Evidence map›Paper›PMID 27213837›Full record

Trial reportDento maxillo facial radiology2016

Can dental panoramic radiographic findings serve as indicators for the development of medication-related osteonecrosis of the jaw?

Christoph Klingelhöffer, Manja Klingelhöffer, Steffen Müller, Tobias Ettl, Ulrich Wahlmann

Open access · greenAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Dento maxillo facial radiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 4 pooled it
2.0field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 4 syntheses or guidelines pooled it, 54 citations in OpenAlex.

  1. MASCC/ISOO Clinical Practice Statement: imaging and clinical laboratory tests in the diagnosis and management of medication-related osteonecrosis of the jaw.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
    Guideline
  2. Differences between bisphosphonate-related and denosumab-related osteonecrosis of the jaws: a systematic review.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2021
    Pooled it
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  17. Radiographic perception of anatomical structures and bony changes in oncologic patients under antiresorptive therapy.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2023
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Christoph KlingelhöfferDepartment of Cranio- and Maxillo-facial Surgery, University Hospital Regensburg, Regensburg, Germany.
Manja KlingelhöfferDepartment of Cranio- and Maxillo-facial Surgery, University Hospital Regensburg, Regensburg, Germany.
Steffen MüllerDepartment of Cranio- and Maxillo-facial Surgery, University Hospital Regensburg, Regensburg, Germany.
Tobias EttlDepartment of Cranio- and Maxillo-facial Surgery, University Hospital Regensburg, Regensburg, Germany.
Ulrich WahlmannDepartment of Cranio- and Maxillo-facial Surgery, University Hospital Regensburg, Regensburg, Germany.
University Hospital Regensburg · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe purpose of this case-control study was to find a correlation between certain imaging findings in dental panoramic radiographs and the risk for developing a medication-related osteonecrosis of the jaw (MRONJ) in patients taking antiresorptive therapy (AT).

methodsRandomized and blinded dental panoramic radiographs of 60 patients undergoing antiresorptive drug treatment (36 patients with MRONJ, 24 patients without MRONJ) and of 60 patients without AT were analyzed by 3 experts for the following signs: sequestrum, osteosclerosis, difference in sclerosing of alveolar process and body of mandible, visible alveolar socket, enhancement and loss of lamina dura, enhancement of the oblique ridge, enhancement of the mandibular canal, proliferative periostitis and osteolytic processes at the cortex.

resultsSigns were seen significantly more often in patients undergoing AT than in the control group (CG) (osteosclerosis p-value = 0.019, visible alveolar socket p-value = 0.001, enhancement of lamina dura p-value < 0.001, enhancement of the mandibular canal p-value = 0.025, proliferative periostitis p-value = 0.05 and osteolytic processes at the cortex p-value < 0.001). While there is no significant difference between the CG and the group of patients with AT without manifest MRONJ for any sign, the significance increases when taking the group of patients under AT with manifest MRONJ into consideration. In addition, if medication was administered for malignant reasons, the signs visible alveolar socket, enhancement of the lamina dura and the enhancement of the mandibular canal were seen significantly more often.

conclusionsThe radiographic findings mentioned above are not indicators for the development of MRONJ, as they are seen only in patients with manifest osteonecrosis. However, these findings could be important to assess the dimension and potency of a MRONJ.

Indexed as

AgedBone Density Conservation AgentsCase-Control StudiesDisease ProgressionHumansJaw DiseasesMiddle AgedOsteonecrosisRadiography, PanoramicBone Density Conservation AgentsbisphosphonatesdenosumabMRONJpanoramic radiographyradiographic findings

Identifiers

PMID27213837
PMCPMC5084706
OpenAlexW2398778105

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.