Treister N, Sheehy N, Bae E H, Friedland B, Lerman M, Woo S
Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, MA 02115, USA.
Oral Dis. 2009 Jan;15(1):88-92. doi: 10.1111/j.1601-0825.2008.01494.x. Epub 2008 Sep 26.
To determine the extent to which clinical and radiographic features of bisphosphonate-associated osteonecrosis of the jaw (BONJ) are correlated.
Retrospective case review.
The records of 39 patients diagnosed with BONJ and examined by panoramic radiography were retrospectively evaluated. The arches were divided into sextants (n = 234) and evaluated for the following signs: sclerosis, surface irregularity, sockets, fragmentation and lysis.
The McNemar, Kruskall-Wallis and equivalency tests were performed to analyze the association between clinical and radiographic signs and BONJ severity.
Sixty-two out of 234 sextants were abnormal by clinical criteria and 61 out of 234 sextants demonstrated at least one radiographic abnormality. There was agreement between clinical and radiographic detection in 41 sextants. The data showed equivalency between BONJ diagnosis and both sclerosis and surface irregularity. The correlation between number of clinical sites and any radiographic finding was significant in the maxilla (P < 0.001) but not in the mandible (P = 0.178). The total number of radiographic signs per patient increased with BONJ stage.
Focal panoramic radiographic findings of sclerosis and surface irregularity correlate with clinical sites of BONJ. This may be a useful and reliable tool to detect early changes of BONJ or to confirm a clinical diagnosis.
确定双膦酸盐相关颌骨坏死（BONJ）的临床和影像学特征之间的关联程度。
回顾性病例分析。
对39例诊断为BONJ并接受全景X线摄影检查的患者记录进行回顾性评估。将牙弓分为六个区段（n = 234），并评估以下征象：硬化、表面不规则、牙槽窝、骨碎片和骨质溶解。
采用McNemar检验、Kruskall-Wallis检验和等效性检验分析临床和影像学征象与BONJ严重程度之间的关联。
根据临床标准，234个区段中有62个异常，234个区段中有61个显示至少一项影像学异常。41个区段的临床和影像学检测结果一致。数据显示BONJ诊断与硬化及表面不规则之间具有等效性。上颌骨临床病变部位数量与任何影像学表现之间的相关性显著（P < 0.001），而下颌骨则无显著相关性（P = 0.178）。每位患者影像学征象的总数随BONJ分期增加。
硬化和表面不规则的局灶性全景影像学表现与BONJ的临床病变部位相关。这可能是检测BONJ早期变化或证实临床诊断的有用且可靠的工具。
