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de Sousa VC, Sousa FRN, Vasconcelos RF, Martins CS, Lopes AP, Alves NM, Viana D, Alves K, Leitão R, Brito GAC, Girão V, Goes P. Atorvastatin reduces zoledronic acid-induced osteonecrosis of the jaws of rats. Bone 2022; 164:116523. [PMID: 35985466 DOI: 10.1016/j.bone.2022.116523] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/03/2022] [Accepted: 08/14/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Vanessa Costa de Sousa
- Post Graduation Program in Morphological Science, Department of Morphology, Medical School, Federal University of Ceará, Fortaleza, CE, Brazil
| | | | - Raquel Felipe Vasconcelos
- Post Graduation Program in Morphological Science, Department of Morphology, Medical School, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Conceição S Martins
- Post Graduation Program in Morphological Science, Department of Morphology, Medical School, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Amanda Pimentel Lopes
- Department of Morphology, Medical School, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Nicholas Militão Alves
- Department of Morphology, Medical School, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Delane Viana
- Department of Morphology, Medical School, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Karuza Alves
- Department of Morphology, Medical School, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Renata Leitão
- Department of Morphology, Medical School, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Gerly A C Brito
- Department of Morphology, Medical School, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Virginia Girão
- Department of Morphology, Medical School, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Paula Goes
- Department of Pathology and Legal Medicine, Medical School, Federal University of Ceará, Fortaleza, CE, Brazil.
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Khalfi L, Ndiaye A, Chabi W, Fiqhi MK, El Khatib K. Osteonecrosis Mandibular Extended to Bisphosphonates: A Very Rare Extensive Case. Cureus 2020; 12:e7428. [PMID: 32351808 PMCID: PMC7186105 DOI: 10.7759/cureus.7428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
After the first report of bisphosphonate-related osteonecrosis of the jaw (BRONJ) in 2003, it has increased significantly since then. We report a very rare extensive case never seen before in our experience of bone exposure with necrosis reaching the mandibular inferior border. Although the treatment modalities are not yet established, most researchers have recommended conservative approaches. The surgery was to be as conservative as possible, with a resection of the mandibular range followed by reconstruction using titanium plate with space maintainer. The authors would like to share their approach, management, and awareness.
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Affiliation(s)
- Lahcen Khalfi
- Plastic and Maxillo-Facial Surgery, Mohammed V Teaching Armed Forces Hospital, Rabat, MAR
| | - Abibou Ndiaye
- Surgery, Mohammed V Teaching Armed Forces Hospital, Rabat, MAR
| | - Wilfried Chabi
- Plastic and Maxillo-Facial Surgery, Mohammed V Teaching Armed Forces Hospital, Rabat, MAR
| | - Mohammed Kamal Fiqhi
- Plastic and Maxillo-Facial Surgery, Mohammed V Teaching Armed Forces Hospital, Rabat, MAR
| | - Karim El Khatib
- Plastic and Maxillo-Facial Surgery, Mohammed V Teaching Armed Forces Hospital, Rabat, MAR
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Gholivand MB, Peyman H, Gholivand K, Roshanfekr H, Taherpour AA, Yaghoubi R. Experimental and Computational Evidence on the Interaction of Cycloalkyl α-Aminobisphosphonates with Calf Thymus DNA. DNA Cell Biol 2017; 36:541-551. [PMID: 28525298 DOI: 10.1089/dna.2016.3624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Fluorescence spectroscopy, ultraviolet-visible absorption spectroscopy, circular dichroism spectroscopy, viscometry, cyclic voltammetry, and differential pulse voltammetry were applied to investigate the competitive interaction of DNA with the three new cycloalkyl α-aminobisphosphonates (D1-D3) and spectroscopic probe, neutral red dye, and Hoechst (HO), in a Tris-hydrogen chloride buffer (pH 7.4). The spectroscopic and voltammetric studies showed that the groove binding mode of interaction is predominant in the solution containing DNA and α-aminobisphosphonates. Furthermore, the results indicated that α-aminobisphosphonate with the lengthy N alkyl chains and larger heterocyclic ring size had a stronger interaction. The principal component analysis and theoretical quantum mechanical and molecular mechanics (QM-DFT B3LYP/6-31+G* and MM-SYBYL) methods were also applied to determine the number of chemical components presented in complexation equilibrium and identify the structure complexes of DNA with the three new cycloalkyl α-aminobisphosphonates (D1-D3), respectively.
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Affiliation(s)
- Mohammad Bagher Gholivand
- 1 Faculty of Chemistry, Sensor and Biosensor Research Center (SBRC) and Nanoscience and Nanotechnology Research Center (NNRC), Razi University , Kermanshah, Iran
| | - Hossein Peyman
- 2 Department of Chemistry, Ilam Branch, Islamic Azad University , Ilam, Iran
| | - Khodayar Gholivand
- 3 Department of Chemistry, Faculty of Science, Tarbiat Modares University , Tehran, Iran
| | - Hamideh Roshanfekr
- 2 Department of Chemistry, Ilam Branch, Islamic Azad University , Ilam, Iran
| | - Avat Arman Taherpour
- 4 Department of Organic Chemistry, Faculty of Chemistry, Razi University , Kermanshah, Iran .,5 Medical Biology Research Center, Kermanshah University of Medical Sciences , Kermanshah, Iran
| | - Rouhollah Yaghoubi
- 3 Department of Chemistry, Faculty of Science, Tarbiat Modares University , Tehran, Iran
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Experimental and theoretical studies of interaction of aliphatic chain α-aminobisphosphonates with DNA. J Photochem Photobiol A Chem 2017. [DOI: 10.1016/j.jphotochem.2017.01.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Theoretical and Instrumental Studies of the Competitive Interaction Between Aromatic α-Aminobisphosphonates with DNA Using Binding Probes. Appl Biochem Biotechnol 2017; 182:925-943. [PMID: 28120240 DOI: 10.1007/s12010-016-2371-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 12/12/2016] [Indexed: 10/20/2022]
Abstract
Fluorescence spectroscopy, UV-visible absorption spectroscopy, circular dichroism (CD) spectroscopy, viscometry, cyclic voltammetry (CV), and differential pulse voltammetry (DPV) were applied to investigate the competitive interaction of DNA with two aromatic α-aminobisphosphonates and neutral red dye (NR, intercalator) and Hoechst (Ho, groove binder) as spectroscopic probes, in a Tris-hydrogen chloride buffer solution (pH 7.4). The principal component analysis (PCA) was applied to determine the number of chemical components presented in complexation equilibrium of DNA with the aromatic α-aminobisphosphonates (B1 and B2). The spectroscopic and voltammetric studies showed that the groove binding mode of interaction is predominant in the solution containing DNA and α-aminobisphosphonates. Furthermore, the results indicated that α-aminobisphosphonate with the lengthy N-alkyl chains had a stronger interaction. The PCA and theoretical quantum mechanical and molecular mechanic methods were also utilized to determine the structure of DNA with the two α-aminobisphosphonates (B1 and B2).
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Kim TH, Seo WG, Koo CH, Lee JH. Evaluation of the predisposing factors and involved outcome of surgical treatment in bisphosphonate-related osteonecrosis of the jaw cases including bone biopsies. J Korean Assoc Oral Maxillofac Surg 2016; 42:193-204. [PMID: 27595086 PMCID: PMC5009193 DOI: 10.5125/jkaoms.2016.42.4.193] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 06/27/2016] [Accepted: 07/22/2016] [Indexed: 12/11/2022] Open
Abstract
Objectives This study examined the statistical relevance of whether the systemic predisposing factors affect the prognosis of surgical treatment of bisphosphonate-related osteonecrosis of the jaw (BRONJ). All cases had undergone bone biopsies to determine the characteristics of the mechanisms of BRONJ by optical microscopy. Materials and Methods The data included 54 BRONJ cases who underwent surgery and in whom bone biopsies were performed. The results of surgery were evaluated and the results were classified into 3 categories: normal recovery, delayed recovery, and recurrence after surgery. The medical history, such as diabetes mellitus, medication of steroids, malignancies on other sites was investigated for an evaluation of the systemic predisposing factors in relation to the prognosis. The three factors involved with the medication of bisphosphonate (BP) were the medication route, medication period, and drug holiday of BP before surgery. The serum C-terminal cross-linking telopeptide (CTX) value and presence of microorganism colony in bone biopsy specimens were also checked. Statistical analysis was then carried out to determine the relationship between these factors and the results of surgery. Results The group of patients suffering from diabetes and on steroids tended to show poorer results after surgery. Parenteral medication of BP made the patients have a poorer prognosis after surgery than oral medication. In contrast, the medication period and drug holiday of BP before surgery did not have significance with the results of surgery nor did the serum CTX value and presence of microorganism colony. Necrotic bone specimens in this study typically showed disappearing new bone formation around the osteocytic lacunae and destroyed Howship's lacunae. Conclusion Although many variables exist, this study could in part, predict the prognosis of surgical treatment of BRONJ by taking the patient's medical history.
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Affiliation(s)
- Tae-Hwan Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University, Cheonan, Korea
| | - Won-Gyo Seo
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University, Cheonan, Korea
| | - Chul-Hong Koo
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University, Cheonan, Korea
| | - Jae-Hoon Lee
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University, Cheonan, Korea
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Siu WS, Ko CH, Wong HL, Gao S, Shum WT, Lau CBS, Hung LK, Leung PC. Seropharmacological study on osteogenic effects of post-absorption ingredients of an osteoprotective herbal formula. Chin J Integr Med 2016; 23:25-32. [PMID: 27299462 DOI: 10.1007/s11655-016-2474-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To further investigate the {ptin vitro} effects of an osteoprotective herbal formula "ELP" (Herba Epimedii, Fructus Ligustri Lucidi and Fructus Psoraleae) using seropharmacological approach. METHODS Rats were fed with ELP or its individual component herbs for 2 days. The serum containing the postabsorbed ingredients of the herbal items were collected for cell culture using UMR106 cell, RAW264.7 cell and mesenchymal stem cell (MSC) isolated from the bone marrow of the rats. The effects of the herbal-containing serum on cell toxicity were detected by 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide assay; bromodeoxyuridine assay was conducted to measure the cell proliferation of UMR106 cell and MSC; cell activity was measured using colorimetric method, and mRNA expression of runt-related transcription factor 2 (Runx2), alkaline phosphatase (ALP) and osteopontin (OPN) of UMR106 and MSC as well as matrix metalloproteinase 9 (MMP-9), tartrate-resistant acid phosphatase (TRAP) and cathepsin K of RAW264.7 were analyzed using real-time reverse-transcription polymerase chain reaction. RESULTS ELP and its component serum exhibited no cytotoxic effects on the cells. The ELP-containing serum increased the proliferation of UMR106 cell and MSC by 25.7% and 14.4 %, respectively and the alkaline phosphatase activity of MSC was increased by 42.6%. On the contrary, it inhibited the RAW264.7 cell differentiation by 29.2 %. ELP serum upregulated the Runx2 expression of UMR and MSC by 1.18 fold and 1.27 fold, respectively. It also upregulated ALP and OPN expression in MSC by 1.69- and 2.12-fold, respectively. On the other hand, ELP serum down-regulated MMP-9 and cathepsin K expression of RAW264.7 cell by 0.46- and 0.36-fold, respectively. CONCLUSIONS The serum of the animals fed with ELP contains active ingredients which are effective in promoting osteogenesis and inhibiting osteoclastogenesis.
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Affiliation(s)
- Wing-Sum Siu
- Institute of Chinese Medicine, Chinese University of Hong Kong, Hong Kong, China.,State Key Laboratory of Phytochemistry and Plant Resources in West China, Chinese University of Hong Kong, Hong Kong, China.,Department of Orthopaedics and Traumatology, Chinese University of Hong Kong, Hong Kong, China
| | - Chun-Hay Ko
- Institute of Chinese Medicine, Chinese University of Hong Kong, Hong Kong, China.,State Key Laboratory of Phytochemistry and Plant Resources in West China, Chinese University of Hong Kong, Hong Kong, China
| | - Hing-Lok Wong
- Institute of Chinese Medicine, Chinese University of Hong Kong, Hong Kong, China.,State Key Laboratory of Phytochemistry and Plant Resources in West China, Chinese University of Hong Kong, Hong Kong, China
| | - Si Gao
- Institute of Chinese Medicine, Chinese University of Hong Kong, Hong Kong, China.,State Key Laboratory of Phytochemistry and Plant Resources in West China, Chinese University of Hong Kong, Hong Kong, China
| | - Wai-Ting Shum
- Institute of Chinese Medicine, Chinese University of Hong Kong, Hong Kong, China.,State Key Laboratory of Phytochemistry and Plant Resources in West China, Chinese University of Hong Kong, Hong Kong, China
| | - Clara Bik-San Lau
- Institute of Chinese Medicine, Chinese University of Hong Kong, Hong Kong, China.,State Key Laboratory of Phytochemistry and Plant Resources in West China, Chinese University of Hong Kong, Hong Kong, China
| | - Lung-Kim Hung
- Department of Orthopaedics and Traumatology, Chinese University of Hong Kong, Hong Kong, China
| | - Ping-Chung Leung
- Institute of Chinese Medicine, Chinese University of Hong Kong, Hong Kong, China. .,State Key Laboratory of Phytochemistry and Plant Resources in West China, Chinese University of Hong Kong, Hong Kong, China. .,Department of Orthopaedics and Traumatology, Chinese University of Hong Kong, Hong Kong, China.
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Affiliation(s)
| | | | - Joël Ferri
- Université Lille Nord de France, Lille, France
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CONTE NETO N, SPOLIDORIO LC, ANDRADE CRD, ESTEVES JC, MARCANTONIO JR E. Experimental osteonecrosis: development of a model in rodents administered alendronate. Braz Oral Res 2016; 30:e99. [DOI: 10.1590/1807-3107bor-2016.vol30.0099] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 06/09/2016] [Indexed: 11/22/2022] Open
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Intraindividual comparison of preoperative (99m)Tc-MDP SPECT/CT and intraoperative and histopathological findings in patients with bisphosphonate- or denosumab-related osteonecrosis of the jaw. J Craniomaxillofac Surg 2015; 43:1461-9. [PMID: 26232916 DOI: 10.1016/j.jcms.2015.06.025] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 06/02/2015] [Accepted: 06/18/2015] [Indexed: 01/18/2023] Open
Abstract
PURPOSE Bisphosphonate- or denosumab-related osteonecrosis of the jaw (BRONJ/DRONJ) requires reliable preoperative assessment of the extent of disease for surgical planning. The aim of this study was to compare the extent of BRONJ/DRONJ as detected by Tc-99m-methylene diphosphonate (MDP) bone scintigraphy with intraoperative and histopathological findings, and to assess the additional value of hybrid single photon emission computed tomography/computed tomography (SPECT/CT) for evaluation of disease. MATERIAL AND METHODS Twenty-one patients with BRONJ/DRONJ underwent three-phase bone scintigraphy including SPECT/CT. The diagnostic certainty using conventional SPECT or fused SPECT/CT imaging was compared. Location and extent of disease on scintigraphic imaging and pre- and intra-operative clinical assessment were compared. Intraoperative and histopathological findings served as reference standard. RESULTS A total of 29 sites of BRONJ/DRONJ were histopathologically confirmed in 21 patients. Bone scintigraphy demonstrated increased perfusion in 57.1% of patients, increased blood pool in 76.2%, and increased tracer accumulation at the metabolic phase in all patients. The intensity of tracer accumulation at the metabolic phase correlated significantly with clinical stage of disease (rs = 0.47, p = 0.03). Clinical examination (p < 0.0001), but not SPECT (p = 0.19), underestimated the extent of disease as determined by surgical evaluation. SPECT/CT offered a significantly higher diagnostic certainty (p < 0.0001). CONCLUSION In patients with BRONJ/DRONJ, the true extent of osseous lesions as determined by surgery is significantly underestimated by clinical examination. Tc-99m-MDP bone scintigraphy can reliably predict the extent of disease. Hybrid SPECT/CT may significantly increase the diagnostic certainty of anatomical localization.
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Rogers S, Palmer N, Lowe D, Randall C. United Kingdom nationwide study of avascular necrosis of the jaws including bisphosphonate-related necrosis. Br J Oral Maxillofac Surg 2015; 53:176-82. [DOI: 10.1016/j.bjoms.2014.11.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Accepted: 11/15/2014] [Indexed: 11/28/2022]
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Olejnik C, Falgayrac G, During A, Vieillard MH, Maes JM, Cortet B, Penel G. Molecular alterations of bone quality in sequesters of bisphosphonates-related osteonecrosis of the jaws. Osteoporos Int 2014; 25:747-56. [PMID: 24081510 DOI: 10.1007/s00198-013-2514-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Accepted: 09/13/2013] [Indexed: 01/09/2023]
Abstract
UNLABELLED Compared to healthy bone, the intrinsic bone materials properties in the pre-existing lamellar bone are altered in jaw bone sequesters of bisphosphonates (BP)-related osteonecrosis. INTRODUCTION The aim of this study was to evaluate the human jaw bone quality, especially intrinsic bone material properties among sequesters of osteonecrosis of the jaw (ONJ) induced by BP. METHODS Bone sequesters were obtained from 24 patients suffering from ONJ following a BP treatment. Within BP-exposed bone samples, benign-BP and malignant-BP groups were distinguished in relation to the underlying disease: osteoporosis and bone metastases or multiple myeloma, respectively. Healthy cadaveric cortical jaw bone samples were used as controls. The physicochemical parameters of bone samples - mineral/organic ratio, relative proteoglycan content, crystallinity, monohydrogen phosphate content, and type-B carbonate substitution - were evaluated by Raman microspectroscopy. Representative Raman spectral features of bones control and BP-exposed bone sequesters were identified with the Partial-Least-Square Discriminant Analysis (PLS-DA). RESULTS BP-exposed bone sequesters are characterized by a significant increase of mineral to organic ratio (+12 %) and a significant decrease of relative proteoglycan content (-35 %), thus regulating initial collagen matrix mineral deposition. Structural changes on mineral components are revealed by a significant decrease of both crystallinity (-2 %) and mineral maturation (-41 %) in the BP-exposed bone sequesters compared to healthy bones. These modifications were also observed distinctly in both benign-BP and malignant-BP groups. In addition, a shift of the phosphate ν1 band was highlighted by PLS-DA between bones control and BP-exposed bone sequesters, revealing a disruption of the apatitic phosphate environment in the jaw bone sequesters. CONCLUSIONS The present data show that jaw bone quality can be altered with an overmineralization and ultrastructural modifications of apatitic mineral in bone sequesters of BP-related ONJ.
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Affiliation(s)
- C Olejnik
- Université Lille Nord de France, 59000, Lille, France,
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SIU WINGSUM, KO CHUNHAY, HUNG LEUNGKIM, LAU CHINGPO, LAU CLARABIKSAN, FUNG KWOKPUI, LEUNG PINGCHUNG. Effect of anti-osteoporotic agents on the prevention of bone loss in unloaded bone. Mol Med Rep 2013; 8:1188-94. [DOI: 10.3892/mmr.2013.1647] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 06/20/2013] [Indexed: 11/05/2022] Open
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Coskun Akar G, Efeoglu C, Alp A, Koseoglu K, Erol H, Yenicerioglu Y, Akar H. Malnutrition due to bisphosphonate-related osteonecrosis of the jaw in a chronic dialysis patient: case report. Ren Fail 2013; 35:1008-12. [DOI: 10.3109/0886022x.2013.809005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Oral bisphosphonate related osteonecrosis of the jaw: a challenging adverse effect. ISRN RHEUMATOLOGY 2013; 2013:215034. [PMID: 23762600 PMCID: PMC3671545 DOI: 10.1155/2013/215034] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Accepted: 05/01/2013] [Indexed: 11/18/2022]
Abstract
Oral bisphosphonates are the most commonly prescribed antiresorptive drugs for the treatment of osteoporosis. However, there are several adverse effects associated with oral bisphosphonates including the bisphosphonate related osteonecrosis of the jaw (BRONJ). With a better understanding of this side effect, reported incidences for BRONJ in oral bisphosphonate users have increased in time. The pathogenesis of BRONJ has not been well determined. Several risk factors such as dentoalveolar surgery, therapy duration, and concomitant steroid usage have been linked to BRONJ. Conservative and surgical methods can be preferred in the treatment. Preventative measures are of great importance for the patients at high risk. In this paper, osteonecrosis of the jaw secondary to oral bisphosphonates was reviewed in order to increase awareness as well as to renew the current knowledge.
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Janovská Z. Bisphosphonate-related osteonecrosis of the jaws. A severe side effect of bisphosphonate therapy. ACTA MEDICA (HRADEC KRÁLOVÉ) 2013; 55:111-5. [PMID: 23297518 DOI: 10.14712/18059694.2015.47] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Bisphosphonates (BP) are potent inhibitors of bone resorption used mainly in the treatment of metastatic bone disease and osteoporosis. By inhibiting bone resorption, they prevent complications as pathological fracture, pain, tumor-induced hypercalcemia. Even though patient's benefit of BP therapy is huge, various side effects may develop. Bisphosphonate-related osteonecrosis of the jaws (BRONJ) is among the most serious ones. Oncologic patients receiving high doses of BP intravenously are at high risk of BRONJ development. BPs impair bone turnover leading to compromised bone healing which may result in the exposure of necrotic bone in the oral cavity frequently following tooth extraction or trauma of the oral mucosa. Frank bone exposure may be complicated by secondary infection leading to osteomyelitis development with various symptoms and radiological findings. In the management of BRONJ, conservative therapy aiming to reduce the symptoms plays the main role. In patients with extensive bone involvement resective surgery may lead to complete recovery, provided that the procedure is correctly indicated. Since the treatment of BRONJ is difficult, prevention is the main goal. Therefore in high risk patients dental preventive measures should be taken prior to bisphosphonate administration. This requires adequate communication between the prescribing physician, the patient and the dentist.
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Affiliation(s)
- Zuzana Janovská
- Department of Dentistry, Charles University in Prague, Faculty of Medicine and University Hospital, Hradec Králové, Czech Republic.
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Funaro M, Bolyakov A, Gimenez E, Herman M, Paduch DA. Low Testosterone—An Important Predictor of Low Mineral Bone Density in Young Men—Our Own Experience and a Review of Literature. ACTA ACUST UNITED AC 2013. [DOI: 10.4236/asm.2013.33a003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Forced eruption as an alternative to tooth extraction in long-term use of oral bisphosphonates. J Am Dent Assoc 2012. [DOI: 10.14219/jada.archive.2012.0091] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Conte-Neto N, Bastos ADS, Spolidorio LC, Chierici Marcantonio RA, Marcantonio E. Long-term treatment with alendronate increases the surgical difficulty during simple exodontias - an in vivo observation in Holtzman rats. Head Face Med 2012; 8:20. [PMID: 22834876 PMCID: PMC3489782 DOI: 10.1186/1746-160x-8-20] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Accepted: 07/13/2012] [Indexed: 11/18/2022] Open
Abstract
Background Atraumatic teeth extractions protocols are highly encouraged in patients taking bisphosphonates (Bps) to reduce surgical trauma and, consequently, the risk of jaws osteonecrosis development. In this way, this paper aims to report the findings of increased surgical difficulty during simple exodontias in animals treated with bisphosphonates. Methods Sixty male Holtzman rats were randomly distributed into three groups of 20 animals and received daily subcutaneous administration of 1 mg/kg (AL1) or 3 mg/kg (AL3) of alendronate or saline solution (CTL). After 60 days of drug therapy all animals were submitted to first lower molars extractions under general anesthesia. Operatory surgical time and the frequency of teeth fractures were measured as principal outcomes and indicators of surgical difficulty degree. Results Animals treated with alendronate (AL1 and AL3) were associated to higher operatory times and increased frequency of teeth fractures compared to match controls. Conclusions The bisphosphonate therapy may be associated with an increased surgical difficulty and trauma following simple exodontias protocols, which is considered a critical issue when it comes to osteonecrosis development.
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Affiliation(s)
- Nicolau Conte-Neto
- Department of Diagnosis and Surgery, Division of Periodontology, UNESP- Univ, Estadual Paulista, School of Dentistry, Rua Humaitá, 1680, Araraquara, SP, 14801-903, Brazil
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Kühl S, Walter C, Acham S, Pfeffer R, Lambrecht JT. Bisphosphonate-related osteonecrosis of the jaws--a review. Oral Oncol 2012; 48:938-947. [PMID: 22525606 DOI: 10.1016/j.oraloncology.2012.03.028] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2012] [Revised: 03/27/2012] [Accepted: 03/28/2012] [Indexed: 01/25/2023]
Abstract
The aim was to evaluate the knowledge about bisphosphonate-related osteonecrosis of the jaws (BRONJ). A bibliographic search in Medline, PubMed and the Cochrane Register of controlled clinical trials was performed between 2003 and 2010 by using the terms bisphosphonate and osteonecrosis of the jaw. The amount of publications per year, the type of journal for publication, and the evidence level of the trial were evaluated. Next to this the incidences and the success of treatment strategies for BRONJ were identified. A total of 671 publications were reviewed. Since 2006 more than 100 publications on BRONJ per year (with an upward trend) have been published, mostly in dental journals. The evidence level could be determined for 176 publications and only one grade Ia study was found. The studies showed a wide variety in design, most of them being retrospective. The incidence of BRONJ is strongly dependent on oral or intravenous application and varies between 0.0% and 27.5%. There is no scientific data to sufficiently support any specific treatment protocol for the management of BRONJ. Further clinical studies are needed to evaluate the incidence and treatment strategies at a higher level of evidence. Therefore uniform study protocols would be favourable.
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Affiliation(s)
- Sebastian Kühl
- School of Dental Medicine, Department of Oral Surgery, Oral Radiology and Oral Medicine, University of Basel, Hebelstrasse 3, CH-4056 Basel, Switzerland.
| | - Christian Walter
- University Medical Center Mainz, Department of Oral and Maxillofacial Surgery, Augustusplatz 2, 55131 Mainz, Germany
| | - Stephan Acham
- School of Dental Medicine, Department of Oral Surgery, Oral Radiology, University of Graz, Auenbruggerplatz 12, 8036 Graz, Austria
| | - Roland Pfeffer
- School of Dental Medicine, Department of Oral Surgery, Oral Radiology and Oral Medicine, University of Basel, Hebelstrasse 3, CH-4056 Basel, Switzerland
| | - J Thomas Lambrecht
- School of Dental Medicine, Department of Oral Surgery, Oral Radiology and Oral Medicine, University of Basel, Hebelstrasse 3, CH-4056 Basel, Switzerland
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Gordon KE, Dooley JM, Sheppard KM, MacSween J, Esser MJ. Impact of bisphosphonates on survival for patients with Duchenne muscular dystrophy. Pediatrics 2011; 127:e353-8. [PMID: 21242224 DOI: 10.1542/peds.2010-1666] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE In this article we describe the association of bisphosphonate therapy on survival within a regional cohort of patients with Duchenne muscular dystrophy (DMD) who received steroid therapy and were managed in a single center. PATIENTS AND METHODS The records of all patients with confirmed DMD who were born between 1963 and 2006 and who had received at least 1 year of steroid therapy were reviewed from birth until they reached the study end points (death, loss to follow-up, or the last follow-up was in 2009). A survival analysis was used to account for the variable follow-up duration within this cohort. RESULTS Forty-four boys from this cohort with DMD were exposed to continuous steroid use. Bisphosphonate therapy was initiated for 16 patients (36%) between 1997 and 2007 at a median age of 12.5 years (range: 7-23 years). At the time of the last follow-up in 2009, 13 patients had died (30%) at a median age of 16 years (range: 14-27 years). Survival curves demonstrate that the prescription of bisphosphonates was associated with a significant improvement in survival rate (P = .005, log-rank test). Furthermore, a possible therapy-duration effect could be shown for bisphosphonate use (P = .007, log-rank test). CONCLUSIONS The treatment of patients with DMD with steroids and bisphosphonates seems to be associated with significantly improved survival compared with treatment with steroids alone.
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Affiliation(s)
- Kevin E Gordon
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
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Paccou J, Confavreux CB, David C, Leboime A, Mehsen N, Cortet B. Stabilized severe osteoporosis: should the treatment be stopped? Joint Bone Spine 2010; 77 Suppl 2:S120-7. [DOI: 10.1016/s1297-319x(10)70007-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Macanovic M, Gangidi S, Porter G, Brown S, Courtney D, Porter J. Incidental bony pathology when reporting trauma orthopantomograms. Clin Radiol 2010; 65:842-9. [DOI: 10.1016/j.crad.2010.06.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2010] [Revised: 05/23/2010] [Accepted: 06/02/2010] [Indexed: 11/30/2022]
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Hutchinson M, O'Ryan F, Chavez V, Lathon PV, Sanchez G, Hatcher DC, Indresano AT, Lo JC. Radiographic Findings in Bisphosphonate-Treated Patients With Stage 0 Disease in the Absence of Bone Exposure. J Oral Maxillofac Surg 2010; 68:2232-40. [DOI: 10.1016/j.joms.2010.05.003] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2009] [Revised: 04/01/2010] [Accepted: 05/15/2010] [Indexed: 11/27/2022]
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Kos M, Kuebler JF, Luczak K, Engelke W. Bisphosphonate-related osteonecrosis of the jaws: A review of 34 cases and evaluation of risk. J Craniomaxillofac Surg 2010; 38:255-9. [DOI: 10.1016/j.jcms.2009.06.005] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2008] [Revised: 06/01/2009] [Accepted: 06/05/2009] [Indexed: 11/26/2022] Open
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Gholivand K, Ghaziani F, Yaghoubi R, Hosseini Z, Shariatinia Z. Design, synthesis and anticholinesterase activity of some new α-aminobisphosphonates. J Enzyme Inhib Med Chem 2010; 25:827-35. [DOI: 10.3109/14756361003691860] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Khodayar Gholivand
- Department of Chemistry, Faculty of Basic Sciences, Tarbiat Modares University, Tehran, Iran
| | - Fatemeh Ghaziani
- Department of Chemistry, Faculty of Basic Sciences, Tarbiat Modares University, Tehran, Iran
| | - Rouhollah Yaghoubi
- Department of Chemistry, Faculty of Basic Sciences, Tarbiat Modares University, Tehran, Iran
| | - Zahra Hosseini
- Department of Chemistry, Faculty of Basic Sciences, Tarbiat Modares University, Tehran, Iran
| | - Zahra Shariatinia
- Department of Chemistry, Amirkabir University of Technology, Tehran, Iran
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Lo JC, O'Ryan FS, Gordon NP, Yang J, Hui RL, Martin D, Hutchinson M, Lathon PV, Sanchez G, Silver P, Chandra M, McCloskey CA, Staffa JA, Willy M, Selby JV, Go AS. Prevalence of osteonecrosis of the jaw in patients with oral bisphosphonate exposure. J Oral Maxillofac Surg 2009; 68:243-53. [PMID: 19772941 PMCID: PMC10159647 DOI: 10.1016/j.joms.2009.03.050] [Citation(s) in RCA: 312] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2009] [Revised: 02/22/2009] [Accepted: 03/17/2009] [Indexed: 10/20/2022]
Abstract
PURPOSE Osteonecrosis of the jaw (ONJ) is a serious complication associated with bisphosphonate therapy, but its epidemiology in the setting of oral bisphosphonate therapy is poorly understood. The present study examined the prevalence of ONJ in patients receiving chronic oral bisphosphonate therapy. MATERIALS AND METHODS We mailed a survey to 13,946 members who had received chronic oral bisphosphonate therapy as of 2006 within a large integrated health care delivery system in Northern California. Respondents who reported ONJ, exposed bone or gingival sores, moderate periodontal disease, persistent symptoms, or complications after dental procedures were invited for examination or to have their dental records reviewed. ONJ was defined as exposed bone (of >8 weeks' duration) in the maxillofacial region in the absence of previous radiotherapy. RESULTS Of the 8,572 survey respondents (71 +/- 9 years, 93% women), 2,159 (25%) reported pertinent dental symptoms. Of these 2,159 patients, 1,005 were examined and an additional 536 provided dental records. Nine ONJ cases were identified, representing a prevalence of 0.10% (95% confidence interval 0.05% to 0.20%) among the survey respondents. Of the 9 cases, 5 had occurred spontaneously (3 in palatal tori) and 4 occurred in previous extraction sites. An additional 3 patients had mandibular osteomyelitis (2 after extraction and 1 with implant failure) but without exposed bone. Finally, 7 other patients had bone exposure that did not fulfill the criteria for ONJ. CONCLUSIONS ONJ occurred in 1 of 952 survey respondents with oral bisphosphonate exposure (minimum prevalence of 1 in 1,537 of the entire mailed cohort). A similar number had select features concerning for ONJ that did not meet the criteria. The results of the present study provide important data on the spectrum of jaw complications among patients with oral bisphosphonate exposure.
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Affiliation(s)
- Joan C Lo
- Research Scientist, Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
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Intravenous Bisphosphonate-Related Osteonecrosis of the Jaw: Bone Scintigraphy as an Early Indicator. J Oral Maxillofac Surg 2009; 67:1363-72. [DOI: 10.1016/j.joms.2009.03.005] [Citation(s) in RCA: 143] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2008] [Accepted: 03/13/2009] [Indexed: 11/20/2022]
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Abstract
Osteoporosis is an escalating global problem. Hip fractures, the most catastrophic complication of osteoporosis, continue to cause significant mortality and morbidity despite increasing availability of effective preventative agents. Among these agents, oral bisphosphonates have been the first choice for the treatment and prevention of osteoporotic fractures. However, the use of oral bisphosphonates, especially in the older population, has been limited by their side effects and method of administration thus compromising their persistent use. The resultant low adherence by patients has undermined their full potential and has been associated with an increase in the incidence of fragility fractures. Recently, annual intravenous zoledronic acid (ZOL) has been approved for osteoporosis. Randomized controlled trials have demonstrated ZOL to be safe, have good tolerability and produce significant effect on bone mass and microarchitecture. Adherence has also been shown to be better with ZOL. Furthermore two large trials firmly demonstrated significant anti-osteoporotic effect (∼59% relative risk reduction of hip fractures) and mortality benefit (28% reduction in mortality) of ZOL in older persons with recent hip fractures. In this review, we report the current evidence on the use of ZOL for the prevention of hip fractures in the elderly. We also report the pharmacological characteristics and the advantages and disadvantages of ZOL in this particular group.
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Affiliation(s)
- Oddom Demontiero
- Aging Bone Research Program, Nepean Clinical School, University of Sydney, Penrith, NSW, Australia
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Current awareness: Pharmacoepidemiology and drug safety. Pharmacoepidemiol Drug Saf 2008. [DOI: 10.1002/pds.1489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Bisphosphonate-induced necrosis of the jaws: a reconstructive nightmare. Curr Opin Otolaryngol Head Neck Surg 2008; 16:325-30. [DOI: 10.1097/moo.0b013e328304b445] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Wimalawansa SJ. Insight into bisphosphonate-associated osteomyelitis of the jaw: pathophysiology, mechanisms and clinical management. Expert Opin Drug Saf 2008; 7:491-512. [DOI: 10.1517/14740338.7.4.491] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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