title: Quantitative ultrasound at the hand phalanges in patients with bisphosphonate-related osteonecrosis of the jaws.
abstract: Patients with bisphosphonate-related osteonecrosis of the jaws (BRONJ) who received intravenous or oral bisphosphonates (BP) were selected for determination of their bone microarchitecture as a risk predictor of BRONJ development. The diagnosis of BRONJ was made based on clinical and radiographic findings. The control group consisted of healthy patients. All patients underwent quantitative and qualitative ultrasound measurements of bone at the hand phalanges carried out using the DBM Sonic BP. Ultrasound bone profile index (UBPI), amplitude-dependent speed of sound (AD-SoS), bone biophysics profile (BBP), and bone transmission time (BTT) were measured. The BRONJ group consisted of 17 patients (62 ± 4.24; range: 45-82); 10 (58.8%) were male and seven (41.1%) were female, of whom 11 (64.7%) suffered from multiple myeloma, three (17.6%) from osteoporosis, one (5.8%) from prostate cancer, one (5.8%) from kidney cancer, and one (5.8%) from leukemia. Fourteen (82.3%) of them received intravenous BP whereas three (17.6%) received oral BP. Nine (9/17; 52.9%) patients developed bone exposure: two in the maxilla and seven in the mandible. Regarding quantitative parameters, Ad-SoS was low in the BRONJ group, but not significant. The UBPI score was significantly reduced in BRONJ patients with exposed bone when compared to controls (0.47 ± 0.12 vs. 0.70 ± 0.15; p = 0.004). The present study demonstrated that quantitative ultrasound was able to show bone microarchitecture alterations in BRONJ patients, and suggests that these analyses may be an important tool for early detection of bone degeneration associated with BRONJ.
authors.affiliation: Department of Stomatology, Public Oral Health and Forensic Dentistry, School of Dentistry of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Ana Carolina Fragoso
authors.initials: AC
authors.lastname: Motta
authors.affiliation: Hospital das Clínicas, Ribeirão Preto, SP, Brazil.
authors.forename: Leandro Dorigan
authors.initials: LD
authors.lastname: de Macedo
authors.affiliation: Department of Food and Nutrition, School of Pharmaceutical Sciences, Universidade Estadual Paulista "Júlio de Mesquita Filho", Araraquara, SP, Brazil.
authors.forename: Gisele Guimarães
authors.initials: GG
authors.lastname: Santos
authors.affiliation: Department of Neurosciences and Behavioral Sciences, School of Medicine of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Carlos Tostes
authors.initials: CT
authors.lastname: Guerreiro
authors.affiliation: Hospital das Clínicas, Ribeirão Preto, SP, Brazil.
authors.forename: Tatiane
authors.initials: T
authors.lastname: Ferrari
authors.affiliation: Department of Stomatology, Dental School of Bauru, Universidade de São Paulo, Bauru, SP, Brazil.
authors.forename: Thais Feitosa Leitão
authors.initials: TF
authors.lastname: de Oliveira
authors.affiliation: Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Paulo Sérgio da Silva
authors.initials: PS
authors.lastname: Santos
authors.affiliation: Department of Stomatology, Public Oral Health and Forensic Dentistry, School of Dentistry of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Christiano
authors.initials: C
authors.lastname: de Oliveira-Santos
authors.affiliation: Department of Gynecology and Obstetrics, School of Medicine of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Hilton Marcos Alves
authors.initials: HM
authors.lastname: Ricz
authors.affiliation: Department of Oral & Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Samuel Porfírio
authors.initials: SP
authors.lastname: Xavier
authors.affiliation: Department of Gynecology and Obstetrics, School of Medicine of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
authors.forename: Odilon
authors.initials: O
authors.lastname: Iannetta
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D015519:Bone Density; D016723:Bone Remodeling / Q000502:physiology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D050278:Finger Phalanges / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D006225:Hand / Q000000981:diagnostic imaging; D006801:Humans; D007568:Jaw / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000473:pathology; D010024:Osteoporosis / Q000139:chemically induced; D015203:Reproducibility of Results; D012307:Risk Factors; D013997:Time Factors; D014463:Ultrasonography