Histomorphologic characteristics of bisphosphonate‐related osteonecrosis of the jaw. (23rd January 2014)

• Record Type: Journal Article
• Authors: Koerdt, Steffen; Dax, Svenja; Grimaldi, Hannes; Ristow, Oliver; Kuebler, Alexander C.; Reuther, Tobias
• Is Part Of: Journal of oral pathology & medicine. Volume 43:Number 6(2014:Jul.)
• Page Start: 448
• Page End: 453
• Publication Date: 2014-01-23
• Subjects: Dentistry -- Periodicals; Teeth -- Diseases -- Periodicals; 617
• DOI: 10.1111/jop.12156
• Languages: English
• ISSNs: 0904-2512

Abstract

<abstract abstract-type="main" id="jop12156-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jop12156-sec-0001" sec-type="section"> <title>Background</title> <p>Bisphosphonate‐related osteonecrosis of the jaw (BRONJ) is a known side effect of the therapy with bisphosphonates. No specific pathologic aspects or histological features are included in the most current definition. This study investigates characteristics of BRONJ with a special emphasis on histomorphologic aspects, evaluating the role of <italic>Actinomyces</italic> spp. as well as other disease‐promoting factors in a formal pathogenetic context.</p> </sec> <sec id="jop12156-sec-0002" sec-type="section"> <title>Methods</title> <p>We investigated 23 patients (14 female, nine male; mean age: 66 ± 11.8 years) who received bisphosphonates with a gender‐ /age‐matched control group. Tissue specimens were treated according to local standards and analyzed histologically.</p> </sec> <sec id="jop12156-sec-0003" sec-type="section"> <title>Results</title> <p>In 18 (78.3%) BRONJ cases, we found <italic>Actinomyces</italic> spp. colonies. Bone remodeling could be found in three specimens (13%). Eight specimens (34.8%) showed signs of epithelial proliferation. Analysis of dental treatment before the onset of BRONJ did not reveal significant differences (<italic>P </italic>><italic> </italic>0.20). In 10 patients (83%; <italic>P </italic>><italic> </italic>0.05) of the reported cases a relationship between dental treatment and the occurrence of a purulent bone necrosis could be observed. Statistically significant differences in thickness of trabeculae were detected between the two study groups (<italic>P </italic>=<italic> </italic>0.04).</p> </sec> <sec id="jop12156-sec-0004" sec-type="section"> <title>Conclusions</title> <p>This study demonstrates the important influence of the osteoblast–osteoclast balance in a histomorphologic analysis. Together with cofactors, which are able to trigger the onset of BRONJ, a new pathogenesis model was developed.</p> </sec> </abstract>