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

Abstract

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.

The effects of icariin on wound healing of extraction sites with administration of zoledronic and dexamethasone: A rat model study

“…Inflammation was rarely found and no bacterial colony was noted in bone marrow in the current study possibly because DX has the anti‐inflammatory effect. Besides, promoted osteoclast and decreased OCN were detected after the use of ZA and DX, which may explain the osteolytic bone loss that has been reported and decreased BMD and BV/TV. And the results of raised CTX‐1 and TRACP 5b concentration confirmed the promoted osteoclast activity.…”

Association between periodontitis and medication‐related osteonecrosis of the jaw: A systematic review and meta‐analysis

“…The included studies are outlined in Table . Out of the 12 relevant studies, 7 were case‐control studies, and 5 were cohort studies . All of the studies had been published since 2008.…”

“…All of the studies had been published since 2008. Six of the studies were based in Europe (two in the Germany, three in Italy, one in Greece and one in Spain), two in United States of America, one in Brazil, one in Japan and one in Australia …”

“…This assessment may have been hindered by the limited information available for some studies. Overall, 10 had a low risk of bias, and 2 had a medium risk …”

“…After applying exclusion criteria, and after eliminating duplicate results, only 32 remained for full-text screening (kappa = 0.82). Of these, 12 [26][27][28][29][30][31][32][33][34][35][36][37] were deemed appropriate for qualitative synthesis and only 9 26,29,30,[32][33][34][35][36][37] were considered appropriate for meta-analysis ( Figure 1).…”