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Prevalence of radiographic findings on jaws exposed to antiresorptive therapy: a meta-analysis.

A new interesting article has been published in Dentomaxillofac Radiol. 2018 Oct 22:20180112. doi: 10.1259/dmfr.20180112. [Epub ahead of print] and titled:

Prevalence of radiographic findings on jaws exposed to antiresorptive therapy: a meta-analysis.

Authors of this article are:

Leonardi Dutra K, Haas L, Zimmermann GS, Melo G, Minamisako MC, Flores-Mir C, Corrêa M.

A summary of the article is shown below:

OBJECTIVE:: Determine the prevalence of radiographic findings (RF) on both jaws among patients receiving antiresorptive bone therapy.METHODS:: Six electronic databases and partial grey literature were searched. Data was collected based on predetermined criteria. The key features from the included studies were extracted. The MAStARI tool assessed the potential risk of bias (RoB) among the studies, while the GRADE approach determined the level of evidence.RESULTS:: Twenty-nine studies were identified and included in the qualitative analysis, totalling 1133 patients. Twenty-seven studies had sufficient data to be included in aseries of meta-analysis reporting twelve types of radiographic findings, and were splitin two groups based on their study design. G1 comprised descriptive observational studies and G2 analytical cross-sectional studies. Two studies presented a high RoB,sixteen had a moderate RoB, and eleven had low risk RoB. The overall level of evidence identified was very low. The most frequent RF were mixed lytic-scleroticareas (73.88%), followed by osteolytic changes (66.18%), osteosclerosis (65.75%),cortical bone erosion (50.83%), persisting alveolar socket (45.77%), periodontalligament (PDL) widening (44.69%), and inferior alveolar canal (IAC) involvement(43.40%). Less frequent, but equally important, were the periosteal reaction (34.27%), lamina dura thickening (32.97%), sequestrum (29.94%), pathologic fracture (20.90%),and density confluence of cortical and cancellous bone (16.61%). Twenty patients reported no signs.CONCLUSIONS:: RF prevalence was high and mainly included mixed lytic-sclerotic areas, osteolysis, osteosclerosis, cortical bone erosion, persisting alveolar socket, PDL-widening, IAC-involvement. Due to the very low level of evidence (GRADE) caution should be exercised when considering these findings.

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