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Hadad H, Matheus HR, Pai SI, Souza FA, Guastaldi FPS. Rodents as an animal model for studying tooth extraction-related medication-related osteonecrosis of the jaw: assessment of outcomes. Arch Oral Biol 2024; 159:105875. [PMID: 38160519 DOI: 10.1016/j.archoralbio.2023.105875] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 12/13/2023] [Accepted: 12/18/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE To assess the outcomes of several rodent animal models for studying tooth extraction-related medication-related osteonecrosis of the jaw (MRONJ). DESIGN After a search of the databases, 2004 articles were located, and 118 corroborated the inclusion factors (in vivo studies in rodents evaluating tooth extraction as a risk factor for the development of MRONJ). RESULTS Numerous studies attempting to establish an optimal protocol to induce MRONJ were found. Zoledronic acid (ZA) was the most used drug, followed by alendronate (ALN). Even when ZA did not lead to the development of MRONJ, its effect compromised the homeostasis of the bone and soft tissue. The association of other risk factors (dexamethasone, diabetes, and tooth-related inflammatory dental disease) besides tooth extraction also played a role in the development of MRONJ. In addition, studies demonstrated a relationship between cumulative dose and MRONJ. CONCLUSIONS Both ZA and ALN can lead to MRONJ in rodents when equivalent human doses (in osteoporosis or cancer treatment) are used. Local oral risk factors and tooth-related inflammatory dental disease increase the incidence of MRONJ in a tooth extraction-related rodent model.
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Affiliation(s)
- Henrique Hadad
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA, USA; Department of Diagnosis and Surgery, Oral & Maxillofacial Surgery Division, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Henrique R Matheus
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA, USA; Department of Diagnosis and Surgery, Periodontics Division, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Sara I Pai
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Yale University School of Medicine, New Haven, CT, USA
| | - Francisley A Souza
- Department of Diagnosis and Surgery, Oral & Maxillofacial Surgery Division, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Fernando P S Guastaldi
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA, USA.
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2
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Correia-Neto IJ, Colafemina ACE, Faustino ISP, Santos-Silva AR, Vargas PA, Lopes MA. Medication-related osteonecrosis in torus palatinus: Report of a case and literature review. SPECIAL CARE IN DENTISTRY 2024; 44:136-142. [PMID: 37055926 DOI: 10.1111/scd.12862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/27/2023] [Accepted: 04/02/2023] [Indexed: 04/15/2023]
Abstract
BACKGROUND Medication-related osteonecrosis of the jaw bones have been frequently reported. However, its occurrence in torus palatinus is very rare with only 10 cases published in the English-language literature. CASE REPORT We describe an additional case in a 79-year-old woman, who was referred for evaluation of a painful swelling with areas of suppuration on the hard palate. CONCLUSION Conservative treatment was performed and after spontaneous sequestrectomy, total healing was achieved.
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Affiliation(s)
- Ivan José Correia-Neto
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | | | | | - Alan Roger Santos-Silva
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Pablo Agustin Vargas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Márcio Ajudarte Lopes
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
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Yoo S, Mun Y, Kang N, Koo JM, Lee DH, Yoo JH, Lee SM, Koh S, Park JC, Kim T, Shin EK, Lee HS, Sim J, Kang KW, Kim SK, Cho C, Kim MG, Kim D, Lee J. Enhancement of the therapeutic efficacy of the MAP regimen using thiamine pyrophosphate-decorated albumin nanoclusters in osteosarcoma treatment. Bioeng Transl Med 2023; 8:e10472. [PMID: 38023714 PMCID: PMC10658614 DOI: 10.1002/btm2.10472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 11/15/2022] [Accepted: 12/06/2022] [Indexed: 12/27/2022] Open
Abstract
Recent studies on osteosarcoma regimens have mainly focused on modifying the combination of antineoplastic agents rather than enhancing the therapeutic efficacy of each component. Here, an albumin nanocluster (NC)-assisted methotrexate (MTX), doxorubicin (DOX), and cisplatin (MAP) regimen with improved antitumor efficacy is presented. Human serum albumin (HSA) is decorated with thiamine pyrophosphate (TPP) to increase the affinity to the bone tumor microenvironment (TME). MTX or DOX (hydrophobic MAP components) is adsorbed to HSA-TPP via hydrophobic interactions. MTX- or DOX-adsorbed HSA-TPP NCs exhibit 20.8- and 1.64-fold higher binding affinity to hydroxyapatite, respectively, than corresponding HSA NCs, suggesting improved targeting ability to the bone TME via TPP decoration. A modified MAP regimen consisting of MTX- or DOX-adsorbed HSA-TPP NCs and free cisplatin displays a higher synergistic anticancer effect in HOS/MNNG human osteosarcoma cells than conventional MAP. TPP-decorated NCs show 1.53-fold higher tumor accumulation than unmodified NCs in an orthotopic osteosarcoma mouse model, indicating increased bone tumor distribution. As a result, the modified regimen more significantly suppresses tumor growth in vivo than solution-based conventional MAP, suggesting that HSA-TPP NC-assisted MAP may be a promising strategy for osteosarcoma treatment.
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Affiliation(s)
- So‐Yeol Yoo
- College of Pharmacy, Chungnam National UniversityDaejeonRepublic of Korea
| | - Yong‐Hyeon Mun
- College of Pharmacy, Chungnam National UniversityDaejeonRepublic of Korea
| | - Nae‐Won Kang
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National UniversitySeoulRepublic of Korea
| | - Jang Mo Koo
- College of Pharmacy, Chungnam National UniversityDaejeonRepublic of Korea
| | - Dong Hwan Lee
- College of Pharmacy, Chungnam National UniversityDaejeonRepublic of Korea
| | - Ji Hoon Yoo
- College of Pharmacy, Chungnam National UniversityDaejeonRepublic of Korea
| | - Sang Min Lee
- College of Pharmacy, Chungnam National UniversityDaejeonRepublic of Korea
| | - Seokjin Koh
- College of Pharmacy, Chungnam National UniversityDaejeonRepublic of Korea
| | - Jong Chan Park
- College of Pharmacy, Chungnam National UniversityDaejeonRepublic of Korea
| | - Taejung Kim
- College of Pharmacy, Chungnam National UniversityDaejeonRepublic of Korea
| | - Eun Kyung Shin
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National UniversitySeoulRepublic of Korea
| | - Han Sol Lee
- College of Pharmacy, Chungnam National UniversityDaejeonRepublic of Korea
| | - Jaehoon Sim
- College of Pharmacy, Chungnam National UniversityDaejeonRepublic of Korea
| | - Keon Wook Kang
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National UniversitySeoulRepublic of Korea
| | - Sang Kyum Kim
- College of Pharmacy, Chungnam National UniversityDaejeonRepublic of Korea
| | - Cheong‐Weon Cho
- College of Pharmacy, Chungnam National UniversityDaejeonRepublic of Korea
| | - Myeong Gyu Kim
- College of Pharmacy and Graduate School of Pharmaceutical Sciences, Ewha Womans UniversitySeoulRepublic of Korea
| | - Dae‐Duk Kim
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National UniversitySeoulRepublic of Korea
| | - Jae‐Young Lee
- College of Pharmacy, Chungnam National UniversityDaejeonRepublic of Korea
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LIMA-SOUZA RAD, LEONEL ACLDS, DUARTE ÂLBP, CASTRO JFLD, CARVALHO EJDA, PEREZ DEDC. Awareness of patients receiving bisphosphonates: a cross-sectional study. Braz Oral Res 2022; 36:e0126. [DOI: 10.1590/1807-3107bor-2022.vol36.0126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2011] [Accepted: 06/02/2022] [Indexed: 11/13/2022] Open
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Isaias PHC, Silva PGDB, do Nascimento IV, Verde MEQL, Moreira MDS, Alves APNN, Sousa FB, Pereira KMA, Mota MRL. Effect of continuous and intermittent sodium alendronate oral dosing on post-extraction alveoli healing in rats. Arch Oral Biol 2021; 132:105291. [PMID: 34700193 DOI: 10.1016/j.archoralbio.2021.105291] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 09/06/2021] [Accepted: 10/13/2021] [Indexed: 01/24/2023]
Abstract
OBJECTIVE This study aimed to compare alveolar healing after tooth extraction in two experimental rat models using continuous or discontinuous dosing of sodium alendronate (ALN). DESIGN Forty-eight male Wistar rats were divided into eight experimental groups (n = 6/group) and administered ALN (2.5, 5.0, or 7.5 mg/kg) by gavage, weekly, either intermittently or following a continuous regimen (2.5, 5.0, or 7.5 mg/kg) before tooth extraction. The positive control rats were administered zoledronic acid (ZA; 0.2 mg/kg, intravenous), whereas negative control rats received sterile saline (0.9% NaCl, gavage). RESULTS Only the ZA-treated animals showed a larger radiolucent extraction site area compared to the saline group (p = 0.007). Small areas of bone tissue filling the alveoli were visualized in the 7.5 mg/kg continuous ALN group and compared with the saline group (p < 0.001). Increased amounts of empty osteocyte lacunae (p < 0.001) and osteoclasts with signs of apoptosis (p = 0.004) were observed in the continuous ALN groups (2.5, 5.0, and 7.5 mg/kg) compared with the saline group. Increased immunolabeling for TNF-α was observed in the 7.5 mg/kg discontinuous ALN group and all continuous ALN groups compared with the saline group (p < 0.001). The number of tartrate-resistant acid phosphatase (TRAP)-positive osteoclasts was higher in the two continuous ALN groups (5.0 and 7.5 mg/kg) than in the saline group (p < 0.001). CONCLUSIONS Continuous administration of ALN impaired post-extraction alveolar bone healing in rats; however, discontinuation of ALN administration before tooth extraction allowed for adequate post-dental extraction alveolar healing.
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Affiliation(s)
- Pedro Henrique Chaves Isaias
- Department of Dental Clinic, Division of Oral Pathology, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Ceará, Brazil.
| | - Paulo Goberlânio de Barros Silva
- Department of Dental Clinic, Division of Oral Pathology, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Ceará, Brazil; Department of Dentistry, Unichristus, Fortaleza, Ceará, Brazil; Ceará Oncology School, Ceará Cancer Institute, Hospital Haroldo Juaçaba, Fortaleza, Ceará, Brazil.
| | - Isabelly Vidal do Nascimento
- Department of Dental Clinic, Division of Oral Pathology, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Ceará, Brazil; Department of Dentistry, Unichristus, Fortaleza, Ceará, Brazil.
| | - Maria Elisa Quezado Lima Verde
- Department of Dental Clinic, Division of Oral Pathology, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Ceará, Brazil; Department of Dentistry, Unichristus, Fortaleza, Ceará, Brazil.
| | - Manuela da Silva Moreira
- Department of Dental Clinic, Division of Oral Pathology, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Ceará, Brazil.
| | - Ana Paula Negreiros Nunes Alves
- Department of Dental Clinic, Division of Oral Pathology, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Ceará, Brazil.
| | - Fabrício Bitu Sousa
- Department of Dental Clinic, Division of Oral Pathology, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Ceará, Brazil; Department of Dentistry, Unichristus, Fortaleza, Ceará, Brazil.
| | - Karuza Maria Alves Pereira
- Department of Dental Clinic, Division of Oral Pathology, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Ceará, Brazil; Department of Morphology, School Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil.
| | - Mário Rogério Lima Mota
- Department of Dental Clinic, Division of Oral Pathology, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Ceará, Brazil.
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Ferreira GZ, Bachesk AB, Bachesk AB, Farah GJ, Filho LI, Dos Santos Silva R, Poluha RL, Danieletto-Zanna CF, Gonçales ES. Oral Rehabilitation With Dental Implants and the Importance of a Preventive Evaluation for Osteonecrosis of the Jaws Associated With Medications. J ORAL IMPLANTOL 2020; 46:431-437. [PMID: 33031547 DOI: 10.1563/aaid-joi-d-19-00275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Osteonecrosis of the jaw is a possible oral complication resulting from antiresorptive therapies, such as bisphosphonates (Bfs). Although the etiology is not entirely clear, it has been shown to be dependent on several factors, with the traumatic stimulation caused by the placement of teeth implants indicated as one of the predisposing factors to this pathology. The indications and preventive methods for performing these procedures have been questioned, making it essential to determine the proper protocols. Thus, the present study aims to discuss the risks of the development of osteonecrosis in patients undergoing dental implant surgery who use Bfs as well as to discuss related local and systemic factors and possible methods for preventing this side effect. The study also aims to present a clinical case of an osteopenic patient who used Bfs and underwent rehabilitation through implants according to specific protocols, which resulted in successful treatment.
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Affiliation(s)
- Gustavo Zanna Ferreira
- Oral and Maxilofacial Surgery of Bauru School of Dentistry - FOB/USP and Oral Surgery, UniCesumar, Maringá Paraná, Brazil
| | | | | | - Gustavo Jacobucci Farah
- Oral and Maxillofacial Surgery, Department of Dentistry, State University of Maringá, Brazil
| | - Liogi Iwaki Filho
- Oral and Maxillofacial Surgery, Department of Dentistry, State University of Maringá, Brazil
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Rotman SG, Moriarty TF, Nottelet B, Grijpma DW, Eglin D, Guillaume O. Poly(Aspartic Acid) Functionalized Poly(ϵ-Caprolactone) Microspheres with Enhanced Hydroxyapatite Affinity as Bone Targeting Antibiotic Carriers. Pharmaceutics 2020; 12:pharmaceutics12090885. [PMID: 32957602 PMCID: PMC7559286 DOI: 10.3390/pharmaceutics12090885] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/08/2020] [Accepted: 09/14/2020] [Indexed: 12/11/2022] Open
Abstract
Bone infection is a feared complication for patients with surgically fixed bone fractures and local antibiotic delivery is important in prophylaxis and treatment of these infections. Recent studies indicated that Staphylococcus aureus can penetrate bone tissue through micron-sized canaliculi and evade systemic and currently available local antibiotic treatments. Targeting bacteria within the bone requires highly efficient delivery of antimicrobials to the infected bone tissue. In this work, a biodegradable microsphere carrier loaded with antibiotics and with specific affinity to bone mineral was developed. Two widely used antibiotics, i.e., Gentamicin-dioctyl sulfosuccinate (GM-AOT) and Ciprofloxacin (CF) were embedded in poly(ϵ-caprolactone) (PCL) microspheres fabricated by oil-in-water emulsion techniques with carboxylated poly(vinyl alcohol) (cPVA) as surfactant. The carboxylic acid groups present at the Poly(ϵ-caprolactone)/cPVA (PCL-cPVA) microsphere surface were functionalized with aspartic acid oligomers (ASP) granting bone targeting properties. We report on cPVA synthesis, microsphere formulation, and antibiotic loading of PCL/cPVA-ASP microspheres. Antibiotic loaded PCL/cPVA-ASP microspheres show sustained release of its antibiotic load and can inhibit bacterial growth in vitro for up to 6 days. PCL/cPVA-ASP microspheres show enhanced affinity to mineralized substrates compared to non-functionalized PCL/cPVA microspheres. These findings support further development of these bone targeting antibiotic carriers for potential treatment of persistent bone infections.
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Affiliation(s)
- Stijn G. Rotman
- AO Research Institute Davos, 7270 Davos Platz, Switzerland; (S.G.R.); (T.F.M.); (D.E.)
- Department of Biomaterials Science and Technology, Faculty of Science and Technology and Technical Medical Centre, University of Twente, 7522 NB Enschede, The Netherlands;
| | - Thomas F. Moriarty
- AO Research Institute Davos, 7270 Davos Platz, Switzerland; (S.G.R.); (T.F.M.); (D.E.)
| | - Benjamin Nottelet
- IBMM, University of Montpellier, CNRS, ENSCM, 34093 Montpellier, France;
| | - Dirk W. Grijpma
- Department of Biomaterials Science and Technology, Faculty of Science and Technology and Technical Medical Centre, University of Twente, 7522 NB Enschede, The Netherlands;
| | - David Eglin
- AO Research Institute Davos, 7270 Davos Platz, Switzerland; (S.G.R.); (T.F.M.); (D.E.)
- Department of Biomaterials Science and Technology, Faculty of Science and Technology and Technical Medical Centre, University of Twente, 7522 NB Enschede, The Netherlands;
| | - Olivier Guillaume
- Institute of Materials Science and Technology, TU Wien, 1060 Vienna, Austria
- Correspondence:
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Boda SK, Wang H, John JV, Reinhardt RA, Xie J. Dual Delivery of Alendronate and E7-BMP-2 Peptide via Calcium Chelation to Mineralized Nanofiber Fragments for Alveolar Bone Regeneration. ACS Biomater Sci Eng 2020; 6:2368-2375. [PMID: 33455340 DOI: 10.1021/acsbiomaterials.0c00145] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
The fixation and stability of dental implants is governed by the quality of the underlying alveolar bone. The current study investigates if the dual delivery of calcium chelating bone therapeutics from mineralized nanofiber fragments can help regenerate alveolar bone in vivo. Alendronate (ALN) or/and bone morphogenetic protein-2-mimicking peptide conjugated to a heptaglutamate moiety (E7-BMP-2) were incorporated onto mineralized nanofiber fragments of polylactide-co-glycolide-collagen-gelatin (PCG in 2:1:1 weight ratios) via calcium coupling/chelation. Two mg of the single-loaded (ALN) and coloaded (ALN + E7-BMP-2) mineralized nanofiber PCG grafts was filled into critical-sized (2 mm diameter × 2 mm depth) alveolar bone defects in rat maxillae and let heal for 4 weeks. X-ray microcomputed tomography analysis of the retrieved maxillae revealed significantly elevated new bone formation parameters for the ALN and ALN + E7-BMP-2 groups compared with the unfilled defect controls. However, no significant differences between the single and coloaded nanofiber grafts were noted. Furthermore, the histopathological analysis of the tissue sections divulged islands of new bone tissue in the ALN and ALN + E7-BMP-2 groups, whereas the control defect was covered with gingival tissue. Together, the presented strategy using mineralized nanofiber fragments in the sustained delivery of dual calcium chelating therapeutics could have potential applications in enhancing bone regeneration.
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Affiliation(s)
- Sunil Kumar Boda
- Department of Surgery-Transplant and Mary & Dick Holland Regenerative Medicine Program, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska 68198, United States.,Minnesota Dental Research Center for Biomaterials and Biomechanics (MDRCBB), Department of Restorative Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota 55455, United States
| | - Hongjun Wang
- Department of Surgery-Transplant and Mary & Dick Holland Regenerative Medicine Program, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska 68198, United States
| | - Johnson V John
- Department of Surgery-Transplant and Mary & Dick Holland Regenerative Medicine Program, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska 68198, United States
| | - Richard A Reinhardt
- Department of Surgical Specialties, College of Dentistry, University of Nebraska Medical Center, Omaha, Nebraska 68198, United States
| | - Jingwei Xie
- Department of Surgery-Transplant and Mary & Dick Holland Regenerative Medicine Program, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska 68198, United States
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Logan L, Haider S, Brauer C, Miettunen PM. Severe bilateral Legg-Calvé-Perthes resolved with pamidronate in combination with casts, physiotherapy and adductor tenotomy: a pictorial essay over 11 years. BMJ Case Rep 2019; 12:12/9/e229919. [PMID: 31537587 PMCID: PMC6754667 DOI: 10.1136/bcr-2019-229919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
We describe an 11-year prospective clinical and radiologic course of a 6-year-old boy with bilateral Legg-Calvé-Perthes disease, who was treated with intravenous pamidronate (IV-PAM). His baseline radiographs showed grade IV avascular necrosis/Catterall stage IV, and at worst he progressed to lateral pillar/Herring stage C bilaterally. His disease initially was extremely functionally limiting with expected poor outcome with eventual joint replacement. Because IV-PAM stops bone breakdown and allows for ongoing bone formation while revascularisation of bone occurs, we hypothesised that IV-PAM could act as an adjunct to traditional treatment to help heal the femoral heads. Our patient received nine once monthly doses of IV-PAM (1 mg/kg/dose) over 13 months, along with Petrie/broomstick casts and physiotherapy. Remarkably, over time, his femoral heads healed. Now, at 11-year follow-up, he has excellent functional and radiologic outcome with congruence between femoral head and acetabulum, no residual osteonecrosis and minimal loss of femoral head sphericity.
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Affiliation(s)
- Lindsey Logan
- Pediatrics, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
| | - Seemab Haider
- Diagnostic Radiology, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Carmen Brauer
- Surgery, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Paivi Maria Miettunen
- Pediatric Rheumatology, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.,Pediatrics, Alberta Children's Hospital, Calgary, Alberta, Canada
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Ihn HJ, Lee T, Lee D, Bae JS, Kim SH, Jang IH, Bae YC, Shin HI, Park EK. Inhibitory Effect of KP-A038 on Osteoclastogenesis and Inflammatory Bone Loss Is Associated With Downregulation of Blimp1. Front Pharmacol 2019; 10:367. [PMID: 31024321 PMCID: PMC6467953 DOI: 10.3389/fphar.2019.00367] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 03/25/2019] [Indexed: 01/25/2023] Open
Abstract
Excessive osteoclastic activity results in pathological bone resorptive diseases, such as osteoporosis, periodontitis, and rheumatoid arthritis. As imidazole-containing compounds possess extensive therapeutic potential for the management of diverse diseases, we synthesized a series of imidazole derivatives and investigated their effects on osteoclast differentiation and function. In the present study, we found that a novel imidazole derivative, KP-A038, suppressed receptor activator of nuclear factor-κB ligand (RANKL)-mediated osteoclastogenesis and bone-resorbing activity in vitro and attenuated lipopolysaccharide (LPS)-induced bone destruction in vivo. KP-A038 significantly inhibited the induction of nuclear factor of activated T-cells, cytoplasmic 1 (NFATc1) and the expression of its target genes, including tartrate-resistant acid phosphatase (Acp5), cathepsin K (Ctsk), dendritic cell-specific transmembrane protein (Dcstamp), and matrix metallopeptidase 9 (Mmp9). KP-A038 upregulated the expression of negative regulators of osteoclast differentiation, such as interferon regulatory factor-8 (Irf8) and B-cell lymphoma 6 (Bcl6). Consistently, KP-A038 downregulated the expression of B lymphocyte-induced maturation protein-1 (Blimp1 encoded by Prdm1), a repressor for Irf8 and Bcl6. Moreover, administration of KP-A038 reduced LPS-induced bone erosion by suppressing osteoclast formation in vivo. Thus, our findings suggest that KP-A038 may serve as an effective therapeutic agent for the treatment and/or prevention of bone loss in pathological bone diseases, including osteoporosis and periodontitis.
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Affiliation(s)
- Hye Jung Ihn
- Institute for Hard Tissue and Bio-tooth Regeneration, Kyungpook National University, Daegu, South Korea
| | - Taeho Lee
- College of Pharmacy, Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, South Korea
| | - Doohyun Lee
- College of Pharmacy, Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, South Korea
| | - Jong-Sup Bae
- College of Pharmacy, Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, South Korea
| | - Sang-Hyun Kim
- Department of Pharmacology, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Il Ho Jang
- Department of Oral Biochemistry and Molecular Biology, School of Dentistry, Pusan National University, Yangsan, South Korea
| | - Yong Chul Bae
- Department of Oral Anatomy and Neurobiology, School of Dentistry, Kyungpook National University, Daegu, South Korea
| | - Hong-In Shin
- Department of Oral Pathology and Regenerative Medicine, School of Dentistry, Institute for Hard Tissue and Bio-tooth Regeneration, Kyungpook National University, Daegu, South Korea
| | - Eui Kyun Park
- Department of Oral Pathology and Regenerative Medicine, School of Dentistry, Institute for Hard Tissue and Bio-tooth Regeneration, Kyungpook National University, Daegu, South Korea
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11
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The Beneficial Effect of Proanthocyanidins and Icariin on Biochemical Markers of Bone Turnover in Rats. Int J Mol Sci 2018; 19:ijms19092746. [PMID: 30217029 PMCID: PMC6163320 DOI: 10.3390/ijms19092746] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 09/10/2018] [Accepted: 09/10/2018] [Indexed: 01/06/2023] Open
Abstract
Nutrition is an important factor that influences bone metabolism, the endocrine and/or paracrine system, and bone-active mineral elements homeostasis. We studied antiosteoporotic effects of grape seed proanthocyanidins extract, icariin or alendronate (ALN) in retinoic acid-induced (13cRA) bone loss in rats. Proanthocyanidins and icariin have beneficial effects on bone health; they have improved the bone weight reduction, the length and the diameter of the bone, calcium, and phosphorus content in bone ash, bone mineral density (BMD), the biochemical markers of bone turnover and uterus atrophy induced by 13cRA. All results suggest that proanthocyanidins and icariin reverse osteoporosis in 13cRA rats by stimulating bone formation or regulating bone resorption by their antioxidative and estrogenic-like activity without toxic side-effects observed in ALN treatment.
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12
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What is the effect of anti-resorptive drugs (ARDs) on the development of medication-related osteonecrosis of the jaw (MRONJ) in osteoporosis patients: A systematic review. J Craniomaxillofac Surg 2017; 45:1493-1502. [DOI: 10.1016/j.jcms.2017.05.028] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 05/03/2017] [Accepted: 05/29/2017] [Indexed: 01/12/2023] Open
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Pan WL, Chen PL, Lin CY, Pan YC, Ju YR, Chan CP, Hsu RW. Strontium ranelate treatment in a postmenopausal woman with osteonecrosis of the jaw after long-term oral bisphosphonate administration: a case report. Clin Interv Aging 2017; 12:1089-1093. [PMID: 28744112 PMCID: PMC5513807 DOI: 10.2147/cia.s141753] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Bisphosphonates (BPs) suppress bone resorption and increase bone strength, thus reducing the risk of fracture. Oral BPs are widely used for the prevention and treatment of osteoporosis and osteopenia. Here, we describe the case of a postmenopausal woman who took oral alendronate for >3 years for osteoporosis. The patient presented at the clinic with sharp jaw pain and swelling on the left mandible 4 months after extraction of the third molar. Clinical examinations identified an inflamed mucosal opening with pus over an area of necrotic bone. Initial images of cone beam computed tomography revealed a sequestrum at the extracted socket. The condition did not improve after 1 week of antibiotic treatment; therefore, the alendronate treatment was terminated and the patient was prescribed strontium ranelate instead. The patient gradually recovered and, at the 2-year follow-up, the site of BP-related osteonecrosis of the jaw healed completely as determined by both clinical and cone beam computed tomography measures. The bone mineral densities in the femoral neck and lumbar spine improved after 1 year, and were maintained at the 3-year follow-up. The serum C-terminal cross-linking telopeptide values also gradually increased from the initial 130 pg/mL to 320 pg/mL at the 3-year follow-up. Taken together, this case supports the use of strontium ranelate as an alternative treatment for postmenopausal women who receive long-term oral BP treatments and are at risk for serious complications of BP-related osteonecrosis of the jaw.
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Affiliation(s)
- Whei-Lin Pan
- Department of Periodontics, Chang Gung Memorial Hospital, Taipei, Taiwan.,Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan
| | - Pi-Lun Chen
- Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan
| | - Cho-Ying Lin
- Department of Periodontics, Chang Gung Memorial Hospital, Taipei, Taiwan.,Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Chun Pan
- Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan
| | - Yuh-Ren Ju
- Department of Periodontics, Chang Gung Memorial Hospital, Taipei, Taiwan.,Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan
| | - Chiu-Po Chan
- Department of Periodontics, Chang Gung Memorial Hospital, Taipei, Taiwan.,Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan
| | - Robert Ww Hsu
- Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan.,Department of Orthopedics, Chang Gung Memorial Hospital, Taipei, Taiwan
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Renvert S, Persson GR. Treatment of periodontal disease in older adults. Periodontol 2000 2016; 72:108-19. [DOI: 10.1111/prd.12130] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2015] [Indexed: 12/20/2022]
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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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Shintani T, Hayashido Y, Mukasa H, Akagi E, Hoshino M, Ishida Y, Hamana T, Okamoto K, Kanda T, Koizumi K, Yoshioka Y, Tani R, Toratani S, Okamoto T. Comparison of the prognosis of bisphosphonate-related osteonecrosis of the jaw caused by oral and intravenous bisphosphonates. Int J Oral Maxillofac Surg 2015; 44:840-4. [PMID: 25861974 DOI: 10.1016/j.ijom.2015.03.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 03/13/2015] [Accepted: 03/23/2015] [Indexed: 01/03/2023]
Abstract
Bisphosphonates (BPs) have been used in medical practice for the treatment of osteoporosis, bone metastasis, and multiple myeloma. Although many studies have been published, the treatment and prognosis of bisphosphonate-related osteonecrosis of the jaw (BRONJ) remain unclear. This study included 59 patients with BRONJ: 29 had taken oral BPs and 30 had taken intravenous (IV) BPs. All received conservative treatments. When separated sequestra were seen, a sequestrectomy was performed. Segmental mandibular resection was performed when pathological fractures were diagnosed. The outcomes of treatments were compared between groups. For patients treated with oral rinses or mandibular resection, the number in whom clinical healing was observed did not differ between the oral BP and IV BP groups. With regard to sequestrectomy, 94% of patients in the oral BP group showed improvement with this treatment compared to 50% in the IV BP group. The number of patients in whom clinical healing of BRONJ was achieved was statistically better in the oral BP group than in the IV BP group after 6 months of treatment (P<0.001). The results showed that >90% of patients treated with oral BPs could be cured. However, 50% of patients treated with IV BPs did not show an improvement. Additional research is needed to further increase the therapeutic efficacy for the resolution of BRONJ.
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Affiliation(s)
- T Shintani
- Centre of Oral Clinical Examination, Hiroshima University Hospital, Hiroshima, Japan.
| | - Y Hayashido
- Oral Maxillofacial Surgery, Hiroshima University Hospital, Hiroshima, Japan
| | - H Mukasa
- Oral Maxillofacial Surgery, Hiroshima University Hospital, Hiroshima, Japan
| | - E Akagi
- Department of Molecular Oral Medicine and Maxillofacial Surgery, Division of Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - M Hoshino
- Department of Molecular Oral Medicine and Maxillofacial Surgery, Division of Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Y Ishida
- Department of Molecular Oral Medicine and Maxillofacial Surgery, Division of Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - T Hamana
- Department of Molecular Oral Medicine and Maxillofacial Surgery, Division of Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - K Okamoto
- Oral Maxillofacial Surgery, Hiroshima University Hospital, Hiroshima, Japan
| | - T Kanda
- Oral Maxillofacial Surgery, Hiroshima University Hospital, Hiroshima, Japan
| | - K Koizumi
- Department of Molecular Oral Medicine and Maxillofacial Surgery, Division of Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Y Yoshioka
- Department of Molecular Oral Medicine and Maxillofacial Surgery, Division of Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - R Tani
- Oral Maxillofacial Surgery, Hiroshima University Hospital, Hiroshima, Japan
| | - S Toratani
- Department of Molecular Oral Medicine and Maxillofacial Surgery, Division of Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - T Okamoto
- Department of Molecular Oral Medicine and Maxillofacial Surgery, Division of Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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