title: Demineralization removes residual alendronate in allograft bone procured from donors with a history of bisphosphonate use.
abstract: BACKGROUND
  Bisphosphonate-associated osteonecrosis (BON) of the jaw is a growing concern in the dental community, but the possible presence of residual bisphosphonates in demineralized allograft bone from bisphosphonate-using tissue donors and the clinical implications of using such bone are unclear. The objectives of this study are to determine whether alendronate remained in demineralized bone matrix (DBM) procured from donors with a documented history of oral bisphosphonate use and to examine whether the demineralization process removes alendronate from allograft bone.
  
  
  METHODS
  A gas chromatography?mass spectrometry method was developed and validated to quantify residual alendronate in allograft bone. Alendronate levels in DBM procured from tissue donors with a history of oral bisphosphonate use were compared to alendronate levels in DBM procured from donors without a history of bisphosphonate use. In addition, mineralized and demineralized bone was soaked in alendronate at concentrations of 0.002, 2.0, and 2,000 ng/mg bone and analyzed to examine the effect of the demineralization process.
  
  
  RESULTS
  Residual alendronate was not detected in the DBM from either group, nor was it detected in any of the DBM samples soaked in alendronate solutions. Soaked mineralized bone contained measureable alendronate, but the substance was removed by demineralization.
  
  
  CONCLUSIONS
  The demineralization process effectively removed residual alendronate from allograft bone. These results may relieve anxieties regarding the use of DBM in dental patients because it is unlikely to trigger BON of the jaw.
authors: Community Blood Center/Community Tissue Services, Dayton, OH 45402-2715, USA. shunter@cbccts.org
authors: Shawn A
authors: SA
authors: Hunter
authors: Robert
authors: R
authors: Orheim
authors: Mia
authors: M
authors: Sazon
authors: Helen
authors: H
authors: Newman
authors: Judith E
authors: JE
authors: Woll
authors: Michael
authors: M
authors: Bergevin
mesh_terms: D000368:Aged; D019386:Alendronate / Q000009:adverse effects / Q000032:analysis*; D018775:Bone Demineralization Technique / Q000379:methods; D050071:Bone Density Conservation Agents / Q000009:adverse effects / Q000032:analysis*; D001857:Bone Matrix / Q000737:chemistry* / Q000637:transplantation; D016025:Bone Transplantation / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010020:Osteonecrosis / Q000139:chemically induced / Q000517:prevention & control*; D014019:Tissue Donors
chemical_list: D050071:Bone Density Conservation Agents; D019386:Alendronate