Imaging Sci Dent.  2021 Mar;51(1):73-80. 10.5624/isd.20200230.

CBCT imaging and histopathological characteristics of osteoradionecrosis and medicationrelated osteonecrosis of the jaw

• Ogura I
• Minami Y
• Ono J
• Kanri Y
• Okada Y
• Igarashi K
• Haga-Tsujimura M
• Nakahara K
• Kobayashi E

• KMID: 2527040
• DOI: http://doi.org/10.5624/isd.20200230

Abstract

Purpose
The purpose of this study was to evaluate the cone-beam computed tomographic (CBCT) imaging and histopathological characteristics of osteoradionecrosis (ORN) and medication-related osteonecrosis of the jaw (MRONJ).
Materials and Methods
Ten surgical specimens from segmental mandibulectomy (3 ORN and 7 MRONJ) were analyzed using CBCT. The CBCT parameters were as follows: high-resolution mode (tube voltage, 90.0 kV; tube current, 4.00 mA; rotation time, 16.8 s; field of view, 56 mm×56 mm; thickness, 0.099 mm). Histopathological characteristics were evaluated using histological slides of the surgical specimens. The Pearson chi-square test was used to compare ORN and MRONJ in terms of CBCT findings (internal texture, sequestrum, periosteal reaction and cortical perforation) and histopathological characteristics (necrotic bone, inflammatory cells, reactive bone formation, bacteria, Actinomyces, and osteoclasts). A P value less than 0.05 was considered to indicate statistical significance.
Results
MRONJ showed periosteal reaction on CBCT more frequently than ORN (7 of 7 [100%] vs. 0 of 3 [0%], P<0.05). Regarding histopathological characteristics, MRONJ showed osteoclasts more frequently than ORN (6 of 7 [85.7%] vs. 0 of 3 [0%], P<0.05).
Conclusion
This study evaluated the CBCT imaging and histopathological characteristics of ORN and MRONJ, and the findings suggest that CBCT could be useful for the evaluation of ORN and MRONJ.

Keyword

Bisphosphonate-Associated Osteonecrosis of the Jaw; Osteoradionecrosis; Cone-Beam Computed Tomography