Multiple myeloma - oral radiological evidences

Abstract

Objective: The aim of this article is to summarize the main radiological evidences induced by multiple myeloma at the jaws level.

Materials and Methods: The analysis examines the main case reports and reviews on the matter. All relevant publications were searched through the PubMed search engine, using the following keywords: "Multiple Myeloma" and "Radiological evidences", "Maxilla", "Jaw", "TMJ". The purpose of our review is to highlight how oral radiological investigation is extremely useful in detecting any bone alterations associated with cases of multiple myeloma. In addition, we investigate the sites of the jaws where direct bone alteration is more frequently, and we perform a differential diagnosis with other focal alterations of the jaws or those that are the result of certain drug therapies (bisphosphonates). Our research stresses the concept that early diagnosis of multiple myeloma at the jaws level may prevent unnecessary and inadequate treatments.

Results: From the evaluation of our research, it is evident that osteolytic lesions are one of the fundamental signs of multiple myeloma, especially in areas undergoing intense hematopoietic activity. Among the radiological techniques used for diagnosis, the most sensitive one appears to be the three-dimensional technique, such as CT or Cone Beam, whereas two-dimensional radiographs (orthopantomography) appear to be exhaustive only when the lesion is very extensive.

Conclusions: It is evident that the dentist figure plays not only a supportive role, but also a fundamental part in the diagnostic process, as lesions that may anticipate a systemic manifestation are often encountered at the oral level.