Use of Cone Beam Computed Tomography for identification and evaluation of medication-related osteonecrosis of the jaws: a dosimetric and multimodal imaging comparison

Marco Barillari; A. Pardo; P. Faccioni; S. Guariglia; C. Cavedon; M. Zarantonello; F. Melloni; P. Zanutto; R. Bettini; G. C.  Mansueto; N. Zerman; F. Lonardi

doi:10.56609/jac.v41i1.273

Authors

M. Barillari Department of Radiology G.B. Rossi Hospital University of Verona Italy
A. Pardo Department of Oral and Maxillofacial Surgery G.B. Rossi Hospital University of Verona Italy
P. Faccioni Department of Oral and Maxillofacial Surgery G.B. Rossi Hospital University of Verona Italy
S. Guariglia Department of Medical Physics University of Verona Italy
C. Cavedon Department of Medical Physics University of Verona Italy
M. Zarantonello Department of Oral and Maxillofacial Surgery G.B. Rossi Hospital University of Verona Italy
F. Melloni Department of Oral and Maxillofacial Surgery G.B. Rossi Hospital University of Verona Italy
P. Zanutto Department of Radiology G.B. Rossi Hospital University of Verona Italy
R. Bettini Department of Radiology G.B. Rossi Hospital University of Verona Italy
G. C. Mansueto Department of Radiology G.B. Rossi Hospital University of Verona Italy
N. Zerman Department of Oral and Maxillofacial Surgery G.B. Rossi Hospital University of Verona Italy
F. Lonardi Department of Oral and Maxillofacial Surgery G.B. Rossi Hospital

Keywords:

cone beam computed tomography, computed tomography, orthopantomograms, medication-related osteonecrosis of the jaws, thermoluminescent dosimeter

Abstract

The aim of this study was to compare Orthopantomograms (OPT) and Computed Tomography (CT) with Cone Beam Computed Tomography (CBCT) in patients with Medication-Related OsteoNecrosis of the Jaws (MRONJ). The study included 25 patients (6 males and 19 females) with MRONJ who had a history of long-term bisphosphonate therapy or one of the recently re-entered MRONJ drugs and underwent OPT, CT and/or CBCT for determination of the extent of disease. We excluded patients with maxillary neoplasia. Considering the presence of early and late signs, OPT was diagnostic in 6 out of 17 cases (35%), while CT and CBCT were diagnostic in 25 out of 25 cases (100%). Analysing the different radiant doses delivered by the selected radiological methods on a phantom, it was found that a more significant effective dose was spread by CT (2.6 mSv) than CBCT (0.164 mSv) or OPT (0.02 mSv). CBCT, from our experience, is a candidate to replace OPT in the first diagnostic step in patients with suspected MRONJ, generating less effective doses and artefacts from metal components than CT.