Imaging features of medicine-related osteonecrosis of the jaws: comparison between panoramic radiography and computed tomography

ObjectiveThe current staging system of medicine-related osteonecrosis of the jaws (MRONJ) assigns patients to different stages based on clinical manifestations. The extent of bone disease cannot be fully determined without radiologic evaluation. Missing radiologic information may lead to incorrect classification of MRONJ, resulting in poor outcomes of treatment. The objective of this study was to compare computed tomography (CT) and panoramic radiography (PR) features of MRONJ in different stages to achieve accurate staging on the basis of combined findings from clinical staging and imaging.Study DesignA retrospective study was carried out to analyze the differences in the radiographic features of various clinical stages in MRONJ, as shown by PR and CT.ResultsBoth PR and CT could detect the typical syndrome of osseous sclerosis in grade 0 and grade 1. For the patients of grade 2, more features were observed on CT, such as periosteal reaction, cortical perforation, and periosteal bone deposition. CT was also conducive to analyzing the degree of the maxillary lesion and soft tissue involvement as compared with PR.ConclusionsThis study showed that CT detects changes that may not be revealed by plain radiography in patients with MRONJ.