Bone Density Conservation Agents ; Diphosphonates ; Humans ; Osteonecrosis

Bone Density Conservation Agents ; Diphosphonates ; Humans ; Osteonecrosis

Bone Density Conservation Agents ; Dental Implants ; Diphosphonates ; Humans

Bone is continuously remodelled at many sites asynchronously throughout the skeleton, with bone formation and resorption balanced at these sites to retain bone structure. Negative balance resulting in bone loss and osteoporosis, with consequent fractures, has mainly been prevented or treated by anti-resorptive drugs that inhibit osteoclast formation and/or activity, with new prospects now of anabolic treatments that restore bone that has been lost. The anabolic effectiveness of parathyroid hormone has been established, and an exciting new prospect is presented of neutralising antibody against the osteocyte protein, sclerostin. The cellular actions of these two anabolic treatments differ, and the mechanisms will need to be kept in mind in devising their best use. On present evidence it seems likely that treatment with either of these anabolic agents will need to be followed by anti-resorptive treatment in order to maintain bone that has been restored. No matter how effective anabolic therapies for the skeleton become, it seems highly likely that there will be a continuing need for safe, effective anti-resorptive drugs.
Anabolic Agents ; Bone and Bones ; Bone Density Conservation Agents ; Osteoclasts ; Osteocytes ; Osteogenesis ; Osteoporosis ; Parathyroid Hormone ; Skeleton

OBJECTIVETo investigate the influence of systemic application of Alendronate sodium, a bone resorption inhibitor, on the osseointegration of implant-bone interface in estrogen-deficient rabbits through mechanical assessment.

METHODS27 five-month-old Japanese white female rabbits were randomly divided into three groups (9 rabbits each group). An ovariectomy group (OVX), an ovariectomy and Alendronate sodium group (ALN) and a shamed-operated group (S). 12 weeks after operation, implants were installed into bilateral distal femurs and proximal tibias in each group. Alendronate sodium was administrated by intraperitoneal injection in ALN group; meanwhile equivalent of normal saline was administrated by intraperitoneal injection in OVX group and S group. Bone mineral density was measured right after the implant operation and also in 4, 8, 12 weeks. Torque-out values were measured in 4, 8, 12 weeks after animal sacrifice.

RESULTSBone mineral density of tibias in ALN group was closed to S group and was significantly different from OVX group (P < 0.05) after 8 weeks. While after 12 weeks, the bone mineral density of tibias and femurs in ALN group was both closed to S group and was significantly different from OVX group (P < 0.05). The torque-out values of tibias in ALN group were closed to S group and were significantly different from OVX group (P < 0.05) after 8 weeks. After 12 weeks, the torque-out values of tibias and femurs in ALN group were both closed to S group and were significantly different from OVX group (P < 0.05).

CONCLUSIONSystemic application of Alendronate sodium in osteoporosis rabbits can improve the bone-implant osseointegration significantly.

Alendronate ; Animals ; Bone Density ; Bone Density Conservation Agents ; Bone and Bones ; Estrogens ; Female ; Osseointegration ; Osteoporosis ; Ovariectomy ; Prostheses and Implants ; Rabbits ; Torque

Paget's disease (PD) of bone is characterized by increase of bone resorption by atypical osteoclasts, followed by rapid new bone formation resulting in a disorganized mosaic bone. Although the pathophysiology is not fully understood, bisphosphonate, which is a potent anti-resorptive agent for treatment of osteoporosis, have been the most effective agents available for the treatment of PD. We report a case of PD of bone in a 49-year-old woman patient, who was treated with intravenous zoledronate.
Bone Density Conservation Agents ; Bone Resorption ; Diphosphonates ; Female ; Humans ; Middle Aged ; Osteitis Deformans ; Osteoclasts ; Osteogenesis ; Osteoporosis

The morbidity rate of medication-related osteonecrosis of the jaws (MRONJ) increased rapidly in recent years. Thusfar, the mechanism of MRONJ has no consensus. The possible mechanisms may include bone remodeling inhibition theory, angiogenesis inhibition theory, oral microorganism infection theory, immunosuppression theory, cytotoxicity-targeted oral epithelial cells, microcrack formation of maxillary or mandibular bone, and single nucleotide polymorphism. However, the efficacy of prevention and treatment based on a single mechanism is not ideal. Routine oral examination before MRONJ-related drug treatment, treatment of related dental diseases, and regular oral follow-up during drug treatment are of great significance for the prevention of MRONJ. During the treatment of MRONJ, the stage of MRONJ must be determined accurately, treatment must be standardized in accordance with the guidelines, and personalized adjustments must be made considering the specific conditions of patients. This review aimed to combine the latest research and guidelines for MRONJ and the experiences on the treatment of MRONJ in the Maxillofacial Surgery Department of West China Hospital of Stomatology, Sichuan University, and discuss the strategies to improve the clinical process.
Bisphosphonate-Associated Osteonecrosis of the Jaw/prevention & control* ; Bone Density Conservation Agents ; Bone Remodeling ; China ; Humans ; Jaw

BACKGROUND: Bisphosphonates are now well established as successful antiresorptive agents for the prevention and treatment of osteoporosis. We investigated the effect of cyclic intravenous treatment with an aminobisphosphonate, pamidronate in cases of primary osteoporosis. METHODS: Eighteen patients with primary osteoporosis (bone mineral density BMD t-score < -2.5) received four courses of pamidronate (30 mg with 500 mL normal saline over 2 hours every 3 months). The serum biochemical parameters and bone turnover markers were measured before each treatment. The bone pain score, medication score, and the side effects were also monitored. BMD and simple spine X-ray were performed before and 1 year after of treatment. RESULTS: BMD at the lumbar spine (L2-4) significantly increased from 0.798+/-0.110 g/cm2 to 0.860+/-0.107 g/cm2 after 1 year of treatment with pamidronate: by +8.3+/-9.4% of baseline. BMDs at the femoral neck, Ward s triangle and the trochanter also increased, but not significantly. Serum total alkaline phosphatase (p<0.05) and urine deoxypyridinoline/creatinine (p=0.069) decreased with treatment. Other bone turnover markers were unchanged. The bone pain score decreased significantly. None of the patients experienced a new fracture during treatment. The frequency of the side effects following the first infusion was 61.1% (a transient fever and myalgia with flu-like symptoms in 10 patients and mild phlebitis in 1 patient). However, only two patients complained of flu-like symptoms after second infusion, and no patient complained following the third infusion. CONCLUSION: Cyclic intravenous treatment of pamidronate every three months was effective in increasing BMD and in the decreasing bone turnover rate, and was relatively well tolerated in primary osteoporotic women.
Alkaline Phosphatase ; Bone Density ; Bone Density Conservation Agents ; Diphosphonates ; Female ; Femur ; Femur Neck ; Fever ; Humans ; Myalgia ; Osteoporosis ; Phlebitis ; Spine

BACKGROUND: Increased BMD after treatment means that the treatment regimen was effective to prevent fracture associated with osteoporosis. But changes of BMD reflected at least after 1 year. Now we use markers of bone turnover more easily, and they reflects bone metabolism faster than BMD within 3 4 months. Some data showed that changes of bone markers after 3 months could predict the changes of the BMD after 1 year. METHODS: 126 postmenopausal Korean women with osteoporosis were evaluated who visited Samsung Cheil hospital from Aug. 1997 to July 2000, with respect to markers of bone turnover and BMD at lumbar spine. Subjects were classified into 3 groups, HRT only group, HRT with alendronate group and HRT with calcitonin group. To evaluate the effectiveness of treatment regimen, we compared changes of markers after 3 months and changes of spinal BMD after 1 year treatment among 3 groups. And also evaluate the predictability of the changes of markers of bone turnover after 3 months about the changes of spinal BMD, multiple regression analysis were made. RESULTS: Our results showed those findings 1. Percent changes of markers of bone turnover decreased significantly compared with baseline(osteocalcin 30.4 53.4%, total alkaline phosphtase 26.7 20.0%, deoxypyridinoline 19.0 30.1%, and mean percent changes of markers among three groups showed no significant differences. 2. No significant relationships were noted between percent changes of spinal BMD and percent changes of markers of bone turnover. 3. Percent changes of BMD at lumbar spine were increased significantly after 1 year treatment(HRT only 5.6 3.6%, HRT with calcitonin 7.8 4.5%, HRT with alendronate 9.8% 4.7%). CONCLUSION: These results made conclusion that changes of markers of bone trunover after 3 months couldn't predict the changes of spinal BMD after 1 year treatment. But, HRT with antiresorptive agents may be effective in treating postmenopausal osteoporotic Korean women.
Alendronate ; Bone Density Conservation Agents ; Calcitonin ; Female ; Humans ; Metabolism ; Osteoporosis* ; Postmenopause ; Spine

OBJECTIVEThe study aims to analyze patients with bisphosphonate-related osteonecrosis of the jaw (BRONJ).

METHODSTwelve patients treated in the Department of Oral and Maxillofacial Surgery, the First Affiliated Hospital of Me-dical School, Zhejiang University from May 2013 to September 2015 were included. Patients' basic situation, medication, clinical symptoms, therapies, and effects were obtained and analyzed.

RESULTSThe treatment of nine patients focused on the mandible, whereas that of three patients was on the maxilla. The clinical symptoms appeared from 10 to 80 months, with an average of about (28.00±21.42) months. Nine patients had tooth extraction history. After operation (nine patients), eight were treated, one had stable in bone exposure and three patients received conservative treatment.

CONCLUSIONSIntravenous infusion of bisphosphonates can induce BRONJ. The mandible is commonly involved and tooth extraction is a big inducement. Treatments nowadays seek to relieve clinical symptoms, but prevention is more important.

Bisphosphonate-Associated Osteonecrosis of the Jaw ; Bone Density Conservation Agents ; Diphosphonates ; Humans ; Mandible ; Maxilla ; Tooth Extraction