Bisphosphonate-associated osteonecrosis of the jaw is a rare but serious disease. In addition to the clinical examination radiological diagnostics and here in particular the cross-sectional imaging plays a major role. Due to the rapidly increasing availability of CBCT in recent years, the question arises whether CBCT is on a par with conventional CT in detecting the presence and extent of osteonecrosis reliably. This was tested in an animal model on an induced osteonecrosis. On ten 2-year old adult Göttingen minipigs an osteonecrosis of the jaw was induced by tooth extraction after intravenously given bisphosphonates. After completion of the experiment, the jaws were examined macroscopically, radiologically and histologically. The findings were classified and validity of various imaging modalities concerning detection and extent of necrosis were compared. Both conventional computed tomography and cone beam computed tomography could reliably distinguish between necrosis and healthy bone. CBCT revealed slight advantages in quantification of the extent of necrosis. The conventional CT, however, had clear advantages in the detection of soft tissue alterations, such as periosteal reaction. The present study compares two major imaging modalities for osteonecrosis induced in a large animal model for the first time.
Comparison of conventional computed tomography and cone beam computed tomography (CBCT) in the diagnosis of bisphosphonate-associated osteonecrosis of the jaw
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