ArticleDento maxillo facial radiology2026
Lamina dura thickening in patients on antiresorptive therapy as a radiographic risk indicator of medication-related osteonecrosis of the jaw: a retrospective longitudinal cohort study.
Article in Dento maxillo facial radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
aimsThis study investigated whether antiresorptive drug (ARD) therapy is associated with lamina dura (LD) thickening, defined as a radiographic increase in the thickness of the normally thin, radiopaque cortical line surrounding the tooth root. It further evaluated whether LD thickening serves as a radiographic marker and risk indicator for medication-related osteonecrosis of the jaw (MRONJ).
methodsPanoramic radiographs from 65 ARD-treated patients (University Hospital Leuven) and 65 age- and sex-matched controls were analyzed. Inclusion criteria were prior oncological diagnosis, high-dose intravenous ARD, and radiographs before and after therapy. Three blinded oral and maxillofacial radiologists categorized LD appearance into 4 grades: (0) not/barely visible, (1) normal, (2) mild thickening, and (3) marked thickening. Group differences and longitudinal changes were evaluated using appropriate non-parametric and time-to-event analyses.
resultsAmong 130 participants, LD thickness remained stable in controls but increased in ARD-treated patients (P < .001). Within the ARD group, LD thickening changed over time (P < .001): 30.6% showed no change, 55.4% developed mild thickening, and 13.8% marked thickening. Controls showed minimal change (P = .011), with 9.2% developing mild thickening. Kaplan-Meier analysis estimated a median time to LD thickening of 27 months, with a higher thickening probability in ARD-treated patients than controls (P < .001). Lamina dura thickening was not directly associated with MRONJ (P = .39).
conclusionLamina dura thickening is strongly associated with long-term ARD exposure and shows progressive changes. Although not directly associated with MRONJ in this cohort, it may still represent a potential risk indicator, warranting confirmation in further studies.
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