title: Surgical evaluation of panoramic radiography and cone beam computed tomography for therapy planning of bisphosphonate-related osteonecrosis of the jaws.
abstract: OBJECTIVE
  The purpose of this retrospective study was to compare the clinical significance of panoramic radiography (orthopantomography [OPTG]) and cone beam computed tomography (CBCT) for therapy planning of bisphosphonate-related osteonecrosis of the jaw (BRONJ) by surgeons.
  
  
  METHODS
  Using standardized questionnaire, eight maxillofacial surgeons evaluated intraoral photographs of the clinical situation of 14 patients with BRONJ as well as the corresponding radiographic images (OPTG, CBCT). The presence of five typical BRONJ signs (bone-remodeling, periosteal reaction, osteosclerosis, sequestra, and continuity of cortical bone) was evaluated with OPTG and CBCT. The influence of radiologic information on therapy decision was examined as well.
  
  
  RESULTS
  On the basis of the information from intraoral photographs only, seven of the eight surgeons indicated that an additional radiographic examination was necessary for further therapy planning. For evaluation of the five radiographic BRONJ signs, CBCT provided significantly better values compared with OPTG (all P < .05). A before-and-after comparison showed that four of the eight surgeons changed their therapy concept after having three-dimensional CBCT information. The majority (6 of 8) of the surgeons considered that an additional CBCT was required for therapy planning, even after having studied the clinical photographs and OPTG images.
  
  
  CONCLUSIONS
  These data demonstrate a significant advantage of CBCT over OPTG for surgeons with regard to therapeutic planning for BRONJ.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, Medical Centre of the University of Rostock, Rostock, Mecklenburg-Vorpommern, Germany. Electronic address: Peer.kaemmerer@med.uni-rostock.de.
authors.forename: Peer W
authors.initials: PW
authors.lastname: Kämmerer
authors.affiliation: Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, Medical Centre of the University of Rostock, Rostock, Mecklenburg-Vorpommern, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Thiem
authors.affiliation: Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Rheinland-Pfalz, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Eisenbeiß
authors.affiliation: Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, Medical Centre of the University of Rostock, Rostock, Mecklenburg-Vorpommern, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Dau
authors.affiliation: Department of Oral Surgery, University Medical Centre Mainz, Mainz, Rheinland-Pfalz, Germany.
authors.forename: Ralf K W
authors.initials: RK
authors.lastname: Schulze
authors.affiliation: Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Rheinland-Pfalz, Germany.
authors.forename: Bilal
authors.initials: B
authors.lastname: Al-Nawas
authors.affiliation: Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Rheinland-Pfalz, Germany.
authors.forename: Florian G
authors.initials: FG
authors.lastname: Draenert
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000000981:diagnostic imaging* / Q000628:therapy*; D054893:Cone-Beam Computed Tomography; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010347:Patient Care Planning; D011862:Radiography, Panoramic; D012189:Retrospective Studies; D011795:Surveys and Questionnaires