title: Jaw osteonecrosis in patients treated with bisphosphonates: an ultrastructural study.
abstract: Osteonecrosis of the jaw is a severe bone disorder traditionally associated with periodontal disease, local malignancy, chemotherapy, glucocorticoid therapy, or trauma. Recently a growing number of publications reported the occurrence of osteonecrosis of the jaw in patients undergoing treatment with bisphosphonates. The mechanism by which bisphosphonates might contribute to the development of osteonecrosis of the jaw is far from being fully elucidated. Suppression of bone turnover, infection, tissue hypoxia and cellular toxicity were proposed as possible mechanisms by which bisphosphonates may exert adverse effects on bone metabolism. Here, we studied 25 consecutive patients treated with bisphosphonates for osteoporosis or tumoral pathologies. We provide good evidence of hyperactive osteoclastic bone resorption and suggest a direct cytotoxic effect of bisphosphonates on bone tissue through induction of osteocyte cell death. We also demonstrate that bisphosphonates only have limited adverse effects on bone vascular network.
authors.affiliation: Department of Ecology, University of Calabria, Arcavacata di Rende, Cosenza, Italy. idaperrotta@yahoo.it
authors.forename: I
authors.initials: I
authors.lastname: Perrotta
authors.forename: M G
authors.initials: MG
authors.lastname: Cristofaro
authors.forename: M
authors.initials: M
authors.lastname: Amantea
authors.forename: E
authors.initials: E
authors.lastname: Russo
authors.forename: S
authors.initials: S
authors.lastname: De Fazio
authors.forename: V
authors.initials: V
authors.lastname: Zuccalà
authors.forename: F
authors.initials: F
authors.lastname: Conforti
authors.forename: A
authors.initials: A
authors.lastname: Amorosi
authors.forename: G
authors.initials: G
authors.lastname: Donato
authors.forename: S
authors.initials: S
authors.lastname: Tripepi
authors.forename: M
authors.initials: M
authors.lastname: Giudice
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050071:Bone Density Conservation Agents / Q000009:adverse effects*; D001862:Bone Resorption / Q000188:drug therapy / Q000473:pathology; D004164:Diphosphonates / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007568:Jaw / Q000473:pathology*; D007571:Jaw Diseases / Q000139:chemically induced* / Q000473:pathology; D008297:Male; D008855:Microscopy, Electron, Scanning; D046529:Microscopy, Electron, Transmission; D008875:Middle Aged; D010010:Osteoclasts / Q000187:drug effects / Q000648:ultrastructure; D010020:Osteonecrosis / Q000139:chemically induced* / Q000473:pathology
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates