Radiography finding in the jaws in children taking bisphosphonate

Area of Science:

• Dentistry
• Radiology
• Oncology

Background:

• Bisphosphonates inhibit osteoclasts, reducing bone resorption and turnover.
• Osteonecrosis of the jaw (ONJ) is a potential side effect of bisphosphonate therapy.
• This study focuses on radiographic findings in pediatric patients with bisphosphonate-associated ONJ.

Purpose of the Study:

• To examine and describe the radiographic features of bisphosphonate-associated osteonecrosis of the jaws (BRONJ) in a pediatric patient cohort.
• To identify common and significant radiographic findings indicative of BRONJ in young individuals.

Main Methods:

• Retrospective analysis of 12 clinically diagnosed patients (ages 7-21) with emergency dental conditions.
• Utilized panoramic radiography and cone-beam computed tomography (CBCT) for assessment.
• Evaluated radiographic findings including osteosclerosis, lamina dura changes, osteolysis, and soft tissue reactions.

Main Results:

• Osteosclerosis, especially in alveolar bone, was observed in most patients.
• Thickening of the lamina dura (58.3%) and full-thickness sclerosis (50%) were common.
• Other findings included osteolysis, sequestra, widening of the periodontal ligament (PDL) space, non-healing extraction sockets, and oroantral fistula.

Conclusions:

• Osteosclerosis is a prevalent radiographic feature in pediatric patients with bisphosphonate-associated ONJ.
• Thickening of the lamina dura and alveolar crest represent the most frequent signs of BRONJ in this population.
• Radiographic evaluation is crucial for diagnosing and managing BRONJ in children and adolescents receiving bisphosphonates.