IADR Abstract Archives
Histologic Study of the Osteonecrosis of the Jaw
Objectives: Among many types of osteonecrosis of the jaw (ONJ), medication-related osteonecrosis of the jaw (MRONJ), osteoradionecrosis of the jaw (ORN) and osteomyelitis of the jaw (OM) share similarities in some clinical symptoms, despite differences in thier cause and pathophysiology. To reach an optimal results in treatment, an accurate diagnosis is essential. Histopathological diagnosis is considered critical for confirming the clinical diagnosis of this pathology group. This study aims to describe the histologic features of MRONJ, ORN and OM and to discuss their differences.
Methods: Biopsy archives from the department of Oral Pathology, Faculty of Dentistry, Chulalongkorn University from 2010 to 2019 were reviewed. Hematoxylin and eosin staining slides of the cases diagnosed with MRONJ, ORN and OM were retrieved for histologic review. Histologic features including the presence of bone cells, inflammation types, and bacterial colonies were studied in 17 MRONJ, 15 ORN and 77 OM cases. Data analysis using Kruskal-Wallis test was performed.
Results: Overall, there were differences in histological features among 3 lesions regarding the presence of osteoclasts, inflammation and bacterial colonies. MRONJ exhibited a statistically significant difference in the presence of osteoclasts compared to ORN and OM (p<0.05). Although the presence of bacterial colonies at the bony periphery was a striking feature in MRONJ, a statistically significant difference was found only between MRONJ and OM (p<0.05). Inflammatory cell infiltration made no difference when comparing groups separately (p>0.05).
Conclusions: The findings of this study suggest that there are differenses in histologic features among MRONJ, ORN and OM. Histologic examination of the specimens from the patients is to confirm the clinical diagnoses and to rule out the possibility of jaw malignancies.
Methods: Biopsy archives from the department of Oral Pathology, Faculty of Dentistry, Chulalongkorn University from 2010 to 2019 were reviewed. Hematoxylin and eosin staining slides of the cases diagnosed with MRONJ, ORN and OM were retrieved for histologic review. Histologic features including the presence of bone cells, inflammation types, and bacterial colonies were studied in 17 MRONJ, 15 ORN and 77 OM cases. Data analysis using Kruskal-Wallis test was performed.
Results: Overall, there were differences in histological features among 3 lesions regarding the presence of osteoclasts, inflammation and bacterial colonies. MRONJ exhibited a statistically significant difference in the presence of osteoclasts compared to ORN and OM (p<0.05). Although the presence of bacterial colonies at the bony periphery was a striking feature in MRONJ, a statistically significant difference was found only between MRONJ and OM (p<0.05). Inflammatory cell infiltration made no difference when comparing groups separately (p>0.05).
Conclusions: The findings of this study suggest that there are differenses in histologic features among MRONJ, ORN and OM. Histologic examination of the specimens from the patients is to confirm the clinical diagnoses and to rule out the possibility of jaw malignancies.