Evidence map›Paper›PMID 41249244›Full record

ArticleScientific reports2025

A multicenter study of CT findings in medication-related osteonecrosis of the jaw.

Mitsunobu Otsuru, Keisuke Omori, Takumi Hasegawa, Yoshiko Yamamura, Eiji Kondo, Nobuhiro Ueda, Sakiko Soutome, Satoshi Rokutanda, Masamichi Ueda, Hirokazu Nakahara and 13 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Observational
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

23 authors.

Mitsunobu OtsuruDepartment of Oral and Maxillofacial Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, Japan. tsuruomymy@yahoo.co.jp.
Keisuke OmoriDepartment of Oral and Maxillofacial Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, Japan.
Takumi HasegawaDepartment of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Japan.
Yoshiko YamamuraDepartment of Oral Surgery, Tokushima University Graduate School of Biomedical Sciences, 3-18-15 Kuramoto, Tokushima, Japan.
Eiji KondoDepartment of Dentistry and Oral Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, Japan.
Nobuhiro UedaDepartment of Oral and Maxillofacial Surgery, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, Japan.
Sakiko SoutomeDepartment of Dentistry and Oral Surgery, Japanese Red Cross Nagasaki Genbaku Hospital, 3-15 Morimachi, Nagasaki, Nagasaki, Japan.
Satoshi RokutandaDepartment of Dentistry and Oral Surgery, Juko Memorial Nagasaki Hospital, 6-17, Maruomachi, Nagasaki, Japan.
Masamichi UedaDepartment of Oral and Maxillofacial Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Wakayama, Japan.
Hirokazu NakaharaDepartment of Oral and Maxillofacial Surgery, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahi-cho, Abeno-ku, Osaka, Osaka, Japan.
Kenichiro IshibashiDepartment of Oral and Maxillofacial Surgery, Graduate School of Medical Sciences, Nagoya City University, 1, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, Japan.
Eiji IwataDepartment of Oral and Maxillofacial Surgery, Kakogawa Central City Hospital, 439 HonchoKakogawa, Hyogo, Japan.
Sachiko YamasakiDepartment of Oral Oncology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-3-2 Kagamiyama, Higashihiroshima, Hiroshima, Japan.
Tomohiro SadoDepartment of Oral and Maxillofacial Surgery, Miyoshi Municipal Hospital, 10531, Higashisakayacho, Miyoshi, Hiroshima, Japan.
Yoshinari MyokenDepartment of Oral Surgery, Hiroshima Red Cross and Atomic-bomb Survivors Hospital, 1-9-6, Senda-machi, Hiroshima, Hiroshima, Japan.
Yuki SakamotoDepartment of Oral Surgery, Kansai Medical University Medical Center, 10-15 Bunencho, Moriguchi, Osaka, Japan.
Masashi KobayashiDepartment of Dentistry and Oral Surgery, Chugoku Rosai Hospital, 1-5-1 Hirotagaya, Kure, Hiroshima, Japan.
Tomoaki HamanaDepartment of Oral Surgery, JA Onomichi General Hospital, 1-10-23, Hirahara, Onomichi, Japan.
Yuka KojimaDepartment of Dentistry and Oral Surgery, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, Japan.
Taku KandaDepartment of Oral and Maxillofacial Surgery, Hiroshima Prefectural Hospital, 1-5-54, Ujinakanda, Hiroshima, Japan.
Misa SumiDepartment of Radiology and Biomedical Informatics, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, Japan.
Akira TaguchiDepartment of Oral and Maxillofacial Radiology, Matsumoto Dental University, 1780 Gobara, Hirooka, Shiojiri, Nagano, Japan.
Masahiro UmedaDepartment of Oral and Maxillofacial Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Medication-related osteonecrosis of the jaw is currently classified only by clinical staging, with no imaging-based qualitative classification available. To establish foundational data for a new classification method that could help guide treatment decisions and predict prognosis, this study investigated the computed tomography findings commonly observed in patients with medication-related osteonecrosis of the jaw and their frequencies. Computed tomography scans from 784 patients across 19 medical institutions were analyzed for the presence of osteolysis, sequestrum separation, periosteal reactions, mixed-type osteosclerosis, and the bone-within-bone appearance. Clinical factors associated with each finding were also examined. Osteolysis appeared as localized in 55.1% of cases, extended in 27.7%, and advanced in 13.8%. In contrast, 3.4% of patients showed no osteolysis. This non-osteolytic pattern was more common among patients treated with denosumab. Sequestrum separation was seen in 34.7% of patients, most frequently among those with osteoporosis. Periosteal reactions were observed in 5.9% of cases as the attached type, 12.4% as the gap type, and 5.6% as the irregular type. Mixed-type osteosclerosis occurred in 31.9% of cases, most often in the mandibles of patients with malignant tumors. The bone-within-bone appearance was observed in 3.1% of cases. Patients with sequestrum separation had more favorable treatment outcomes. In contrast, those without osteolysis and those with periosteal reactions, mixed-type osteosclerosis, or bone-in-bone appearance were more likely to have poorer outcomes. This multicenter study clarified the prevalence of several key computed tomography features in medication-related osteonecrosis of the jaw, highlighting their potential relevance to clinical outcomes. These findings lay the groundwork for future research into their prognostic and therapeutic implications to support the development of a new imaging-based classification system.

Indexed as

Bisphosphonate-Associated Osteonecrosis of the JawTomography, X-Ray ComputedAdultAgedAged, 80 and overDenosumabFemaleHumansMaleMiddle AgedOsteolysisDenosumabComputed tomographyMedication-related osteonecrosis of the jawOsteolysisOsteosclerosisPeriosteal reactionSequestrum

Identifiers

PMID41249244
PMCPMC12623489

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