Computed tomography imaging for assessment at risk of development of MRONJ in oncological patients under antiresorptive drugs

Abstract Background Oncological patients subjected to bisphosphonate therapy may develop medication-related osteonecrosis of the jaw (MRONJ). This study compares the mandibular bone density of these patients with a control group, by using computed tomography (CT), and evaluated whether this imaging modality potentially detects early changes associated with bisphosphonate therapy in oncological patients. Materials and Methods This study included 32 patients treated with zoledronic acid and 43 patients in the control group. Two lower mandible regions of interest (total and medullary bone contours) were selected and standardized in patients under antiresorptive drug treatment (experimental group) and the control group. The intraclass correlation coefficient (ICC) test evaluated reproducibility and repeatability, the Shapiro-Wilk test analyzed sample normality, and the independent sample t-test indicated statistical significance. Results Inter- and intra-examiner analyses considered the indicators excellent, and dental extractions were the most associated with MRONJ development. Patients subjected to antiresorptive medication experienced higher density in the mandibular medullary bone (p = 0.009) than the control group. Conclusions CT was useful to show changes in bone densities in patients using bisphosphonates.