6533b836fe1ef96bd12a19ec
RESEARCH PRODUCT
Staging of osteonecrosis of the jaw requires computed tomography for accurate definition of the extent of bony disease
Alberto BedogniGiorgia SaiaStefano FedeleGiorgio BedogniMatteo ScolettaGianfranco FaviaGiuseppe ColellaAlessandrog AgrilloGiordanah Bettini Di Fede OlgaiGiacomoj OteriVittoriok FuscoMariol GabrieleLiviam OttolenghiStefanon ValsecchiStepheno PorterMassimoe PetruzziPaolod ArduinoSalvatoref D’amatoClaudiog Ungari Fung Polly Pok LamoGiorgiah SaiaGiuseppinaiauniversity CampisiGiordana Bettinisubject
AdultMaleCutaneous FistulaSettore MED/50 - Scienze Tecniche Mediche ApplicateDental Fistulastaging system; bisphosphonate; computed tomography; aaoms; osteonecrosis of the jaw; antiresorptive agentsAAOMSAntiresorptive agentSettore MED/29 - Chirurgia MaxillofaccialeAAOMS Antiresorptive agents Bisphosphonate Computed tomography Osteonecrosis of the jaw Staging systemBronj; AAOMS; Antiresorptive agents; Bisphosphonate; Computed tomography; Osteonecrosis of the jaw; Staging systemSettore MED/28 - Malattie OdontostomatologicheMandibular FracturesBronjOsteonecrosis of the jaw; Bisphosphonate; Staging system; AAOMS; Computed tomography; Antiresorptive agentsAlveolar ProcessHumansBisphosphonateMandibular DiseasesComputed tomographyAgedRetrospective StudiesAged 80 and overSuppurationBone Density Conservation AgentsOsteonecrosis of the jawPatient AcuityAntiresorptive agentsCone-Beam Computed TomographyMiddle AgedStaging systemMaxillary DiseasesPhenotypeOtorhinolaryngologyTooth ExtractionBisphosphonate-Associated Osteonecrosis of the JawDrug Therapy CombinationFemaleSurgeryOsteonecrosis of the jaw; Bisphosphonate; Staging system; AAOMS; Computed tomography; Antiresorptive agentsAAOMS; Antiresorptive agents; Bisphosphonate; Computed tomography; Osteonecrosis of the jaw; Staging systemOral SurgeryTomography X-Ray ComputedTomography Spiral ComputedOsteosclerosisdescription
AbstractManagement of osteonecrosis of the jaw associated with antiresorptive agents is challenging, and outcomes are unpredictable. The severity of disease is the main guide to management, and can help to predict prognosis. Most available staging systems for osteonecrosis, including the widely-used American Association of Oral and Maxillofacial Surgeons (AAOMS) system, classify severity on the basis of clinical and radiographic findings. However, clinical inspection and radiography are limited in their ability to identify the extent of necrotic bone disease compared with computed tomography (CT). We have organised a large multicentre retrospective study (known as MISSION) to investigate the agreement between the AAOMS staging system and the extent of osteonecrosis of the jaw (focal compared with diffuse involvement of bone) as detected on CT. We studied 799 patients with detailed clinical phenotyping who had CT images taken. Features of diffuse bone disease were identified on CT within all AAOMS stages (20%, 8%, 48%, and 24% of patients in stages 0, 1, 2, and 3, respectively). Of the patients classified as stage 0, 110/192 (57%) had diffuse disease on CT, and about 1 in 3 with CT evidence of diffuse bone disease was misclassified by the AAOMS system as having stages 0 and 1 osteonecrosis. In addition, more than a third of patients with AAOMS stage 2 (142/405, 35%) had focal bone disease on CT. We conclude that the AAOMS staging system does not correctly identify the extent of bony disease in patients with osteonecrosis of the jaw.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2014-01-01 |