Clinical and panoramic radiographic features of osteomyelitis of the jaw: A comparison between antiresorptive medication-related and medication-unrelated conditions
신정원, 김조은, 허경회, 이원진, 허민석, 이삼선, 최순철,
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신정원 ( Shin Jeong-Won ) - Ajou University School of Medicine Department of Orthodontics
김조은 ( Kim Jo-Eun ) - Seoul National University Dental Hospital Department of Oral and Maxillofacial Radiology
허경회 ( Huh Kyung-Hoe ) - Seoul National University School of Dentistry Department of Oral and Maxillofacial Radiology
이원진 ( Yi Won-Jin ) - Seoul National University School of Dentistry Department of Oral and Maxillofacial Radiology
허민석 ( Heo Min-Suk ) - Seoul National University School of Dentistry Department of Oral and Maxillofacial Radiology
이삼선 ( Lee Sam-Sun ) - Seoul National University School of Dentistry Department of Oral and Maxillofacial Radiology
최순철 ( Choi Soon-Chul ) - Seoul National University School of Dentistry Department of Oral and Maxillofacial Radiology
Abstract
Purpose: This study was performed to analyze the clinical and imaging features of contemporary osteomyelitis (OM) and to investigate differences in these features on panoramic radiography according to patients' history of use of medication affecting bone metabolism.
Materials and Methods: The records of 364 patients (241 female and 123 male, average age 66.8±14.9 years) with OM were retrospectively reviewed. Panoramic imaging features were analyzed and compared between patients with medication-related OM (m-OM) and those with conventional, medication-unrelated OM (c-OM).
Results: The age of onset of OM tended to be high, with the largest number of patients experiencing onset in their 70s. The 2 most frequent presumed causes were antiresorptive medication use (44.2%) and odontogenic origin (34.6%). On panoramic radiographs, a mix of osteolysis and sclerosis was the most common lesion pattern observed (68.6%). Sequestrum, extraction socket, and periosteal new bone formation were found in 143 (42.1%), 79 (23.2%), and 24 (7.1%) cases, respectively. The m-OM group exhibited sequestrum and extraction socket more frequently and displayed significantly higher mandibular cortical index values than the c-OM group.
Conclusion: We observed some differences in imaging features as shown on panoramic radiography according to the history of antiresorptive medication use. This study may help elucidate the predictive imaging features of medication-related osteonecrosis of the jaw.
키워드
Osteomyelitis; Osteonecrosis; Radiography, Panoramic
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