Analysis of Radiological Changes in Medication- Related Osteonecrosis of the Jaw (MRONJ) by Cone-beam Computed Tomography

Purpose: The aim of this study was to evaluate the radiological findings in the jaw bones by examining the cone beam computed tomography (CBCT) images of patients diagnosed with medication-related osteonecrosis of the jaw (MRONJ) and to contribute to the diagnosis and management of MRONJ. Material & Methods: In this study, 50 CBCT imaging data of patients (34 female, 16 male, mean age=70,44±11,09) with MRONJ were evaluated retrospectively. Radiological findings on CBCT images were recorded as osteolysis, focal or generalized bone sclerosis, sequestra, unhealed extraction socket, periosteal reaction and pathological fracture. Descriptive analyses were used to evaluate the data. Results: 44% of the 50 patients had osteoporosis, 12% had multiple myeloma, and 44% had malignancies. The most significant changes were observed in the posterior mandible (57.4%), and the most common findings were osteolysis (73.8%) and sequestrum (50.8%). In some cases, less frequent findings such as non-healed extraction socket (14.8%), periosteal reaction (6.6%), and pathological fracture (3.3%) were observed. Additionally, no radiographic changes were observed in the CBCT images of 4 patients (6.6%). Conclusion: In our study, the CBCT images of the patients revealed the presence of various findings associated with MRONJ but did not present a specific radiological feature common to all patients. Therefore, it was concluded that in the diagnosis and management of MRONJ, each patient should be evaluated individually, and the medical history and clinical findings should be considered as a whole.