The Maxillofacial Center for Diagnostics & Research

Radiographic Changes in Maxillofacial Osteonecrosis

Note: Enlarged versions of each photo may be available by clicking on the left-hand image.  These are larger jpeg files but should not take too long to download.

		Regional Osteoporosis As in long bones, alveolar bone involvement often presents with very subtle, generalized loss of trabeculae, resulting in an area of osteoporosis.  Called transient ischemic osteoporosis or regional osteoporosis in long bones, the area of involvement is very poorly demarcated from surrounding marrow and is often too subtle to see without darkroom viewing or computer enhancement of the film.  Here, the depth of an almost invisible cavitation is illustrated by the placement of a round bur through the cortex and pushing gently until it stopped at the inferior wall of the lesion.
	Patient with atypical facial neuralgia.
		Regional Osteoporosis This more obvious subpontic area of regional osteoporosis has a typical inverted triangle shape situated immediately beneath the crest of the ridge, probably as a result of poor healing of the extraction socket when the tooth was originally extracted.  Such inverted triangular lesions are often hollow at the time of surgery, i.e. are intramedullary cavitations.  Notice that endodontic treatment was performed on the anterior tooth in a failed attempt to alleviate the pain.
	Patient with phantom pain/toothache.