Sancar Bilay Stevanovic, Gök Rümeysa Şendişçi, Tunç Selmi
Faculty of Dentistry, Departmant of Oral and Maxillofacial Radiology, Akdeniz University, Konyaaltı, 07058, Antalya, Turkey.
Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Antalya Bilim University, Antalya, Turkey.
Oral Radiol. 2025 Mar 12. doi: 10.1007/s11282-025-00816-3.
The aim of this study was to evaluate the mandibular condyle and articular eminences of patients diagnosed with medication-related osteonecrosis of the jawbone (MRONJ) and those who use bisphosphonates (BP) but do not have MRONJ findings, by comparing them with a healthy control group.
The cone beam computed tomography (CBCT) images of 20 patients (15 male, 5 female) who were diagnosed with MRONJ and 20 patients (16 male and 4 female) who were using bisphosphonates but had no MRONJ were included in the study. A control group consisted of 20 age- and gender-matched patients (13 male, 7 female) who had no clinical complaints or signs and symptoms of TMD or rheumatic disease. The imaging characteristics relating to osseous changes of the condyles and in the articular fossa, such as flattening, erosion, osteophytes, subcortical sclerosis, subchondral cyst, loose joint bodies, joint space narrowing, flattening of the articular eminence, and resorption in the articular eminence, were evaluated. SPSS Statistics 20 software was used to statistically evaluate the data collected within the scope of the investigated variables. The results of the analyses were evaluated at 0.05.
Analysis of temporomandibular joint osseous changes in the patient and control groups found statistically significantly higher subcortical sclerosis in both the patient group diagnosed with MRONJ and the patient group using BP, compared with the control group. In addition, a statistically significant difference was found between the patient groups and the control group in terms of condylar flattening, articular eminence flattening, and resorption.
Understanding the changes in physiological bone remodeling of the mandibular condyle after BP administration is crucial in the development of future treatment modalities for degenerative TMJ diseases that cause condylar bone resorption.
本研究旨在通过将诊断为药物相关性颌骨坏死（MRONJ）的患者以及使用双膦酸盐（BP）但无MRONJ表现的患者与健康对照组进行比较，评估其下颌髁突和关节结节情况。
本研究纳入了20例诊断为MRONJ的患者（15例男性，5例女性）以及20例使用双膦酸盐但无MRONJ的患者（16例男性，4例女性）的锥形束计算机断层扫描（CBCT）图像。对照组由20例年龄和性别匹配的患者组成（13例男性，7例女性），这些患者无颞下颌关节紊乱病（TMD）或风湿性疾病的临床主诉及体征和症状。评估了与髁突和关节窝骨质变化相关的影像学特征，如扁平、侵蚀、骨赘、皮质下硬化、软骨下囊肿、关节内游离体、关节间隙变窄、关节结节扁平以及关节结节吸收。使用SPSS Statistics 20软件对在所研究变量范围内收集的数据进行统计学评估。分析结果以0.05为标准进行评估。
对患者组和对照组颞下颌关节骨质变化的分析发现，与对照组相比，诊断为MRONJ的患者组和使用BP的患者组皮质下硬化在统计学上均显著更高。此外，患者组与对照组在髁突扁平、关节结节扁平以及吸收方面存在统计学显著差异。
了解BP给药后下颌髁突生理性骨重塑的变化对于导致髁突骨吸收的退行性颞下颌关节疾病未来治疗方式的发展至关重要。
