Radiographic Analysis of MRONJ in Osteoporotic and Oncologic Patients on Bisphosphonates or Denosumab
Omar Ghanaiem1,2, Gavriel Chaushu1,2, Daya Masri1,2
1Department of Oral and Maxillofacial Surgery, the Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
Introduction:
Medication-Related Osteonecrosis of the Jaw (MRONJ) is a severe adverse effect of antiresorptive and antiangiogenic treatment, primarily in osteoporotic and oncologic patients. The disease is characterized by persistent jawbone necrosis that results in significant impairment of the quality of life of involved patients. The aim of this study is to compare the radiographic characteristics of MRONJ between osteoporotic and oncologic patients and assess the differences based on treatment type, particularly bisphosphonates and denosumab (RANK-L inhibitors).
Methods:
A retrospective analysis of 152 MRONJ patients (41 osteoporotic, 111 oncologic) from Rabin-Bilinson Medical Center (2014-2024) examined radiographic features-lytic changes, sclerosis, periosteal reactions, sequestration, and periodontal ligament destruction-using panoramic radiography, CBCT, and MDCT.
Results:
Sclerosis was more frequent in osteoporotic patients compared to oncologic patients (p < 0.05). No statistically significant differences were found in other radiographic features. Bisphosphonate-induced MRONJ was more frequently accompanied by sclerosis compared to denosumab-related cases in osteoporotic patients (p = 0.0318), while no significant differences were found in the oncologic group.
Conclusions:
Most of the radiographic features of MRONJ were similar in osteoporotic and oncologic patients. However, sclerosis was more common in osteoporotic patients exposed to Bisphosphonates, which may be due to their prolonged exposure to antiresorptive drugs.
More Related Videos
08:53Drug Treatment and In Vivo Imaging of Osteoblast-Osteoclast Interactions in a Medaka Fish Osteoporosis Model
Published on: January 1, 2017
05:55Author Spotlight: Developing a Rat Model for Weight-Bearing Intervention to Investigate Osteonecrosis of the Femoral Head
Published on: September 27, 2024
Related Concept Videos
01:31Osteoclasts in Bone Remodeling
01:29Bone Disorders
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
01:24X-ray Imaging