Instrumental diagnosis

In the diagnosis of osteonecrosis of the jaw (ONJ), imaging may have a role in determining the extent of the disease, diagnosing early stages of osteonecrosis, identifying a potential association between metastasis to the jaw and ONJ lesions, excluding other diseases or complications of the jaws, such as fractures, and evaluating the jaw before surgical orofacial procedures. Since the appearance of ONJ at imaging is variable and very often nonspecific, imaging findings should always be related to the clinical context. The panoramic radiograph is the most often used imaging technique in cases of ONJ, whereas CT and MRI are adequate in evaluating bone involvement, in addition to offering the advantage that destructive processes can be seen at high resolution. Functional imaging, especially bone scintigraphy, provides a tool for the detection of early stages of ONJ. © 2012 Springer-Verlag Italia.