In:
Journal of Oral Pathology & Medicine, Wiley, Vol. 43, No. 6 ( 2014-07), p. 448-453
Kurzfassung:
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 A ctinomyces spp. as well as other disease‐promoting factors in a formal pathogenetic context. Methods 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. Results In 18 (78.3%) BRONJ cases, we found A ctinomyces 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 ( P 〉 0.20). In 10 patients (83%; P 〉 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 ( P = 0.04). Conclusions 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.
Materialart:
Online-Ressource
ISSN:
0904-2512
,
1600-0714
DOI:
10.1111/jop.2014.43.issue-6
Sprache:
Englisch
Verlag:
Wiley
Publikationsdatum:
2014
ZDB Id:
2026385-5
