title: Diabetes mellitus and corticotherapy as risk factors for alendronate-related osteonecrosis of the jaws: a study in Wistar rats.
abstract: BACKGROUND
  The purpose of this study was to investigate the influence of diabetes and corticotherapy on the development of osteonecrosis of the jaws associated with sodium alendronate.
  
  
  METHODS
  Rats were allocated into 4 groups of 11 animals each, representing different treatments: (1) alendronate; (2) alendronate and corticotherapy; (3) alendronate and diabetes; and (4) control. Tooth extractions were performed in all animals, and histological analysis was performed by hematoxylin and eosin staining and immunohistochemistry using anti-bone morphogenetic protein (BMP)-4 and anti-matrix metalloproteinase (MMP)-13 antibodies.
  
  
  RESULTS
  On hematoxylin and eosin analysis, proportions of inflammatory infiltrate, microbial colonies, and osteonecrosis were significantly greater in the diabetes group. BMP-4 expression in connective tissue was higher in the corticosteroid group than the alendronate group. There were no significant differences between the other groups. MMP-13 expression did not differ between the groups analyzed.
  
  
  CONCLUSIONS
  Diabetes but not corticotherapy is associated with jaw osteonecrosis in rats undergoing alendronate therapy and subjected to tooth extractions.
authors: Dental College, Pontifical Catholic University of Rio Grande do Sul, Hospital São Lucas, Porto Alegre, RS, Brazil.
authors: Soraya A
authors: SA
authors: Berti-Couto
authors: Ana Carolina U
authors: AC
authors: Vasconcelos
authors: Júlia E
authors: JE
authors: Iglesias
authors: Maria Antonia Z
authors: MA
authors: Figueiredo
authors: Fernanda G
authors: FG
authors: Salum
authors: Karen
authors: K
authors: Cherubini
mesh_terms: D000305:Adrenal Cortex Hormones / Q000009:adverse effects* / Q000494:pharmacology; D019386:Alendronate / Q000009:adverse effects* / Q000494:pharmacology; D000818:Animals; D001707:Biopsy, Needle; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000209:etiology* / Q000473:pathology*; D050071:Bone Density Conservation Agents / Q000009:adverse effects / Q000494:pharmacology; D003921:Diabetes Mellitus, Experimental / Q000150:complications* / Q000473:pathology; D004195:Disease Models, Animal; D007150:Immunohistochemistry; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar; D012016:Reference Values; D012307:Risk Factors
chemical_list: D000305:Adrenal Cortex Hormones; D050071:Bone Density Conservation Agents; D019386:Alendronate
keywords: alendronate; bisphosphonate-related osteonecrosis of the jaw (BRONJ); bisphosphonates; corticotherapy; diabetes mellitus