Goknur Topaloglu1, Osman Taha Koseoglu2, Cigdem Karaca2, Kemal Kosemehmetoglu3. 1. Department of Oral and Maxillofacial Surgery, (Head: Prof. Osman Taha Koseoglu), Faculty of Dentistry, Hacettepe University, Ankara, Turkey. Electronic address: gknrtopaloglu@hotmail.com. 2. Department of Oral and Maxillofacial Surgery, (Head: Prof. Osman Taha Koseoglu), Faculty of Dentistry, Hacettepe University, Ankara, Turkey. 3. Department of Pathology, School of Medicine, Hacettepe University, Ankara, Turkey.
Abstract
OBJECTIVE: The pathogenesis of medication-related osteonecrosis of jaw (MRONJ) is poorly understood. The aim of this prospective study was to determine the effect of chronic dental inflammation on the development of Stage 0 MRONJ based on histopathological findings. METHODS: The study involved patients with a history of bisphosphonate use and an indication for tooth extraction. Before surgery, C-terminal telopeptide test (CTX) values were collected from all patients. All tooth extractions were performed according to a determined protocol. To detect whether any medication-related osteonecrotic changes were present in the non-exposed bone, biopsy samples were taken from the alveolar bone. RESULTS: A total of 50 patients were included in the study (39 women and 11 men). The patients were mean age of 57.4 ± 12.1 years. In total, 74 teeth were extracted (29 maxillary and 45 mandibular). Histologic examination of three patients (6%) revealed Stage 0 MRONJ. Postoperatively, the complete mucosal healing success rate was 96%. MRONJ risk was not significantly correlated with low CTX value (p = 0.285). CONCLUSIONS: Chronic inflammation may contribute to Stage 0 MRONJ; however, its role may not be sufficient alone for its development. Application of a predetermined protocol for dentoalveolar processes will help to prevent MRONJ development.
OBJECTIVE: The pathogenesis of medication-related osteonecrosis of jaw (MRONJ) is poorly understood. The aim of this prospective study was to determine the effect of chronic dental inflammation on the development of Stage 0 MRONJ based on histopathological findings. METHODS: The study involved patients with a history of bisphosphonate use and an indication for tooth extraction. Before surgery, C-terminal telopeptide test (CTX) values were collected from all patients. All tooth extractions were performed according to a determined protocol. To detect whether any medication-related osteonecrotic changes were present in the non-exposed bone, biopsy samples were taken from the alveolar bone. RESULTS: A total of 50 patients were included in the study (39 women and 11 men). The patients were mean age of 57.4 ± 12.1 years. In total, 74 teeth were extracted (29 maxillary and 45 mandibular). Histologic examination of three patients (6%) revealed Stage 0 MRONJ. Postoperatively, the complete mucosal healing success rate was 96%. MRONJ risk was not significantly correlated with low CTX value (p = 0.285). CONCLUSIONS:Chronic inflammation may contribute to Stage 0 MRONJ; however, its role may not be sufficient alone for its development. Application of a predetermined protocol for dentoalveolar processes will help to prevent MRONJ development.
Authors: Akishige Hokugo; Keiichi Kanayama; Shuting Sun; Kenzo Morinaga; Yujie Sun; QingQing Wu; Hodaka Sasaki; Hiroko Okawa; Courtney Evans; Frank H Ebetino; Mark W Lundy; Keivan Sadrerafi; Charles E McKenna; Ichiro Nishimura Journal: Bone Date: 2019-03-26 Impact factor: 4.398