IADR Abstract Archives
Analysis of Bone Mineral Density Distribution in Osteonecrosis Affected Bone
Objectives: Severe medication-related osteonecrosis of the jaw (MRONJ) needs significant oral surgery. The surgical site is determined using clinical and radiographic findings to determine the affected area, which is resected with a wide margin. The objective of this study was to examine whether detailed BMD distribution can help identify the local necrosis site of oral bone in MRONJ patients.
Methods: After IRB approval, 7 oral bone regions were resected from 6 patients during surgery to treat MRONJ. These bone specimens were scanned by clinical cone beam computed tomography (CBCT) with 200 micron resolution. 42 diseased (25 radiolucent and 17 radiopaque) and 8 unaffected local bone sites were identified by both clinical biopsy and CBCT image based examination. A 4 mm3 cube was digitally isolated from each site. Gray value distribution, which is proportional to BMD distribution, was analyzed to obtain mean, standard deviation (SD), 5 percentile low and high gray values. Multivariate analysis of variance was performed to compare the gray value parameters between diseased radiolucent, diseased radiopaque, and unaffected sites (significant, p<0.05).
Results: The diseased radiolucent bone sites had lower mean, low, and high gray values than the diseased radiopaque and unaffected sites (p<0.001) while the SD was not significantly different from the other sites (p>0.077). The diseased radiopaque bone sites did not have significantly different mean, low and high gray values from the unaffected sites (p>0.075), but the SD was significantly different between these two groups (p=0.020).
Conclusions: Radiolucent diseased bone can be distinguished from the other types of bone by its lower gray values while the diseased radiopaque bone is indistinguishable from unaffected bone because of the similar gray values. However, the current results suggest that the radiopaque bone sites can be distinguished from unaffected bone sites by the variability (SD) of BMD.
Methods: After IRB approval, 7 oral bone regions were resected from 6 patients during surgery to treat MRONJ. These bone specimens were scanned by clinical cone beam computed tomography (CBCT) with 200 micron resolution. 42 diseased (25 radiolucent and 17 radiopaque) and 8 unaffected local bone sites were identified by both clinical biopsy and CBCT image based examination. A 4 mm3 cube was digitally isolated from each site. Gray value distribution, which is proportional to BMD distribution, was analyzed to obtain mean, standard deviation (SD), 5 percentile low and high gray values. Multivariate analysis of variance was performed to compare the gray value parameters between diseased radiolucent, diseased radiopaque, and unaffected sites (significant, p<0.05).
Results: The diseased radiolucent bone sites had lower mean, low, and high gray values than the diseased radiopaque and unaffected sites (p<0.001) while the SD was not significantly different from the other sites (p>0.077). The diseased radiopaque bone sites did not have significantly different mean, low and high gray values from the unaffected sites (p>0.075), but the SD was significantly different between these two groups (p=0.020).
Conclusions: Radiolucent diseased bone can be distinguished from the other types of bone by its lower gray values while the diseased radiopaque bone is indistinguishable from unaffected bone because of the similar gray values. However, the current results suggest that the radiopaque bone sites can be distinguished from unaffected bone sites by the variability (SD) of BMD.