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RESEARCH PRODUCT

Surgical evaluation of panoramic radiography and cone beam computed tomography for therapy planning of bisphosphonate-related osteonecrosis of the jaws

Daniel G. E. ThiemMichael DauBilal Al NawasFlorian G. DraenertPeer W. KämmererChristoph EisenbeißRalf Schulze

subject

MaleCone beam computed tomographymedicine.medical_specialtyRadiographymedicine.medical_treatmentDecision MakingPeriosteal reactionTherapy planningPatient Care PlanningPathology and Forensic Medicine03 medical and health sciences0302 clinical medicinestomatognathic systemSurveys and QuestionnairesRadiography PanoramicmedicineHumansRadiology Nuclear Medicine and imagingDentistry (miscellaneous)Clinical significanceAgedRetrospective StudiesAged 80 and overbusiness.industryRetrospective cohort study030206 dentistryCone-Beam Computed TomographyMiddle Agedrespiratory systemBisphosphonatemedicine.disease030220 oncology & carcinogenesisBisphosphonate-Associated Osteonecrosis of the JawFemaleSurgeryRadiologyOral SurgerybusinessOsteonecrosis of the jaw

description

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.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.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.These data demonstrate a significant advantage of CBCT over OPTG for surgeons with regard to therapeutic planning for BRONJ.

yearjournalcountryeditionlanguage
2015-08-02Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://doi.org/10.1016/j.oooo.2015.11.012