Moeini M, Moeini M, Lotfizadeh N, Alavi M
Resident of Oral and Maxillofacial Radiology, Faculty of Dentistry, Shahid Sadoughi University of Medical Science and Health Services, Yazd, Iran.
Dentist, Esfahan, Iran.
Iran J Ped Hematol Oncol. 2013;3(3):114-8. Epub 2013 Jul 22.
Bisphosphonates inhibit osteoclasts, prevent bone resorption and decrease bone turnover. This study examined radiography finding in bisphosphonate-associated osteonecrosis of jaws.
This is a retrospective series of 12 clinically diagnosed patients between 7 to 21 year old (average 13 years). They required emergency dental conditions requiring management by dentist: non healing extraction sockets and pain of bone exposure. The panoramic radiography and cone beam computed tomography was performed to assess the problem. Thickening of the lamina dura was observed in 7 patients (58.3 %). But full-thickness sclerosis was seen in 6 patients (50 %). Sclerotic changes in the mandibular canal were noted in 3 patients (25 %). 5 patients (41.6 %) had poorly healing or non-healing of socket in extracted tooth and periapical lucencies. 4 people (33.3 %) had widening of periodontal ligament (PDL) space and osteolysis. Sequestra were seen in 3 persons (25 %). Finally in 2 children (16.6 %) were found oroantral fistula. Only one child (8.3 %) had thickening of soft tissue mid periosteal reaction.
Most patients had some degree of osteosclerosis, especially in the area of alveolar bone. Thickening of the lamina dura was also seen in children. Other findings include: osteolysis, sequestra, periosteal new bone formation, widening of PDL,soft tissue thickening, non healing extraction sockets, oroantral fistula and periapical lucencies (P-value < 0.05).
Common radiographic features in patients taking bisphosphonate, was osteosclerosis. This sclerosis had different views that thickening of the lamina dura and alveolar crest were most common.
双膦酸盐可抑制破骨细胞，防止骨吸收并降低骨转换。本研究检查了双膦酸盐相关颌骨坏死的影像学表现。
这是一项回顾性研究，纳入了12例临床诊断为双膦酸盐相关颌骨坏死的患者，年龄在7至21岁之间（平均13岁）。他们因急诊牙科情况需要牙医进行处理：拔牙创不愈合和骨暴露疼痛。进行全景X线摄影和锥形束计算机断层扫描以评估问题。7例患者（58.3%）观察到硬骨板增厚。但6例患者（50%）出现全层硬化。3例患者（25%）在下颌管出现硬化改变。5例患者（41.6%）拔牙创愈合不良或不愈合，且根尖有透射区。4例患者（33.3%）出现牙周膜间隙增宽和骨质溶解。3例患者（25%）出现死骨。最后，2例儿童（16.6%）发现口腔上颌窦瘘。只有1例儿童（8.3%）出现软组织骨膜中层反应增厚。
大多数患者有一定程度的骨质硬化，尤其是在牙槽骨区域。儿童也可见硬骨板增厚。其他表现包括：骨质溶解、死骨、骨膜新生骨形成、牙周膜增宽、软组织增厚、拔牙创不愈合、口腔上颌窦瘘和根尖透射区（P值<0.05）。
服用双膦酸盐患者常见的影像学特征是骨质硬化。这种硬化有不同表现，硬骨板增厚和牙槽嵴增厚最为常见。
