[Morphological analysis of bone dynamics and metabolic bone disease. Does bisphosphonate treatment cause severely suppressed bone turnover (SSBT) ?].

Bisphosphonates are anti-resorptive drug and increase both bone strength and toughness. However, their long term treatment oversuppresses bone turnover and promotes advanced glycation end-products in bone tissue, resulting in low bone quality. These conditions are called "severely suppressed bone turnover (SSBT) " , and can cause "atypical" , low-impact fractures of the femoral subtrochanteric or shaft. It is evident that bisphosphonates prevent fracture risk in vertebral body or femoral neck and improve quality of life in patients with osteoporosis, but clinicians, especially bone specialists, have to keep the associations between bisphosphonate use and SSBT in mind. Rational approach to atypical femoral subtrochanteric÷shaft fractures should be determined in near future.