Effect of different doses of zoledronic acid in establishing of bisphosphonate-related osteonecrosis

Silva, Paulo Goberlânio de Barros; Ferreira, Antonio Ernando Carlos; Teófilo, Carolina Rodrigues; Barbosa, Maritza Cavalcante; Júnior, Roberto César Pereira Lima; Sousa, Fabrício Bitú; Mota, Mário Rogério Lima; Ribeiro, Ronaldo de Albuquerque; Alves, Ana Paula Negreiros Nunes

doi:10.1016/j.archoralbio.2015.05.015

Cited by 56 publications

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References 41 publications

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“…27,31,34,36 In agreement with our results, zoledronic acid-induced leukocytosis has been reported in an in vivo study. 38 Moreover, considering that BRONJ is an infectious process, it could itself explain the occurrence of leukocytosis. 39 A local triggering factor was identified in 96.3% of our patients with BRONJ, where tooth extraction was the most prevalent one, as already reported.…”

Section: Discussionmentioning

confidence: 99%

Interrelationship of clinical, radiographic and haematological features in patients under bisphosphonate therapy

Koth

Figueiredo

Salum

et al. 2017

Dentomaxillofacial Radiology

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Objectives: To analyze the clinical, radiographic and haematological aspects of patients under bisphosphonate therapy. Methods: A retrospective study was conducted where the records of patients taking bisphosphonates were analyzed considering the occurrence of bisphosphonate-related osteonecrosis of the jaw (BRONJ). Evaluation included panoramic and periapical radiographies, haematological examinations and clinical features. Radiographies were analyzed determining the presence or absence of bone sclerosis, osteolysis, persisting alveolar socket, narrowing of the mandibular canal, widening of the periodontal ligament space, periradicular radiolucency, sequestrum and thickening of the lamina dura. Laboratory tests consisted of complete blood count, fasting serum glucose, erythrocyte sedimentation rate (ESR) and serum levels of calcium, phosphorus, alkaline phosphatase, parathormone (PTH) and C-terminal telopeptide of collagen I (CTX). Results: Alkaline phosphatase and ESR were significantly higher in the BRONJ group, whereas fasting serum glucose, CTX, PTH, calcium and phosphorus did not significantly differ. BRONJ showed association with smoking, tooth extraction, anaemia and leukocytosis. On radiographic analysis, persisting alveolar socket, osteolysis, bone sclerosis and narrowing of the mandibular canal were significantly more prevalent in the BRONJ group. Thickening of the lamina dura, periapical radiolucencies, widening of the periodontal ligament space and sequestrum did not significantly differ between the groups. Conclusions: BRONJ is a multifactorial disease with high morbidity, which requires experimental studies to clarify the role of the reported risk factors and clinical radiographic signs to improve its diagnosis.

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Section: Discussionmentioning

confidence: 99%

Interrelationship of clinical, radiographic and haematological features in patients under bisphosphonate therapy

Koth

Figueiredo

Salum

et al. 2017

Dentomaxillofacial Radiology

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“…Silva et al10 reported that the incidence of BRONJ increased when more than a certain level of zoledronate was administered. In a study conducted by Manzano-Moreno et al11, as the duration of bisphosphonate administration increased, the differentiation of the osteoblast-like cells decreased, and cell death and necrosis occurred.…”

Section: Introductionmentioning

confidence: 99%

Relationship between disease stage and renal function in bisphosphonate-related osteonecrosis of the jaw

Kim

Park

Choi

et al. 2017

J Korean Assoc Oral Maxillofac Surg

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ObjectivesBisphosphonate is the primary cause of bisphosphonate-related osteonecrosis of the jaw (BRONJ). Bisphosphonates are eliminated from the human body by the kidneys. It is anticipated that bisphosphonate levels in the body will increase if the kidney is in a weak state or if there is systemic disease that affects kidney function. The aim of this study was to analyze the relevance of renal function in the severity of BRONJ.Materials and MethodsNinety-three patients diagnosed with BRONJ in Pusan National University Dental Hospital from January 2012 to December 2014 were included in this study. All patients underwent a clinical exam, radiographs, and serologic lab test, including urine analysis. The patient's medical history was also taken, including the type of bisphosphonate drug, the duration of administration and drug holiday, route of administration, and other systemic diseases. In accordance with the guidelines of the 2009 position paper of American Association of Oral and Maxillofacial Surgeons, the BRONJ stage was divided into 4 groups, from stage 0 to 3, according to the severity of disease. IBM SPSS Statistics version 21.0 (IBM Co., USA) was used to perform regression analysis with a 0.05% significance level.ResultsBRONJ stage and renal factor (estimated glomerular filtration rate) showed a moderate statistically significant correlation. In the group with higher BRONJ stage, the creatinine level was higher, but the increase was not statistically significant. Other factors showed no significant correlation with BRONJ stage. There was a high statistically significant correlation between BRONJ stage and ‘responder group’ and ‘non-responder group,’ but there was no significant difference with the ‘worsened group.’ In addition, the age of the patients was a relative factor with BRONJ stage.ConclusionWith older age and lower renal function, BRONJ is more severe, and there may be a decrease in patient response to treatment.

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“…Then, a dose–response curve was calculated with three values: 0.20 mg kg −1 , five times greater (1.00 mg kg −1 ) and five times less (0.04 mg kg −1 ; Silva et al . ).…”

Section: Methodsmentioning

confidence: 97%

Immune cell profile of dental pulp tissue treated with zoledronic acid

et al. 2017

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Effect of different doses of zoledronic acid in establishing of bisphosphonate-related osteonecrosis

Cited by 56 publications

References 41 publications

Interrelationship of clinical, radiographic and haematological features in patients under bisphosphonate therapy

Interrelationship of clinical, radiographic and haematological features in patients under bisphosphonate therapy

Relationship between disease stage and renal function in bisphosphonate-related osteonecrosis of the jaw

Immune cell profile of dental pulp tissue treated with zoledronic acid

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