Meaning and Limitation of Cortical Bone Width Measurement with DentaScan in Medication-Related Osteonecrosis of the Jaws

摘要

Mandibular cortical bone measurement w ith x-ray imaging is known to be a potentially useful tool in the detection of dimensional changes caused by bisphosphonate. The primary purpose of this study was to assess the meaning and limitation of cortical bone measurement with computed tomography (C T) in patients with medication-related osteonecrosis of the jaw (MRONJ). The investigators obtained DentaScan images of the mandible from 15 patients with MRONJ, 15 patients with a history of antiresorptive agent administration without symptoms of MRONJ (non-MRONJ), and 15 control subjects. The co rtical bone width measured on DentaScan images w as compared between the three groups (ANOVA and Tukey's test). Interobserver reliability between two observers was also assessed. The values of interclass correlation coefficient w ere 0.48 in the MRONJ group, 0.29 in the Non -MRONJ group, and 0.34 in control group. The cortical bone widths calculated both by observer 1 and observer 2 were thicker in patients with MRONJ than in the non-MRONJ group and controls. There were significant differences in cortical bone width among the MRONJ, non-MRONJ, and control groups in observer 1 (P 0.001) and observer 2 (P 0.001), specifically comparing the MRONJ group with the non-MRONJ group and the control group. Cortical bone width mea surement is useful for the distinction between medication-related osteonecrosis of the jaw and normal bone, in spite of the low interobserver reliability.