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Introduction: Osteonecrosis of the jaw is defined
as avascular necrosis of the alveolar cancellous and cortical bone of
the maxilla or mandible, most commonly as the result of a therapeutic
intervention—either radiotherapy or pharmacological treatment. Certain
criteria define medication-related osteonecrosis of the jaw (MRONJ) and
can be staged in four degrees. MRONJ develops as a consequence of the
systemic effects of certain medications, primarily bisphosphonates, that
inhibit bone remodeling by suppressing the activity of bone-resorbing
cells—osteoclasts.
Aim. The study aimed to compare the multislice computed tomography
(MSCT) radiological changes in MRONJ caused by bisphosphonates stage to
clinical signs and symptoms, such as the presence of pain, infection and
fistula in patients with diagnosed MORNJ.
Materials and Methods: Patient data were collected from medical
records and included duration of bisphosphonate therapy, stage of MRONJ,
MSCT radiograph findings, and questionnaire about the presence and
intensity of pain, measured using a numerical pain rating scale.
Results: All patients had been receiving oral antiresorptive
bisphosphonate therapy for periods ranging from 1 to 15 years; 63.63%
had been on bisphosphonate therapy for more than three years, 27.27% for
less than three years, and 9.09% for more than 15 years. In patients who
developed Stage II, the mean pain intensity was 5.1 ± 1.1; Stage III
reported pain level 9, Stage II MRONJ experienced mild pain 2. There was
no drug holiday in any patient involved in the study.
Conclusion: Radiologists play an important role in the early
diagnosis of all stages of MRONJ. Pain could be considered as an early
sign of this pathological condition of the bone, and it correlates with
the stage of MRONJ in lesions caused by bisphosphonate intake.
Key words:
MSCT radiography MRONJ, pain
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Address of correspondence:
Maja Jocić, Radiologist, PhD Student
University clinical center niš, Center for radiology
48 Dr Zorana Djindjic Blvd., Niš, Serbia
E-mail: majajocic722@gmail.com
Copyright © 2025by The Editorial Council of The Acta
Stomatologica Naissi
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