Theoretical physical chemical studies of the cause of fluoride-induced osteomalacia.
In this study we investigated the possibility of the formation of a calcium fluoride surface film on the new bone matrix in patients undergoing fluoride treatment for osteoporosis. This calcium fluoride film could interfere with the normal mineralization process and lead to hyperosteoidosis (osteomalacia), a well-documented complication seen in fluoride-treated patients. During treatment, fluoride circulating in the blood and extracellular fluid of patients, could interact with the components of the serum, but particularly calcium and magnesium ions. The interrelationships among serum components in the presence of fluoride ion may result, at thermodynamic equilibrium, in deposition on the apatitic bone surface of phases such as calcium fluoride, fluorapatite, or fluorhydroxyapatite. Differences in the phase deposited among patients could result in differences in response to fluoride treatment. A computer program based on equilibrium thermodynamic data was utilized to study the physicochemical calcium, fluoride, and phosphate interrelationships in serum. In all the computer calculations, fluorhydroxyapatite (FHAP), alone or in combination with hydroxyapatite (HAP), was determined to be the thermodynamically stable precipitating surface phase. These data strongly suggest that calcium fluoride surface film is not the reason for the delay of mineralization of fluoride-stimulated new bone. Based on these calculations, we now advance the hypothesis that the effect of fluoride to cause osteomalacia is due to an effect on osteoblasts and also on osteocytes.(ABSTRACT TRUNCATED AT 250 WORDS)
Wiers
B H
BH
Miami Valley Laboratories, Procter and Gamble Co., Cincinnati, OH 45239-8707.
Francis
M D
MD
Hovancik
K
K
Ritchie
C K
CK
Baylink
D J
DJ
D001706:Biopsy; D001842:Bone and Bones / Q000473:pathology; D055598:Chemical Phenomena; D002627:Chemistry, Physical; D006801:Humans; D008956:Models, Chemical; D010018:Osteomalacia / Q000139:chemically induced*; D012969:Sodium Fluoride / Q000009:adverse effects* / Q000378:metabolism; D012984:Software; D013499:Surface Properties
D012969:Sodium Fluoride