Are imaging exams relevant in aiding the diagnosis of focal osteoporotic bone marrow defect: A systematic review

Background: Focal osteoporotic bone marrow defect (FOBMD) is a rare and poorly documented pathology corresponding to an unusual hematopoietic tissue in maxillary bones. Several studies have investigated FOBMD but reported different and heterogenous approaches to a correct diagnosis. Therefore, this systematic review evaluated the relevance of imaging exams in aiding FOBMD diagnosis and the implications in surgical planning for dental implants. The research question was: What is the relevance of imaging tests in aiding FOBMD diagnosis? Methods: Online databases were searched to select articles based on eligibility criteria. The studies included in the systematic review were submitted to bias and applicability assessments using the Joanna Briggs Institute tool for study quality assessment. Results: A total of 383 articles were obtained from all the databases, 27 studies were included, and all performed biopsies to confirm the diagnosis. The selected studies evaluated 698 patients, including approximately 80% of women, corroborating the literature that notes a higher prevalence of this lesion in women. The reviewed articles showed a low risk of bias for case series, moderate for case reports, and low for cross-sectional studies. Conclusion: The studies considered in this systematic review have shown that radiographic characteristics may sufficiently identify the lesion and provide a periodic radiographic follow-up. However, it is worth noting the need for CBCT for planning oral rehabilitation through implants to minimize the risks of such complications.