Evaluation of the effects of bisphosphonate therapy on the temporomandibular joint using cone beam computed tomography.

OBJECTIVE

The aim of this study was to evaluate the mandibular condyle and articular eminences of patients diagnosed with medication-related osteonecrosis of the jawbone (MRONJ) and those who use bisphosphonates (BP) but do not have MRONJ findings, by comparing them with a healthy control group.

METHODS

The cone beam computed tomography (CBCT) images of 20 patients (15 male, 5 female) who were diagnosed with MRONJ and 20 patients (16 male and 4 female) who were using bisphosphonates but had no MRONJ were included in the study. A control group consisted of 20 age- and gender-matched patients (13 male, 7 female) who had no clinical complaints or signs and symptoms of TMD or rheumatic disease. The imaging characteristics relating to osseous changes of the condyles and in the articular fossa, such as flattening, erosion, osteophytes, subcortical sclerosis, subchondral cyst, loose joint bodies, joint space narrowing, flattening of the articular eminence, and resorption in the articular eminence, were evaluated. SPSS Statistics 20 software was used to statistically evaluate the data collected within the scope of the investigated variables. The results of the analyses were evaluated at 0.05.

RESULTS

Analysis of temporomandibular joint osseous changes in the patient and control groups found statistically significantly higher subcortical sclerosis in both the patient group diagnosed with MRONJ and the patient group using BP, compared with the control group. In addition, a statistically significant difference was found between the patient groups and the control group in terms of condylar flattening, articular eminence flattening, and resorption.

CONCLUSION

Understanding the changes in physiological bone remodeling of the mandibular condyle after BP administration is crucial in the development of future treatment modalities for degenerative TMJ diseases that cause condylar bone resorption.