Hiroaki Shimamoto1,2, Tristan R Grogan3, Tomomi Tsujimoto1, Naoya Kakimoto4, Shumei Murakami1, David Elashoff3, Tara L Aghaloo5, Sotirios Tetradis2. 1. 1 Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry , Suita, Osaka , Japan. 2. 2 Section of Oral and Maxillofacial Radiology, UCLA School of Dentistry , Los Angeles, CA , USA. 3. 3 Statistics Core, David Geffen School of Medicine, University of California Los Angeles , Los Angeles, CA , USA. 4. 4 Department of Oral and Maxillofacial Radiology, Institute of Biomedical & Health Sciences, Hiroshima University , Minami-ku, Hiroshima , Japan. 5. 5 Section of Oral and Maxillofacial Surgery, UCLA, School of Dentistry , Los Angeles, CA , USA.
Abstract
OBJECTIVES: To evaluate the impact of cone beam CT (CBCT) in the diagnostic thinking efficacy, management and prognosis of patients with suspected Stage 0 medication-related osteonecrosis of the jaw (MRONJ). METHODS: For 15 patients with suspected Stage 0 MRONJ, clinical photographs, a panoramic radiograph and selected CBCT sections were identified. 13 oral surgeons reviewed the material and answered 10 questions in two different sessions. First session included clinical photographs and panoramic radiographs, while second session also included CBCT images. Questions (Qs) referred to dental disease and bone abnormalities (Qs 1, 2 and 3), differential diagnosis (Qs 4 and 5), patient management (Qs 6 and 7) and prognosis (Qs 8 and 9). Q 10 queried indication (first session) and usefulness (second session) of CBCT images. RESULTS: Qs 2, 3, 5, 7 and 9 scores increased between sessions, with statistical differences for Qs 2, 3, 5 and 7 (<0.05). Patients 2, 8 and 11 showed a significant increase in the average score of all Qs between sessions, while scores for patient 10 nearly reached statistical significance (p = 0.055). For Q 10, 57.4% of answers reported that CBCT was needed (first session) and was beneficial (second session). CONCLUSIONS: CBCT had a significant impact in differential diagnosis and management of patients with suspected Stage 0 MRONJ.
OBJECTIVES: To evaluate the impact of cone beam CT (CBCT) in the diagnostic thinking efficacy, management and prognosis of patients with suspected Stage 0 medication-related osteonecrosis of the jaw (MRONJ). METHODS: For 15 patients with suspected Stage 0 MRONJ, clinical photographs, a panoramic radiograph and selected CBCT sections were identified. 13 oral surgeons reviewed the material and answered 10 questions in two different sessions. First session included clinical photographs and panoramic radiographs, while second session also included CBCT images. Questions (Qs) referred to dental disease and bone abnormalities (Qs 1, 2 and 3), differential diagnosis (Qs 4 and 5), patient management (Qs 6 and 7) and prognosis (Qs 8 and 9). Q 10 queried indication (first session) and usefulness (second session) of CBCT images. RESULTS: Qs 2, 3, 5, 7 and 9 scores increased between sessions, with statistical differences for Qs 2, 3, 5 and 7 (<0.05). Patients 2, 8 and 11 showed a significant increase in the average score of all Qs between sessions, while scores for patient 10 nearly reached statistical significance (p = 0.055). For Q 10, 57.4% of answers reported that CBCT was needed (first session) and was beneficial (second session). CONCLUSIONS: CBCT had a significant impact in differential diagnosis and management of patients with suspected Stage 0 MRONJ.
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