title: A simple evaluation method for early detection of bisphosphonate-related osteonecrosis of the mandible using computed tomography.
abstract: OBJECTIVE
  The aim of this study was to establish a simple method for the early detection of bisphosphonate-related osteonecrosis of the jaw (BRONJ) using computed tomography (CT).
  
  
  METHODS
  CT images of the mandible were obtained from a total of 20 patients with BRONJ and 20 control subjects. BRONJ was classified into 2 groups, with bone exposure (Stage 1-3 BRONJ) or without (Stage 0 BRONJ). In each patient, 15 transaxial CT images were selected and 30 configured regions of interest (ROI) were identified. The ANOVA test was applied to test the relationship between the severity of systemic risk factors.
  
  
  RESULTS
  Regarding the local status of the mandible, significant differences were observed among the Stage 0 BRONJ, Stage 1-3 BRONJ, non-BRONJ and control groups in the cancellous bone CT radiodensity values, but there were no significant differences between the Stage 0 and Stage 1-3 BRONJ groups. In the cortical bone widths, significant differences were observed only between BRONJ and the controls.
  
  
  CONCLUSIONS
  Measuring cancellous bone CT radiodensity value has the potential to be a simple and quantitative method to detect the early stages of BRONJ.
authors: Department of Oral and Maxillofacial Surgery, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan. Electronic address: h-hamada@tokyo-med.ac.jp.
authors: Hayato
authors: H
authors: Hamada
authors: Department of Oral and Maxillofacial Surgery, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
authors: Akira
authors: A
authors: Matsuo
authors: Department of Oral and Maxillofacial Surgery, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
authors: Toshiyuki
authors: T
authors: Koizumi
authors: Department of Oral and Maxillofacial Surgery, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
authors: Takafumi
authors: T
authors: Satomi
authors: Department of Oral and Maxillofacial Surgery, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
authors: Daichi
authors: D
authors: Chikazu
mesh_terms: D061605:Administration, Intravenous; D000284:Administration, Oral; D019386:Alendronate / Q000008:administration & dosage; D000539:Alveolar Process / Q000000981:diagnostic imaging; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000145:classification / Q000000981:diagnostic imaging*; D015519:Bone Density / Q000502:physiology; D050071:Bone Density Conservation Agents / Q000008:administration & dosage; D016022:Case-Control Studies; D004164:Diphosphonates / Q000008:administration & dosage; D042241:Early Diagnosis; D012968:Etidronic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007093:Imidazoles / Q000008:administration & dosage; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging; D008336:Mandibular Diseases / Q000145:classification / Q000000981:diagnostic imaging*; D008875:Middle Aged; D010014:Osteolysis / Q000000981:diagnostic imaging; D010026:Osteosclerosis / Q000000981:diagnostic imaging; D000077268:Pamidronate; D000068296:Risedronic Acid; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*; D000077211:Zoledronic Acid
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid; D000068296:Risedronic Acid; D012968:Etidronic Acid; D000077268:Pamidronate; D019386:Alendronate
keywords: Bisphosphonate; CT radiodensity value; Early detection; Mandible; Osteonecrosis