Methods: We described the clinical and CT appearance of a cohort of patients with ONJ. Out of 110 patients, 30 fulfilled the inclusive criteria. In accordance with the position paper of the American Academy of Oral Medicine, the diagnosis of ONJ was based on the medical and dental history of each patient, as well as on the observation of clinical signs and symptoms (pain, erythema, bone exposure, fistula, purulent secretion, sensory abnormality or swelling) of this pathological process. Another inclusion criterion was an available CT scan of the relevant jaw. Selected clinical parameters were then analyzed (analysis of variance test) for correlation with CT parameters. These data were recorded and analyzed for all eligible patients.
Results: CT and clinical findings correlated significantly for the size of the lesion on CT and the presence of purulent secretion (p = 0.03). When sequestrum was present the averaged size of the lesion on CT was 29.4„b8mm. The mandibular canal cortex was resistant to the destructive process of the jaw.
Conclusions: CT appearance of a continuous cortex of the mandibular canal may serve as a differential parameter between ONJ and metastasis. Purulent secretion indicates the likelihood that a more extensive involvement will be displayed on CT than is apparent clinically. A large lesion on CT should raise the index of suspicion for sequestrum.