{"title":"Imaging aspects of maxillomandibular bone alterations in patients with multiple myeloma treated with bisphosphonates: A systematic review.","authors":"Amanda Katarinny Goes Gonzaga, Hannah Gil de Farias Morais, Camila Dayla Melo Oliveira, Magda Lyce Rodrigues Campos, Carolina Raiane Leite Dourado Maranhão Diaz, Marcos Custódio, Natália Silva Andrade, Thalita Santana","doi":"10.5624/isd.20240032","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Multiple myeloma (MM) is a rare cancer that is typically managed with bisphosphonates to slow bone resorption and prevent skeletal complications. This study aimed to identify imaging patterns in MM patients receiving bisphosphonate therapy.</p><p><strong>Materials and methods: </strong>This systematic review included studies investigating maxillomandibular bone alterations based on imaging examinations in MM patients treated with bisphosphonates. The selected studies were qualitatively assessed using the Critical Appraisal Tools from SUMARI.</p><p><strong>Results: </strong>Six studies, involving 669 MM patients, were included, with 447 receiving bisphosphonate treatment. The majority were treated with pamidronate, zoledronate, or a combination of both. Seventy patients developed medication-related osteonecrosis of the jaw (MRONJ), predominantly in the mandible, characterized by the presence of bony sequestrum, bone sclerosis, increased periodontal ligament space, osteolytic lesions, and osteomyelitis as observed in imaging analyses. For non-MRONJ lesions, the mandible also exhibited the highest frequency of asymptomatic bone alterations. These ranged from \"punched-out\" osteolytic lesions or \"soap bubble\" lesions to solitary bone lesions, areas of bone sclerosis, abnormalities of the hard palate, osteoporosis, non-healed alveoli, and cortical bone rupture.</p><p><strong>Conclusion: </strong>MM patients treated with bisphosphonates display radiographic patterns of maxillomandibular bone lesions. These patterns aid in diagnosis and facilitate early and targeted treatment, thereby contributing to improved morbidity outcomes for these patients.</p>","PeriodicalId":51714,"journal":{"name":"Imaging Science in Dentistry","volume":null,"pages":null},"PeriodicalIF":1.7000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11450414/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Imaging Science in Dentistry","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5624/isd.20240032","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/7/17 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: Multiple myeloma (MM) is a rare cancer that is typically managed with bisphosphonates to slow bone resorption and prevent skeletal complications. This study aimed to identify imaging patterns in MM patients receiving bisphosphonate therapy.
Materials and methods: This systematic review included studies investigating maxillomandibular bone alterations based on imaging examinations in MM patients treated with bisphosphonates. The selected studies were qualitatively assessed using the Critical Appraisal Tools from SUMARI.
Results: Six studies, involving 669 MM patients, were included, with 447 receiving bisphosphonate treatment. The majority were treated with pamidronate, zoledronate, or a combination of both. Seventy patients developed medication-related osteonecrosis of the jaw (MRONJ), predominantly in the mandible, characterized by the presence of bony sequestrum, bone sclerosis, increased periodontal ligament space, osteolytic lesions, and osteomyelitis as observed in imaging analyses. For non-MRONJ lesions, the mandible also exhibited the highest frequency of asymptomatic bone alterations. These ranged from "punched-out" osteolytic lesions or "soap bubble" lesions to solitary bone lesions, areas of bone sclerosis, abnormalities of the hard palate, osteoporosis, non-healed alveoli, and cortical bone rupture.
Conclusion: MM patients treated with bisphosphonates display radiographic patterns of maxillomandibular bone lesions. These patterns aid in diagnosis and facilitate early and targeted treatment, thereby contributing to improved morbidity outcomes for these patients.
目的:多发性骨髓瘤(MM)是一种罕见的癌症,通常使用双膦酸盐来减缓骨吸收和预防骨骼并发症。本研究旨在确定接受双膦酸盐治疗的 MM 患者的成像模式:本系统综述纳入了根据影像学检查调查接受双膦酸盐治疗的 MM 患者上颌骨骨质改变的研究。使用 SUMARI 的关键评估工具对所选研究进行定性评估:结果:共纳入六项研究,涉及 669 名 MM 患者,其中 447 人接受了双膦酸盐治疗。大多数患者接受了帕米膦酸盐、唑来膦酸盐或两者的联合治疗。70名患者出现了与药物相关的颌骨骨坏死(MRONJ),主要发生在下颌骨,其特征是出现骨赘、骨硬化、牙周韧带间隙增大、溶骨性病变以及影像学分析中观察到的骨髓炎。在非 MRONJ 病变中,下颌骨出现无症状骨质改变的频率也最高。这些病变包括 "打孔 "溶骨病变或 "肥皂泡 "病变、单发骨病变、骨硬化区域、硬腭异常、骨质疏松症、未愈合肺泡和皮质骨破裂:结论:接受双膦酸盐治疗的 MM 患者会出现上颌骨骨质病变的影像学模式。结论:接受双膦酸盐治疗的 MM 患者会出现上颌骨病变的影像学模式,这些模式有助于诊断,有利于早期和有针对性的治疗,从而改善这些患者的发病率。