School of Dentistry, University of São Paulo Av. Prof. Lineu Prestes 2227 Zip code: 05508-000, São Paulo, SP, Brazil
Med Oral Patol Oral Cir Bucal. 2022 Nov 1;27(6):e489-e496. doi: 10.4317/medoral.25191.
The purpose of this study was to compare jaw and cervical vertebrae bone density in computed tomography (CT) analyses of oncological patients undergoing antiresorptive medication with control patients, aiming to find information that may assist the radiologist and clinician in predicting risks and monitoring osteonecrosis in the jaw.
Thirty-one patients treated with zoledronic acid and 37 control were included in the study. Two areas in regions of interest were chosen and standardized, one in the lower portion of the mandible and another in the axial cervical vertebra (C2) of patients undergoing antiresorptive drug treatment (experimental group) and the control group. Density analysis was performed using Hounsfield scale grayscale values obtained from multislice CT exams. Interclass correlation coefficient test (ICC) was performed to assess reproducibility and repeatability. The test of normality of the samples was demonstrated using the Shapiro-Wilk test and the comparison performed using Mann-Whitney U non-parametric test.
When compared to patients in the control group, patients undergoing antiresorptive medication depicted an increase in bone density in both jaw bone (p=0.021) and cervical vertebrae (p=0.002). The same pattern could be observed in patients who used the medication on a monthly basis for analysis of jaw bone (p=0.021), the cervical vertebrae (p=0.002), and the cervical vertebrae of the patients who used the medication on a quarterly basis (p=0.003).
CT can be a potentially useful method for detecting alterations associated with antiresorptive therapy, serving as a possible tool in the prediction of the disease progression.
本研究旨在比较接受抗吸收药物治疗的肿瘤患者与对照组患者的颌骨和颈椎骨密度在计算机断层扫描（CT）分析中的差异，旨在为放射科医生和临床医生寻找可能有助于预测颌骨坏死风险和监测的信息。
本研究纳入了 31 名接受唑来膦酸治疗的患者和 37 名对照组患者。在感兴趣区域选择并标准化了两个区域，一个位于下颌骨下部，另一个位于接受抗吸收药物治疗的患者的颈椎（C2）轴位（实验组）和对照组。使用从多层 CT 检查获得的亨氏灰度值进行密度分析。采用组内相关系数检验（ICC）评估可重复性和再现性。采用 Shapiro-Wilk 检验证明样本的正态性检验，采用 Mann-Whitney U 非参数检验进行比较。
与对照组患者相比，接受抗吸收药物治疗的患者在颌骨（p=0.021）和颈椎（p=0.002）的骨密度均增加。在每月使用药物分析颌骨（p=0.021）、颈椎（p=0.002）和每季度使用药物的患者的颈椎（p=0.003）中，也观察到了相同的模式。
CT 可能是一种检测与抗吸收治疗相关改变的有效方法，可作为预测疾病进展的一种可能工具。
