis and management.
Purpose of the Study:
- To highlight the histopathologic and radiologic features of bisphosphonate-associated jawbone osteonecrosis.
- To evaluate the utility of advanced imaging techniques in assessing the extent of the disease.
- To correlate imaging findings with histopathologic results.
Main Methods:
- Retrospective analysis of 11 patients with bisphosphonate-associated jawbone osteonecrosis.
- Surgical resection of diseased jawbone following hyperbaric oxygen therapy.
- Comprehensive clinical, laboratory, and imaging (CT, MRI) evaluation.
- Histopathologic and immunohistochemical analysis of surgical specimens.
Main Results:
- CT scans revealed increased bone density, periosteal reaction, and sequestration in advanced stages.
- MRI demonstrated distinct patterns: osteonecrotic areas showed low signal (low water content), while osteomyelitic areas showed high signal (high water content, inflammation).
- Histopathology confirmed the imaging findings, correlating with cell and vessel content.
Conclusions:
- Bisphosphonate-associated jawbone osteonecrosis can extend beyond clinically exposed bone.
- Histopathologic examination strongly correlates with CT and MRI findings.
- CT and MRI are the imaging modalities of choice for evaluating bisphosphonate-associated jawbone osteonecrosis.
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