CT images of the mandible were obtained from a total of 14 patients with BRONJ, 14 patients treated with BPs and 14 control patients. In each patient, 15 transaxial CT images were selected and 30 configured regions of interest (ROI) were identified. We measured the CT values in the interdentium mandibular region between the bilateral second molars. On the axial CT images, CT measurements were obtained in the mesiodistal direction in order to assess the widest diameter of osteolysis/sequestrum.
Regarding the total area, the CT values in the BRONJ group were higher than those observed in the bisphosphonate treatment group (P = 0.011), which were higher than those observed in the control group (P = 0.014). There were no significant differences between the sites with and without BRONJ development in the incisal areas (P = 0.13); however, there was a significant difference in the molar areas (P = 0.001).
Assessing the molar area is more useful than assessing the incisal area for evaluating BRONJ. Measuring of CT values may be useful for diagnosis and early detection of BRONJ.