Analysis of Three-Phase Bone Scintigraphy Findings in Medication-Related Osteonecrosis of the Jaw
10.5856/JKDS.2026.19.1.35
- Author:
Malavika Geetha SUBU
1
;
Ming-Xu JIN
;
Ji-Eun CHOI
;
Jin-Wook KIM
;
So-Young CHOI
;
Tae-Geon KWON
Author Information
1. Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University, Daegu, Korea
- Publication Type:ORIGINAL ARTICLE
- From:Journal of Korean Dental Science
2026;19(1):35-46
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:Medication-related osteonecrosis of the jaw (MRONJ) is a complication of antiresorptive therapy, including bisphosphonates and denosumab. Although bone scintigraphy (BS) detects early metabolic changes, its diagnostic role in MRONJ and its role in assessing systemic skeletal involvement remain unclear. This study analyzed BS tracer uptake patterns and their association with MRONJ severity and clinical variables.
Materials and Methods:This retrospective study analyzed 319 patients diagnosed with MRONJ from 2010 to 2019. Three-phase BS, cone-beam computed tomography (CBCT), and clinical data were reviewed. Tracer uptake intensity in the jaw was visually graded, and extra-jaw skeletal uptake was categorized by region and number of involved sites. Associations between the MRONJ stage, jaw uptake intensity, and skeletal uptake beyond the jaw were analyzed.
Results:Higher tracer uptake intensity in the jaw was associated with advanced MRONJ stages (P<0.001), particularly Stage 3. However, the number of skeletal sites beyond the jaw did not correlate with the MRONJ stage (P=0.512).Distribution of local and systemic tracer uptake in body patterns across MRONJ Stages did not show statistical significance.
Conclusion:Elevated tracer uptake in the jaw correlates with advanced MRONJ stages and broader skeletal tracer uptake, suggesting a potential link between local disease severity and systemic skeletal involvement. However, skeletal uptake beyond the jaw does not independently predict the MRONJ stage, suggesting that systemic bone involvement alone may not reflect increased disease severity.
