Skip Navigation LinksHome > May/June 2009 - Volume 33 - Issue 3 > Bisphosphonate-Related Osteonecrosis of the Mandible and Max...
Journal of Computer Assisted Tomography:
doi: 10.1097/RCT.0b013e318186b179
Musculoskeletal Imaging

Bisphosphonate-Related Osteonecrosis of the Mandible and Maxilla: Clinical and Imaging Features

Gill, Sonia B. MD*; Valencia, Maria P. MD*; Sabino, Mary Lou C. DDS†; Heideman, Gregory M. MD*; Michel, Michelle A. MD*

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Objective: Bisphosphonate-related osteonecrosis of the jaws is a rare, but morbid, condition. We present the clinical and imaging features of 19 patients.

Methods: A review of 19 bisphosphonate-related osteonecrosis patients was performed. Patient demographics, diagnosis, dental procedures, symptoms and clinical findings, location and pattern of involvement, and presence of fractures, sequestra, and fistulae were documented.

Results: Patients included 14 women and 5 men aged 48 to 80 years. Diagnoses included breast carcinoma (n = 11), multiple myeloma (n = 4), osteoporosis (n = 4), prostate carcinoma (n = 2), and lymphoma (n = 1). Seventeen patients received intravenous and 2 received oral bisphosphonates for 2 to 5 years. Bone involvement was noted in the mandible (74%), maxilla (16%), and both (10%). A lytic and sclerotic pattern was most common (58%). Additional findings included fractures (n = 5), sequestra (n = 4), and oroantral fistulae (n = 2).

Conclusions: Bisphosphonate-related osteonecrosis is a rare, but morbid, condition, and imaging features can mimic other conditions. It is important for the radiologist to consider this entity in the appropriate clinical setting.

© 2009 Lippincott Williams & Wilkins, Inc.



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