To verify the radiographic, demographic, and clinical features of BRONJ
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
PAN was found to be of limited use in assessing BRONJ in patients for whom CT imaging was subsequently ordered
To verify radiographic changes that develop BRONJ after extraction and the correlation between BRONJ and reduced serum CTX values
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
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
To compare the extent of changes compatible with BRONJ on MRI, PET/CT, and CBCT of the jaw with clinical preoperative and intraoperative examinations
There were significant differences in BRONJ extent among modalities and examinations ().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 )
PET/CT and MRI imaging revealed more extensive involvement of BRONJ compared with panoramic views from CBCT and clinical examinations
To compare radiographic alterations in patients taking bisphosphonate with a control group that would permit early diagnosis of BRONJ
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
The use of panoramic radiographs facilitates early identification of bone alterations, which can improve early diagnosis of BRONJ
To characterize alveolar bone under imminent danger for BRONJ by a radiogrammetric method on the alveolar bone mineral density
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
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
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
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
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
To compare cortical bone measures in CBCT exams of patients with BRONJ with a control group
The cortical bone measurements were significantly higher in cases than in controls. The bone measurements were strongly associated with BRONJ case status
Mandibular cortical bone measurement is a potentially useful tool in the detection of bone dimensional changes caused by bisphosphonates
To determine the extent to which clinical and radiographic features of BRONJ are correlated
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 () but not in the mandible (). The total number of radiographic signs per patient increased with BRONJ stage
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
To identify images that predict the healing of BRONJ
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
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
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
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
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
