scholarly journals Antiresorptive drug-related changes of the mandibular bone densitiy in medication-related osteonecrosis of the jaw patients

2019 ◽  
Vol 48 (8) ◽  
pp. 20190132 ◽  
Author(s):  
Nils Heim ◽  
Werner Götz ◽  
Franz-Josef Kramer ◽  
Anton Faron

Objectives: Medication-related osteonecrosis of the jaw (MRONJ) is a well known side-effect of anti-resorptive drugs. Changes in bone density might potentially constitute the development of ONJ. This study aimed to investigate, to which degree bisphosphonates (bp) and denosumab (db) induce changes in bone density that can be determined from routine diagnostic CT. Methods: CT scans of 101 patients were investigated. MRONJ was present in 61 patients (n = 26: db-treated; n = 35 bp-treated). 40 patients were included as a reference group. Bone density was measured at two distinct locations in the mandible (M1: anterior of the mental foramen; M2: retromolar), each on the contralateral side to the necrosis. Results: The bone density values measured at both locations were found to be significantly higher in the bp-group compared to the db-group (p = 0.027) and to the reference-group (p = 0.016). Almost no difference (p = 0.84) in bone density value was found between the db- and reference-groups.Investigating the effect of duration of treatment, none of the measured values showed significant differences in both locations of db- and bp-group. Conclusion: The findings from this study suggest that that bisphosphonates change the microarchitecture of the alveolar bone by being embedded in the mandible, which may subsequently lead to a bp-specific corticalization, and a decrease in vascularization of the lower jaw. This process may be distinctive for bp-treatment and seems to induce the congestion of cancellous bone rather rapidly after the first administrations. This effect could not be determined in denosumab-treated patients.

2021 ◽  
pp. 146531252110200
Author(s):  
Prasanna Arvind TR ◽  
Ravindra Kumar Jain

Objective: To quantitatively measure and report bone density of maxilla in the interradicular (alveolar and basal bone) and infrazygomatic crest (IZC) region in various growth patterns among Dravidian individuals. Design: This was a retrospective spiral computed tomography (CT) study. Setting: The study was conducted at the Department of Orthodontics, Saveetha Dental College and Hospital, Tamil Nadu, India. Methods: Sixty CT scans (24 men, 36 women; mean age = 25.3 years and 23.8 years, respectively) divided equally into three groups based on vertical facial proportions were included. Bone density measurements in Hounsfield units (HU) were performed using Philips and RadiAnt DICOM viewers. Buccal cortical, palatal cortical and cancellous bone regions were analysed in a Philips DICOM viewer and IZC region was analysed in a RadiAnt DICOM viewer. Statistical analysis with one-way ANOVA and post-hoc Tukey HSD test was done. Results: The hypodivergent group had a significantly higher bone density at the buccal cortex in posterior region ( P < 0.05) when compared to the normodivergent and hyperdivergent groups. Buccal basal bone was denser than buccal alveolar bone ( P < 0.05) in all three groups. In the IZC region, hypodivergent groups had significantly higher density values when compared to the normodivergent and hyperdivergent groups ( P < 0.05). Conclusion: The present study concluded that cancellous bone density in the interradicular regions was greatest in the anterior sites and was not influenced by growth pattern. Hypodivergent groups tend to have higher density in the posterior regions (buccal and palatal cortical bone) and at the IZC region compared to normodivergent and hyperdivergent groups.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Michele Kaplan ◽  
Zana Kalajzic ◽  
Thomas Choi ◽  
Imad Maleeh ◽  
Christopher L. Ricupero ◽  
...  

Abstract Background Orthodontic tooth movement (OTM) has been shown to induce osteocyte apoptosis in alveolar bone shortly after force application. However, how osteocyte apoptosis affects orthodontic tooth movement is unknown. The goal of this study was to assess the effect of inhibition of osteocyte apoptosis on osteoclastogenesis, changes in the alveolar bone density, and the magnitude of OTM using a bisphosphonate analog (IG9402), a drug that affects osteocyte and osteoblast apoptosis but does not affect osteoclasts. Material and methods Two sets of experiments were performed. Experiment 1 was used to specifically evaluate the effect of IG9402 on osteocyte apoptosis in the alveolar bone during 24 h of OTM. For this experiment, twelve mice were divided into two groups: group 1, saline administration + OTM24-h (n=6), and group 2, IG9402 administration + OTM24-h (n=6). The contralateral unloaded sides served as the control. The goal of experiment 2 was to evaluate the role of osteocyte apoptosis on OTM magnitude and osteoclastogenesis 10 days after OTM. Twenty mice were divided into 4 groups: group 1, saline administration without OTM (n=5); group 2, IG9402 administration without OTM (n=5); group 3, saline + OTM10-day (n=6); and group 4, IG9402 + OTM10-day (n=4). For both experiments, tooth movement was achieved using Ultra Light (25g) Sentalloy Closed Coil Springs attached between the first maxillary molar and the central incisor. Linear measurements of tooth movement and alveolar bone density (BVF) were assessed by MicroCT analysis. Cell death (or apoptosis) was assessed by terminal dUTP nick-end labeling (TUNEL) assay, while osteoclast and macrophage formation were assessed by tartrate-resistant acid phosphatase (TRAP) staining and F4/80+ immunostaining. Results We found that IG9402 significantly blocked osteocyte apoptosis in alveolar bone (AB) at 24 h of OTM. At 10 days, IG9402 prevented OTM-induced loss of alveolar bone density and changed the morphology and quality of osteoclasts and macrophages, but did not significantly affect the amount of tooth movement. Conclusion Our study demonstrates that osteocyte apoptosis may play a significant role in osteoclast and macrophage formation during OTM, but does not seem to play a role in the magnitude of orthodontic tooth movement.


Author(s):  
Marcin Stasiak ◽  
Anna Wojtaszek-Słomińska ◽  
Bogna Racka-Pilszak

Abstract Purpose The aims of this retrospective cross-sectional study were to measure and compare labial and palatal alveolar bone heights of maxillary central incisors in unilateral cleft lip and palate patients, following STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. Patients and methods The study group consisted of 21 patients with a mean age of 16 years. High-resolution cone-beam computed tomography was performed at least one year after secondary alveolar bone grafting. The experimental side was the cleft side and the contralateral side without congenital cleft was the control. Measurements were performed on incisors’ midsagittal cross-sections. The Wilcoxon signed-rank test was used for intergroup comparisons. Results The labial and palatal distances between alveolar bone crests and cementoenamel junctions were significantly greater on the cleft side than on the noncleft side. Mean differences were 0.75 and 1.41 mm, respectively. The prevalence of dehiscences at the cleft side maxillary central incisors was 52% on the labial surface and 43% on the palatal surface. In the controls, it was 19% and 14%, respectively. Conclusion The cleft-adjacent maxillary central incisors had more apically displaced alveolar bone crests on the labial and palatal sides of the roots than the controls. Higher prevalence of dehiscences was found on the cleft side. Bone margin differences predispose to gingival height differences of the central incisors. These differences could increase the demands of patients to obtain more esthetic treatment results with orthodontic extrusion and periodontal intervention on the cleft side.


2014 ◽  
Vol 52 (3) ◽  
pp. 233
Author(s):  
Eun-Jin Park ◽  
David-Hyungjin Kim ◽  
Eun-Suk Kim

2019 ◽  
Vol 20 (12) ◽  
pp. 1430-1435
Author(s):  
Venith J Pulikkottil ◽  
Lakshmi Lakshmanan ◽  
Sanju T Varughese ◽  
Pavithra U Shamanna ◽  
Neeraj Goyal ◽  
...  

2010 ◽  
Vol 43 (3) ◽  
pp. 141
Author(s):  
Sri Kentjananingsih

Background: Tooth extraction can cause alveolar resorption, and will reduce the denture retention. The process of bone resorption looks like the process of osteoporosis. Calcium and vitamin D supplementation is the rational therapy for minimizing bone loss. Miacalcic is the drug of choice for osteporotic patient. Purpose: This study is aimed to know whether the combination of miacalcic, calcium lactate, and vitamin C are effective in inhibiting post extracted alveolar resorption. Methods: Thirty three healthy postmenopausal women were chosen as samples and they were classified randomly into control group (without treatment), 1st experiment group (treatment was started 3 months post extraction), and 2nd experiment group (treatment was started at the 2nd day post extraction). The treatment was done by giving miacalcic nasal spray, calcium lactate 500 mg and vitamin C 100 mg tablets every morning in 10 days every month for 3 months. X-ray photo of the post extracted area were taken an hour, 3 months, and 6 months post-extraction. Results: After 6 month, there was significant difference in buccolingual thickness decreasing among three groups (p<0.05). The maximum mean difference of buccolingual thickness decreasing was 0.72 mm, between control and 2nd experiment groups. There was no significant difference about decreasing bone density among them (p>0.10). The maximum difference of the mean of density decreasing was 1,906 g/cm2/mm between control and 2nd experiment groups. The increasing density mostly occurred in the 2nd experiment group. Conclusion: The combination of miacalcic, calcium lactate, and vitamin C are effective for inhibiting alveolar resorption, although statistically there was no significant difference about bone density decreasing. The sooner this treatment is given the better result will be achieved.Latar belakang: Pencabutan gigi menyebabkan resorpsi tulang alveolaris, dan akan mengurangi retensi geligi tiruan. Proses resorpsi tulang alveol pada osteoporosis mirip dengan proses resorpsi tulang pada penyembuhan luka bekas pencabutan. Miacalcic adalah obat utama untuk penderita osteoporosis. Kalsium dan vitamin D merupakan terapi yang rasional untuk meminimalkan resorpsi tulang. tujuan: Membuktikan apakah kombinasi miacalcic, kalsium laktat, and vitamin C juga efektif menghambat resorpsi tulang alveol pasca pencabutan. Metode: Sampel 33 wanita postmenopause yang sehat, terbagi secara acak ke dalam kelompok kontrol (tanpa perlakuan), kelompok eksperimen 1 (perlakuan mulai 3 bulan pasca pencabutan) dan kelompok eksperimen 2 (perlakuan mulai hari kedua pasca pencabutan). Perlakuannya yaitu: pemberian miacalcic semprot hidung, tablet kalsium laktat 500 mg dan vitamin C 100 mg setiap pagi, 10 hari dalam sebulan, selama tiga bulan. Foto sinar-X dari regio pasca pencabutan dibuat satu jam, 3 bulan, dan 6 bulan pasca pencabutan. Hasil: 6 bulan pasca-cabut, ada beda bermakna perihal selisih tebal bukolingual tulang alveol antar ketiga kelompok (p<0,05). Rerata penurunan ketebalan ini maksimal sebanyak 0.72 mm, antara kelompok kontrol dan kelompok eksperimen 2. Penurunan kepadatan tulang antar ketiga kelompok tidak bermakna (p>0,10). Beda maksimum rerata kepadatan tulang antara kelompok kontrol dan kelompok eksperimen 2 sebesar 1,906 g/cm2/mm. Peningkatan kepadatan terbanyak dialami anggota kelompok eksperimen 2. Kesimpulan: Kombinasi miacalcic, kalsium laktat, vitamin C efektif menghambat resorpsi tulang alveolaris, walaupun secara statistik beda penurunan kepadatan tidak bermakna. Makin awal pemberian perlakuan, hasilnya akan lebih baik.


2007 ◽  
Vol 10 (1) ◽  
pp. 25-33 ◽  
Author(s):  
Stefan Goemaere ◽  
Dirk Vanderschueren ◽  
Jean-Marc Kaufman ◽  
Jean-Yves Reginster ◽  
Yves Boutsen ◽  
...  

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