Imaging Sci Dent.  2019 Dec;49(4):281-286. 10.5624/isd.2019.49.4.281.

Computer programme to assess mandibular cortex morphology in cases of medication-related osteonecrosis of the jaw with osteoporosis or bone metastases

• Ogura I
• Kobayashi
• Nakahara K
• Haga-Tsujimura M
• Igarashi K
• Katsumata

• KMID: 2466550
• DOI: http://doi.org/10.5624/isd.2019.49.4.281

Abstract

PURPOSE
The purpose of this study was to evaluate the morphology of the mandibular cortex in cases of medication-related osteonecrosis of the jaw (MRONJ) in patients with osteoporosis or bone metastases using a computer programme.
MATERIALS AND METHODS
Fifty-four patients with MRONJ (35 with osteoporosis and 19 with bone metastases) were examined using panoramic radiography. The morphology of the mandibular cortex was evaluated using a computer programme that scanned the mandibular inferior cortex and automatically assessed the mandibular cortical index (MCI) according to the thickness and roughness of the mandibular cortex, as follows: normal (class 1), mildly to moderately eroded (class 2), or severely eroded (class 3). The MCI classifications of MRONJ patients with osteoporosis or bone metastases were evaluated with the Pearson chi-square test. In these analyses, a 5% significance level was used.
RESULTS
The MCI of MRONJ patients with osteoporosis (class 1: 6, class 2: 15, class 3: 14) tended to be higher than that of patients with bone metastases (class 1: 14, class 2: 5, class 3: 0) (P=0.000).
CONCLUSION
The use of a computer programme to assess mandibular cortex morphology may be an effective technique for the objective and quantitative evaluation of the MCI in MRONJ patients with osteoporosis or bone metastases.

Keyword

Image Processing, Computer-Assisted; Radiography, Panoramic; Bisphosphonate-Associated Osteonecrosis of the Jaw; Osteoporosis

MeSH Terms

Bisphosphonate-Associated Osteonecrosis of the Jaw
Classification
Cytochrome P-450 CYP1A1
Evaluation Studies as Topic
Humans
Image Processing, Computer-Assisted
Jaw*
Neoplasm Metastasis*
Osteonecrosis*
Osteoporosis*
Radiography, Panoramic
Cytochrome P-450 CYP1A1

Figure

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  Fig. 1 A. Panoramic radiography shows medication-related osteonecrosis of the jaw in a 56-year-old woman with bone metastases of breast cancer. B. PanoSCOPE software indicates that the mandibular cortical index (MCI) is class 1.

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  Fig. 2 A. Panoramic radiography shows medication-related osteonecrosis of the jaw in an 81-year-old woman with osteoporosis. B. PanoSCOPE software indicates that the mandibular cortical index (MCI) is class 2.

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  Fig. 3 A. Panoramic radiography shows medication-related osteonecrosis of the jaw in a 77-year-old woman with osteoporosis. B. PanoSCOPE software indicates that the mandibular cortical index (MCI) is class 3.

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