Findings:
Well marginated area of osteolysis in the mandibular body, including the incisor, canine and premolar regions bilaterally. It involves the outer and inner cortices of the bone. Separated piece of bone within osteolysis is in keeping with bony sequestrum. Compared to the previous study interval improvement with significant sclerosis of the mandible.
Also, marked interval improvement of the bony defect in the floor of the right maxillary sinus, which currently measures about 1.5 mm, compared to 7 mm in the previous study. Almost complete interval resolution of the mucosal thickening in the right maxillary sinus with minimal residual mucosal thickening and occlusion of the right maxillary sinus. The paranasal sinuses are otherwise clear.
Right-sided concha bullosa is noted. Mild nasal septal deviation is seen.
The mastoid air cells and the middle ear cavities are clear.
Mild-to-moderate degenerative changes of the imaged cervical spine are seen.
Conclusion:
Marked interval improvement of the known medication-related osteonecrosis of the jaw (MRONJ) involving the mandibular body with increased sclerosis.
Almost complete resolution of the known right-sided oroantral fistula with complete resolution of the right-sided maxillary sinusitis.