A simple evaluation method for early detection of bisphosphonate-related osteonecrosis of the mandible using computed tomography

Objectives 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). Materials and 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.