Retrospective study of two biochemical markers for the risk assessment of oral bisphosphonate-related osteonecrosis of the jaws: can they be utilized as risk markers?

Kwon, Yong‐Dae; Ohe, Joo-Young; Kim, Deog-Yoon; Chung, DongJin; Park, Yong-Duk

doi:10.1111/j.1600-0501.2010.01965.x

Cited by 47 publications

(35 citation statements)

References 27 publications

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“…The histopathological specimens obtained from patients that have been affected by BRONJ appears to be consistent among studies [37,[154][155][156][157][158][159][160].…”

Section: Histology Of Bronjsupporting

confidence: 82%

“…Serum CTX is used in most oral bisphosphonate research and is a standard test for bone turnover [43,160].…”

Section: Bone Markersmentioning

confidence: 99%

“…Serum CTX is known to be subject to circadian variation and can also be affected by fasting [63]. Marx's use of the s-CTX to determine treatment protocols for patients being treated with oral bisphosphonates has received much criticism and the reliability of this test has been called into question [132,160] due to Marxs' failure to use a control group.…”

Section: Bone Markersmentioning

confidence: 99%

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“Bisphosphonates: Possible Modes of Action and Implications for Dental Implant Treatment. A Review of the Literature”

Ballantyne¹

2016

J Gen Pract

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“…The histopathological specimens obtained from patients that have been affected by BRONJ appears to be consistent among studies [37,[154][155][156][157][158][159][160].…”

Section: Histology Of Bronjsupporting

confidence: 82%

“…Serum CTX is used in most oral bisphosphonate research and is a standard test for bone turnover [43,160].…”

Section: Bone Markersmentioning

confidence: 99%

Section: Bone Markersmentioning

confidence: 99%

See 1 more Smart Citation

“Bisphosphonates: Possible Modes of Action and Implications for Dental Implant Treatment. A Review of the Literature”

Ballantyne¹

2016

J Gen Pract

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“…8 patients with BP-ONJ in the maxilla, 9 patients with BP-ONJ in the mandible, 2 patients with BP-ONJ in mandible and maxilla Jacobsen 2013 [18]RS CS14 patients with established BP-ONJ due to dental implantsOsteoporosis 5Breast cancer 5multiple myeloma 2prostate cancer 1lung cancer 1A I P ZAverage BP duration3.2 osteoporosis; 4.2 malignant disease14n.s.n.s.n.s.n.s.The authors state that implants placed posterior are of higher risk than implants in the anterior region.4 patients had implants in the posterior maxilla, 5 in the posterior mandible and 3 in the anterior mandible.In one patient implants were removed and new implants were inserted at the same site with continuing problems.In one patient a sinus lift was performed Famili 2011 [25]RS CS211 female patients with 592 dental implants, out of those 120 older than 50 y with 347 implants out of those 22 with BP and 75 implantsOsteoporosis 21 osteoarthritis 1A I<1 - > 5075n.s.At least 20n.s.All female patients with implant therapy from 01/2008 – 06/2010 were analyzed. Among those 22 with oral BP therapy.One implant did not heal and was successfully replaced Kwon 2011 [21]RS CCS but not focused on dental implants→ RS CSBiochemical bone markers were evaluated in 23 osteoporosis patients with established BP-ONJOsteoporosisA2.5 - 52n.s.n.s.n.s.n.s.It is not clear, when and how the 23 BP-ONJ patients were recruited. 61 BP control patients.2 patients developed BP-ONJ due to implantsCTX was evaluated at the time of ONJ diagnosis and not at the time point of any possible BP-ONJ triggering intervention. Koka 2010 [22]RS CS370 patients over 50 years old with 818 implants.…”

Section: Resultsmentioning

confidence: 99%

Dental implants in patients treated with antiresorptive medication – a systematic literature review

et al. 2016

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ObjectiveBisphosphonate-associated osteonecrosis of the jaws (BP-ONJ) is triggered by inflammatory processes. Typical trigger factors are periodontal disease, denture pressure sores, and surgical interventions such as tooth extractions. Unfortunately there is only little data on how to proceed with implant therapy in patients with bisphosphonate treatment. This topic is not addressed in the German guidelines on medication-associated osteonecrosis. Therefore a systematic literature review was performed.MethodsThe PICO design was used: (Patients) For which subclientel of patients with antiresorptive therapy (intervention) do dental implants have a benefit (control) compared to forgoing dental implants (outcome) in regards to oral rehabilitation and quality of life without having a substantial risk of BP-ONJ development? A PubMed search was performed including all studies dealing with this topic. Case reports and studies with less than 5 cases were excluded.ResultsThere is only very little data available, mostly retrospective case series. 50 articles were analyzed in detail. BP-ONJ can be triggered by dental implants and by dentures in patients with benign and malignant primary diseases. In most studies, analyzing osteoporosis patients only, no cases of BP-ONJ were observed in patients with implant therapy in the time span observed. There are no studies about implant therapy in patients with malignant diseases. Many case series analyzing the trigger factors for BP-ONJ describe dentures as one of the main causes. Perioperative antimicrobial prophylaxis has a benefit in the prevention of BP-ONJ development.ConclusionSuccessful implant therapy is possible in patients receiving antiresorptive therapy. The possibility of osteonecrosis development needs to be explained to the patient. An individual risk assessment is essential, taking the primary disease with the medication and further wound-healing-compromising diseases and medications into account. If possible, bone augmentations should be avoided, and a perioperative antimicrobiological prophylaxis is strongly recommended in these patients.

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“…10,11,36 In a prospective study investigating the predictive value of BALP, CTX, and parathyroid hormone in BRONJ development, Lazarovici et al noted that among patients receiving intravenous BP therapy for cancer management, the mean BALP level did not differ significantly between BRONJ and non-BRONJ patients (22.32 versus 20.78 pg/mL, p=>0.05). 10 A large retrospective study from Memorial Sloan-Kettering Cancer Center found no trends in BALP and NTX values in bone metastasis patients before the diagnosis of ONJ.…”

Section: Discussionmentioning

confidence: 99%

Serum Markers of Bone Turnover and Angiogenesis in Patients With Bisphosphonate-Related Osteonecrosis of the Jaw After Discontinuation of Long-Term Intravenous Bisphosphonate Therapy

Thumbigere‐Math

Michalowicz

Hughes

et al. 2016

Journal of Oral and Maxillofacial Surgery

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Purpose To analyze serum markers of bone turnover, angiogenesis, endocrine function, and inflammation in bisphosphonate-related osteonecrosis of the jaw (BRONJ) patients who discontinued long-term intravenous bisphosphonate (BP) therapy. Patients and Methods Serum samples were obtained from 25 BRONJ patients who had discontinued long-term intravenous BP therapy for an average of 11.4±8.7 months and 48 non-BRONJ controls who continued receiving intravenous BP therapy. Samples were analyzed for total alkaline phosphatase (ALP), bone-specific alkaline phosphatase (BALP), osteocalcin (OCN), C-telopeptide (CTX), vascular-endothelial growth factor (VEGF), triiodothyronine (T3), thyroxine (T4), thyroid-stimulating hormone (TSH), 25-hydroxyvitamin D, and C-reactive protein (CRP). Results The mean number of BP infusions was significantly higher in BRONJ subjects compared with controls (38.4±26.3 infusions vs 18.8±7.2, p<0.0001); however, the duration of BP therapy was not significantly different between the groups (p=0.23). Overall, there were no significant differences in any of the markers between BRONJ subjects and controls (all p values ≥ 0.16). In a subgroup analysis that matched BRONJ subjects and controls according to mean age and BP infusions (BRONJ, n=10 and controls, n=48), log10VEGF (2.9±0.4 vs 2.4±0.4, p=<0.001) and CRP (34±26 vs 13±8, p=<0.01) levels were significantly higher in BRONJ subjects compared with controls. Within BRONJ subjects, none of the serum markers were correlated with duration of BP discontinuation. Conclusions Bone turnover and endocrine markers in BRONJ subjects who discontinue long-term intravenous BP therapy are similar to non-BRONJ controls receiving intravenous BP therapy. However, angiogenesis and inflammation markers are higher in BRONJ subjects who discontinue long-term intravenous BP therapy. The prolonged skeletal half-life of BPs may suppress bone turnover markers in BRONJ subjects for several years following discontinuation of intravenous BP therapy, suggesting an extended effect on bone homeostasis.

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Retrospective study of two biochemical markers for the risk assessment of oral bisphosphonate-related osteonecrosis of the jaws: can they be utilized as risk markers?

Cited by 47 publications

References 27 publications

“Bisphosphonates: Possible Modes of Action and Implications for Dental Implant Treatment. A Review of the Literature”

“Bisphosphonates: Possible Modes of Action and Implications for Dental Implant Treatment. A Review of the Literature”

Dental implants in patients treated with antiresorptive medication – a systematic literature review

Serum Markers of Bone Turnover and Angiogenesis in Patients With Bisphosphonate-Related Osteonecrosis of the Jaw After Discontinuation of Long-Term Intravenous Bisphosphonate Therapy

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