Bone Quality Evolution in Medication-Related Osteonecrosis of the Jaw Assessed by CBCT (B-ONJ EVOL)
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Cone Beam Computed Tomography Imaging.
- Who it may be relevant to
- Registry conditions: Medication-related Osteonecrosis of the Jaw, Osteonecrosis of the Jaw. Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Center list to be confirmed — check the primary protocol.
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Evolution of Bone Quality in Medication-Related Osteonecrosis of the Jaw: A Retrospective Multicenter Study Using Cone Beam Computed Tomography (CBCT)
Overview
Medication-related osteonecrosis of the jaw (MRONJ) is a known complication of antiresorptive therapies such as bisphosphonates and denosumab. It can lead to bone damage in the jaw, with variable clinical outcomes depending on disease stage and management. Cone Beam Computed Tomography (CBCT) is currently recommended for diagnosis and follow-up of MRONJ. However, most studies rely on qualitative or descriptive imaging findings, and little is known about how bone quality evolves over time using quantitative imaging parameters. This retrospective multicenter study aims to describe the evolution of bone quality in patients with MRONJ using CBCT imaging. Bone parameters such as bone mineral density and trabecular structure will be measured at diagnosis and during follow-up. The study will help improve understanding of bone changes over time in MRONJ and may contribute to better assessment and management of the disease.
Detailed description
Medication-related osteonecrosis of the jaw (MRONJ) is a serious adverse effect associated with antiresorptive therapies, including bisphosphonates and anti-RANKL monoclonal antibodies. It is characterized by necrotic bone lesions of the jaw, often triggered by dental procedures, and is associated with significant morbidity.
Current imaging evaluation relies primarily on Cone Beam Computed Tomography (CBCT), which is recommended for both diagnosis and follow-up. However, most published studies provide only qualitative or descriptive assessments of bone lesions. Quantitative and longitudinal analyses of bone microarchitecture remain limited.
This retrospective, multicenter, observational study aims to describe the evolution of bone quality in patients with MRONJ managed according to current clinical guidelines.
The primary objective is to evaluate changes in bone mineral density (BMD) measured on CBCT scans at diagnosis and during follow-up.
Secondary objectives include longitudinal assessment of bone morphometric parameters using CBCT imaging and dedicated software (3D Slicer), including:
Bone volume to total volume ratio (BV/TV) Trabecular number (Tb.N) Trabecular separation (Tb.Sp) Hounsfield units (HU), when applicable
Data will be collected retrospectively from clinical records and imaging databases across multiple centers. All data will be pseudonymized prior to analysis.
Statistical analyses will be descriptive. Quantitative variables will be expressed as mean ± standard deviation or median with interquartile range, depending on distribution. Qualitative variables will be presented as frequencies and percentages. Comparisons between subgroups may be performed using appropriate statistical tests (Chi-square or Fisher's exact test for categorical variables, Student's t-test or Mann-Whitney test for continuous variables), with a significance level set at p \< 0.05.
The study is conducted in accordance with applicable data protection regulations (MR-004 framework), with minimal risk to participants, as it involves retrospective analysis of existing clinical and imaging data.
Interventions
- Diagnostic test Cone Beam Computed Tomography Imaging
Cone beam computed tomography (CBCT) imaging is used to assess bone mineral density, trabecular structure, and morphometric characteristics of the jaw in patients with medication-related osteonecrosis of the jaw. Imaging data are retrospectively analyzed without any additional procedure performed for research purposes.
Primary outcome measures
- Bone Mineral Density Measured on Cone Beam Computed Tomography [Time frame: Baseline and up to 24 months]
Secondary outcome measures (4)
- Trabecular Bone Separation Measured on Cone Beam Computed Tomography [Time frame: Baseline and up to 24 months]
- Bone Volume to Total Volume Ratio Measured on Cone Beam Computed Tomography [Time frame: Baseline and up to 24 months]
- Trabecular Bone Number Measured on Cone Beam Computed Tomography [Time frame: Baseline and up to 24 months]
- Hounsfield Unit Values Measured on Cone Beam Computed Tomography [Time frame: Baseline and up to 24 months]
Eligibility criteria
Inclusion criteria
- Adult patient aged 18 years or older
- Diagnosis of medication-related osteonecrosis of the jaw (MRONJ), stage 0, 1, or 2
- Available diagnostic CBCT and at least 2 follow-up cone beam computed tomography (CBCT) examinations
- Able to understand the study information and not opposed to participation
Exclusion criteria
- Other jaw bone disease
- History of cervicofacial irradiation
- Stage 3 medication-related osteonecrosis of the jaw
- Fewer than 2 follow-up cone beam computed tomography (CBCT) examinations
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Observational model
- Cohort
Study locations
Center list to be confirmed — check the primary protocol.
Identifiers
NCT: NCT07588269 · AP_AGC_SG_B-ONJ-EVOL