Diabetes Microvascular Disease and the Risk for bisphosphonate-related Osteonecrosis of the Jaw: A Single Center Study

Molcho, Shira; Peer, Avivit; Berg, Tal; Futerman, Boris; Khamaisi, Mogher

doi:10.1210/jc.2013-2434

Cited by 26 publications

(24 citation statements)

References 12 publications

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“…The presence of DM and the incidence of smoking were researched in previous studies as risk factors for the development of BRONJ (23,28). In the present study, the association between DM and smoking and the risk of BRONJ was assessed in the BRONJ and control groups, and the results were not significantly different (P=0.09 and P=0.08, respectively).…”

Section: Discussionmentioning

confidence: 57%

Effect of the cumulative dose of zoledronic acid on the pathogenesis of osteonecrosis of the jaws

et al. 2015

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Abstract. Bisphosphonate-related osteonecrosis of the jaws (BRONJ) is a severe bone disease for which the pathogenetic mechanisms and risk factors are not fully understood. The present study evaluated the data of 652 patients with bone metastasis that had undergone treatment with biphosphonates. Subsequently, 24 patients with BRONJ and 20 control patients without BRONJ that were treated with zoledronic acid were enrolled. It was found that BRONJ occurred in 3.6% of patients. The mean age and the administration of dental treatment were found to be significantly associated with BRONJ development (P=0.049 and P=0.013, respectively). The cumulative dose median in the BRONJ group was found to be significantly higher compared with the cumulative dose average in the control group (P=0.037). In addition, at the time of BRONJ development, improvement in the disease was determined to be better in the BRONJ group than in the control group (P=0.031). The present study determined that age, the existence of dental extraction and the cumulative dose of zoledronate were all important risk factors in BRONJ development.

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Section: Discussionmentioning

confidence: 57%

Effect of the cumulative dose of zoledronic acid on the pathogenesis of osteonecrosis of the jaws

et al. 2015

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“…Our recent findings (Molcho et al 2013) of higher rates of microvascular complications among MRONJ patients with DM or IFG than among those without DM or IFG suggest an increased probability of developing MRONJ among individuals with microvascular complications of DM.…”

Section: Angiogenesis Vascularization and Endothelial Damagementioning

confidence: 74%

Diabetes as a Risk Factor for Medication-Related Osteonecrosis of the Jaw

Peer¹,

Khamaisi²

2014

J Dent Res

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Medication-related osteonecrosis of the jaw (MRONJ) is a severe devastating complication for which the exact pathogenesis is not completely understood. Multiple systemic and local factors may contribute to the development of MRONJ. A growing body of evidence supports diabetes mellitus (DM) as an important risk factor for this complication; however, the exact mechanism by which DM may promote MRONJ has yet to be determined. The current review elucidates the role of DM in the pathogenesis of MRONJ and the mechanisms by which DM may increase the risk for MRONJ. Factors related to DM pathogenesis and treatment may contribute to poor bone quality through multiple damaged pathways, including microvascular ischemia, endothelial cell dysfunction, reduced remodeling of bone, and increased apoptosis of osteoblasts and osteocytes. In addition, DM induces changes in immune cell function and promotes inflammation. This increases the risk for chronic infection in the settings of cancer and its treatment, as well as antiresorptive medication exposure, thus raising the risk of developing MRONJ. A genetic predisposition for MRONJ, coupled with CYP 450 gene alterations, has been suggested to affect the degradation of medications for DM such as thiazolidinediones and may further increase the risk for MRONJ.

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“…To date, most studies of prognostic factors have been conducted on systemic diseases (such as diabetes mellitus and malignant tumors), BP dosage, route of administration, duration of discontinuation, and bone response factors (such as C-terminal telopeptide and bone-specific alkaline phosphatase)10131415. However, few studies have been conducted on serologic factors commonly performed in surgical patients.…”

Section: Introductionmentioning

confidence: 99%

Prognostic factors for outcome of surgical treatment in medication-related osteonecrosis of the jaw

Shin

Kim

2018

J Korean Assoc Oral Maxillofac Surg

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ObjectivesThe number of patients with medication-related osteonecrosis of the jaw (MRONJ) is increasing, but treatment remains controversial. Published papers and systematic reviews have suggested that surgical treatment is effective in patients with MRONJ. The purpose of this study was to determine whether preoperative University of Connecticut Osteonecrosis Numerical Scale (UCONNS), other serologic biomarkers, and size of necrosis are prognostic factors for outcome of surgical treatment in MRONJ.Materials and MethodsFrom January 2008 to December 2016, 65 patients diagnosed with MRONJ at the Department of Oral and Maxillofacial Surgery in College of Dentistry, Dankook University who required hospitalization and surgical treatment were investigated. Patient information, systemic factors, and UCONNS were investigated. In addition, several serologic values were examined through blood tests one week before surgery. The size of osteolysis was measured by panoramic view and cone-beam computed tomography in all patients. With this information, multivariate logistic regression analysis with backward elimination was used to examine factors affecting postoperative outcome.ResultsIn multivariate logistic analysis, higher UCONNS, higher C-reactive protein (CRP), larger size of osteolysis, and lower serum alkaline phosphate were associated with higher incidence of incomplete recovery after operation. This shows that UCONNS, CRP, serum alkaline phosphate, and size of osteolysis were statistically significant as factors for predicting postoperative prognosis.ConclusionThis study demonstrated that CRP, UCONNS, serum alkaline phosphate, and size of osteolysis were statistically significant factors in predicting the prognosis of surgical outcome of MRONJ. Among these factors, UCONNS can predict the prognosis of MRONJ surgery as a scale that includes various influencing factors, and UCONNS should be used first as a predictor. More aggressive surgical treatment and more definite surgical margins are needed when the prognosis is poor.

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Diabetes Microvascular Disease and the Risk for bisphosphonate-related Osteonecrosis of the Jaw: A Single Center Study

Abstract: This retrospective study suggests an association between diabetes, perhaps mediated through microvascular complications, and the development of BRONJ.

Cited by 26 publications

References 12 publications

Effect of the cumulative dose of zoledronic acid on the pathogenesis of osteonecrosis of the jaws

Effect of the cumulative dose of zoledronic acid on the pathogenesis of osteonecrosis of the jaws

Diabetes as a Risk Factor for Medication-Related Osteonecrosis of the Jaw

Prognostic factors for outcome of surgical treatment in medication-related osteonecrosis of the jaw

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