Staging of osteonecrosis of the jaw requires computed tomography for accurate definition of the extent of bony disease.

Giuseppina Campisi, Olga Di Fede, Giordana Bettini, Giacomo Oteri, Matteo Scoletta, Massimo Petruzzi, Pok-Lam Fung Polly, Giuseppe Colella, Mario Gabriele, Claudio Ungari, Giorgia Saia, Alberto Bedogni, Salvatore D'Amato, Livia Ottolenghi, Alessandro Agrillo, Stefano Valsecchi, Stefano Fedele, Giorgio Bedogni, Gianfranco Favia, Vittorio FuscoStephen Porter, Paolo Arduino

Risultato della ricerca: Articlepeer review

54 Citazioni (Scopus)

Abstract

Management of osteonecrosis of the jaw associated with antiresorptive agents is challenging, and outcomes are unpredictable. The severity of disease is the main guide to management, and can help to predict prognosis. Most available staging systems for osteonecrosis, including the widely-used American Association of Oral and Maxillofacial Surgeons (AAOMS) system, classify severity on the basis of clinical and radiographic findings. However, clinical inspection and radiography are limited in their ability to identify the extent of necrotic bone disease compared with computed tomography (CT). We have organised a large multicentre retrospective study (known as MISSION) to investigate the agreement between the AAOMS staging system and the extent of osteonecrosis of the jaw (focal compared with diffuse involvement of bone) as detected on CT. We studied 799 patients with detailed clinical phenotyping who had CT images taken. Features of diffuse bone disease were identified on CT within all AAOMS stages (20%, 8%, 48%, and 24% of patients in stages 0, 1, 2, and 3, respectively). Of the patients classified as stage 0, 110/192 (57%) had diffuse disease on CT, and about 1 in 3 with CT evidence of diffuse bone disease was misclassified by the AAOMS system as having stages 0 and 1 osteonecrosis. In addition, more than a third of patients with AAOMS stage 2 (142/405, 35%) had focal bone disease on CT. We conclude that the AAOMS staging system does not correctly identify the extent of bony disease in patients with osteonecrosis of the jaw.
Lingua originaleEnglish
pagine (da-a)603-608
Numero di pagine6
RivistaBRITISH JOURNAL OF ORAL & MAXILLOFACIAL SURGERY
Volume52
Stato di pubblicazionePublished - 2014

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oral Surgery
  • Otorhinolaryngology

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