PURPOSE: The purpose of this study was to compare the mitigative effect of alendronate and risedronate on osteolysis in the mouse calvarian model by using titanium (Ti) and polymethylmethacrylate (PMMA) particles. MATERIALS AND METHODS: Experimental mice (male C57/BL6) are divided into three groups; control, Ti particle-treated and PMMA particle-treated group. Each Ti and PMMA particle-treated group was divided into three subgroups which received no bisphosphonates, which received alendronate, and which received risedronate. We measured number of osteoclast, area of osteolysis, bone and soft tissue thickness, ratio of bone and total tissue on mid-sagittal suture area (MSSA) and compared between two groups. RESULTS: Both alendronate and risedronate had significant inhibitory effect on Ti or PMMA particle-induced osteolysis in mouse calvarian model (p<0.05). Furthermore, bisphosphonates prevented formation of particleinduced osteolysis as RANK/Fc. Risedronate had better capability for preserving bone thickness in PMMA treated mice and also showed decreased soft tissue thickness in Ti treated mice than alendronate (p<0.05). CONCLUSION: Both alendronate and risedronate may be an effective agents on mitigation of Ti and PMMA particle-induced osteolysis. However, risedronate showed better structual bone preserving capacity than alendronate in particle-treated mouse calvariae.
Alendronate ; Animals ; Diphosphonates ; Etidronic Acid ; Mice ; Osteoclasts ; Osteolysis ; Polymethyl Methacrylate ; Sutures ; Titanium ; Risedronate Sodium

OBJECTIVE: To assess the efficacies of once-weekly bisphosphonates on bone mineral density (BMD) gains in Korean women aged 50 years or more. METHODS: We selected 166 patients who received: alendronate 70 mg (n=48), alendronate 70 mg + cholecalciferol 2,800 IU (n=31) or risedronate 35 mg (n=87) for one year. The baseline BMD and the % changes of BMD at one-year were compared among the three medication groups. RESULTS: The menopausal status and number of women with osteoporosis was not different among the three groups, but mean age of women was significantly lower in alendronate group. Baseline BMD at L1-4 and femur neck (FN) was similar, but baseline BMD at femur total (FT) was significantly lower in alendronate group. After one-year use, the median % changes of BMD at three sites were similar among the three groups; however, the median values were highest in alendronate + cholecalciferol group (L1-4: 4.48%, 6.74%, and 4.50%; FT: 2.09%, 3.70%, and 2.31%; FN: 3.05%, 3.79%, and 2.03%). CONCLUSION: Among three once-weekly bisphosphonates, BMD gains were highest after one-year use of alendronate+cholecalciferol, although statistically not significant.
Aged ; Alendronate ; Bone Density ; Cholecalciferol ; Diphosphonates ; Etidronic Acid ; Female ; Femur ; Femur Neck ; Humans ; Osteoporosis ; Risedronate Sodium

INTRODUCTION: The utility of the C-terminal cross-linking telopeptide test (CTX) as a method for staging Bisphosphonate-related osteonecrosis of the jaws (BRONJ) and its healing process was examined. MATERIALS AND METHODS: A total 19 patients who were diagnosed with BRONJ underwent a fasted morning CTX test, were enrolled in this study. The serum CTX values ranged from 50 to 630 pg/mL (mean 60). The risk assessment was rated according to the CTX values of the individual patient (minimal risk, > or =150 pg/mL, moderate, 100 to 150 pg/mL, high, < or =100 pg/mL). The BRONJ scores were then calculated according to the number of BRONJ lesions and their stage. The operation was done as soon as possible, regardless of BORNJ stage. RESULTS: The mean duration of bisphosphonate therapy was 4.1 years. Of the 19 patients, 15, 2 ans 2 received alendronate, risedronate and zoledronate, respecively. Of the 19 patients who underwent a sequestrectomy, saucerization and smoothing, 15 healed after the initial surgery, 1 patient healed after one more surgical procedure, 3 patients did not heal completely but showed improvement in symptoms. Therefore, 17 out of the 19 patients healed completely with complete mucosal coverage and the elimination of pain. The risk assessment using the CTX value and disease severity were not correlated (r=-0.264, P=0.275). In addition, the risk assessment using CTX value and healing after surgery were not correlated (r=-0.147, P=0.547). CONCLUSION: The serum CTX should be considered carefully by clinicians as part of overall management. Early surgical intervention is of benefit in the treatment of stage II BRONJ.
Alendronate ; Bisphosphonate-Associated Osteonecrosis of the Jaw ; Collagen Type I ; Diphosphonates ; Etidronic Acid ; Humans ; Imidazoles ; Jaw ; Jaw Diseases ; Osteonecrosis ; Peptides ; Risk Assessment ; Risedronate Sodium

OBJECTIVES: Bisphosphonates (BP) are widely used in medicine for inhibiting bone resorption; however bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a major side effect of BP. To date, there have been no specific reports on the incidence of BRONJ among Koreans. This study investigated the preliminary results from a nationwide survey of BRONJ in the Departments of Oral and Maxillofacial Surgery (OMFS) at individual training hospitals. MATERIALS AND METHODS: A total of 15 OMFS departments (10 from dental schools, 4 from medical schools, and 1 from a dental hospital) participated in a multi-centric survey. This study assessed every BRONJ case diagnosed between January 2010 and December 2010. The patient age and BP type were evaluated. RESULTS: A total of 254 BRONJ cases were collected. The majority of BRONJ cases were associated with oral BP therapy, while 21.8% of the cases were associated with intravenous administration. Alendronate was the drug most frequently related to BRONJ (59.2% of cases), followed by risedronate (14.3%) and zolendronate (17.0%). The average age of BRONJ patients was 70.0+/-10.1 years, with a range of 38-88 years of age. With the number of BP patients in Korea reported to be around 600,000 in 2008, the estimated incidence of BRONJ is at least 0.04% or 1 per 2,300 BP patients. CONCLUSION: The results suggest that the estimated incidence of BRONJ in Korea is higher than the incidence of other countries. Future prospective studies should be carried out to investigate the exact epidemiological characteristics of BRONJ in Korea.
Administration, Intravenous ; Alendronate ; Bisphosphonate-Associated Osteonecrosis of the Jaw ; Data Collection ; Diphosphonates ; Etidronic Acid ; Humans ; Incidence ; Jaw ; Korea ; Osteonecrosis ; Schools, Dental ; Schools, Medical ; Surgery, Oral ; Risedronate Sodium

OBJECTIVES: Bisphosphonates (BP) are widely used in medicine for inhibiting bone resorption; however bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a major side effect of BP. To date, there have been no specific reports on the incidence of BRONJ among Koreans. This study investigated the preliminary results from a nationwide survey of BRONJ in the Departments of Oral and Maxillofacial Surgery (OMFS) at individual training hospitals. MATERIALS AND METHODS: A total of 15 OMFS departments (10 from dental schools, 4 from medical schools, and 1 from a dental hospital) participated in a multi-centric survey. This study assessed every BRONJ case diagnosed between January 2010 and December 2010. The patient age and BP type were evaluated. RESULTS: A total of 254 BRONJ cases were collected. The majority of BRONJ cases were associated with oral BP therapy, while 21.8% of the cases were associated with intravenous administration. Alendronate was the drug most frequently related to BRONJ (59.2% of cases), followed by risedronate (14.3%) and zolendronate (17.0%). The average age of BRONJ patients was 70.0+/-10.1 years, with a range of 38-88 years of age. With the number of BP patients in Korea reported to be around 600,000 in 2008, the estimated incidence of BRONJ is at least 0.04% or 1 per 2,300 BP patients. CONCLUSION: The results suggest that the estimated incidence of BRONJ in Korea is higher than the incidence of other countries. Future prospective studies should be carried out to investigate the exact epidemiological characteristics of BRONJ in Korea.
Administration, Intravenous ; Alendronate ; Bisphosphonate-Associated Osteonecrosis of the Jaw ; Data Collection ; Diphosphonates ; Etidronic Acid ; Humans ; Incidence ; Jaw ; Korea ; Osteonecrosis ; Schools, Dental ; Schools, Medical ; Surgery, Oral ; Risedronate Sodium

Osteoporosis is the most common metabolic bone disease that results in an increased risk of fragility fractures. Bisphosphonates are commonly used in the treatment of osteoporosis. Concerns about their association with several possible adverse effects have been raised. Here, we experienced a rare case regarding a 63-year-old female patient who had localized amnesia related to once-monthly oral risedronate. A clear cause-and-effect relationship between the treatment of risedronate and this event has not been established and the mechanism behind the adverse effect is unknown. As clinical uses of bisphosphonates continue to expand, clinicians should be aware of the rare but potential adverse effects associated with bisphosphonates including neuropsychiatric problems.
Aged ; Amnesia ; Bone Diseases, Metabolic ; Diphosphonates ; Etidronic Acid ; Female ; Humans ; Osteoporosis ; Risedronate Sodium

Bisphosphonates are widely used in the management of metastatic bone disease and in the prevention of osteomalacia and osteoporosis. In particular, oral preparations are more commonly used for the prevension and treatment of osteoporosis. Bisphosphonate-related osteonecrosis of the jaws (BRONJ) has been well documented recently in relation to intravenous preparations of the drug. But, a few cases have been reported of oral bisphosphonate-associated osteonecrosis. We could not find any risedronate cases in the Korean medical literature. Here we report a case of BRONJ in a 91-year-old woman patient receiving an oral bisphosphonate (risedronate) for the treatment of osteoporosis.
Bisphosphonate-Associated Osteonecrosis of the Jaw ; Bone Diseases ; Diphosphonates ; Etidronic Acid ; Female ; Humans ; Jaw ; Osteomalacia ; Osteonecrosis ; Osteoporosis ; Risedronate Sodium

OBJECTIVE: To evaluate the potential effects of risedronate (RIS) which shows a higher anti-resorptive effect among bisphosphonates, after a posterolateral lumbar intertransverse process spinal fusion using both autograft and allograft in a rat model. METHODS: A totoal of 28 Sprague-Dawley rats were randomized into 2 study groups. A posterolateral lumbar intertransverse process spinal fusion was peformed using both autograft and allograft in a rat model. Group I (control) received 0.1 mL of steril saline (placebo) and Group II (treatment) received risedronate, equivalent to human dose (10 microgram/kg/week) for 10-weeks period. RESULTS: The fusion rates as determined by manual palpation were 69% in the group I and 46% in the group II (p = 0.251). According to radiographic score, the spinal segment was considered to be fused radiographically in 7 (53%) of the 13 controls and 9 (69%) of the 13 rats treated with RIS (p = 0.851). The mean histological scores were 5.69 +/- 0.13 and 3.84 +/- 0.43 for the control and treatment groups, respectively. There was a significant difference between the both groups (p = 0.001). The mean bone density of the fusion masses was 86.9 +/- 2.34 in the control group and 106.0 +/- 3.54 in the RIS treatment group. There was a statistical difference in mean bone densities of the fusion masses comparing the two groups (p = 0.001). CONCLUSION: In this study, risedronate appears to delay bone fusion in a rat model. This occurs as a result of uncoupling the balanced osteoclastic and osteoblastic activity inherent to bone healing. These findings suggest that a discontinuation of risedronate postoperatively during acute fusion period may be warranted.
Animals ; Bone Density ; Diphosphonates ; Etidronic Acid ; Humans ; Osteoblasts ; Osteoclasts ; Palpation ; Rats ; Rats, Sprague-Dawley ; Spinal Fusion ; Spine ; Transplantation, Homologous ; Risedronate Sodium

No abstract available.
Alendronate* ; Animals ; Diphosphonates ; Rats*

Osteoporosis, now defined as a disease characterized by a low bone mass and a microarchitectural deterioration of bone tissue leading to an enhanced bone fragility and fracture risk, is a major public health problem, affecting 200 million individuals worldwide. Optimal treatment and prevention of osteoporosis require modification of risk factors, particularly smoking cessation, adequate physical activity, and attention to diet, in addition to pharmacologic intervention. A number of pharmacologic options are now available to health care providers. The estrogens and raloxifene both prevent bone loss in postmenopausal women, and the estrogens probably also decrease the risk of first fracture. There is a good evidence that raloxifene prevents further fractures in postmenopausal women who already have had fractures and some evidence that estrogen does as well. Bisphosphonate alendronate prevents bone loss and reduces fractures in healthy and osteoporotic postmenopausal women, and in osteoporotic men as well. Risedronate is more potent and has fewer upper gastrointestinal side effects than alendronate, and reduces the incidence of fractures in osteoporotic women. An intermittent use of potent bisphosphonate zoledronate also increases bone mineral density and may become an alternative in the prevention and treatment of osteoporosis. Calcitonin increases bone mineral density in early postmenopausal women and men with idiopathic osteoporosis, and also reduces the risk of new fractures in osteoporotic women. All of the agents discussed above prevent bone resorption, whereas teriparatide increases bone formation and is effective in the treatment of osteoporotic women and men. Bisphosphonates are also effective in the treatment of secondary osteoporosis associated with the use of glucocorticoids to treat inflammation or prevent rejection after transplantation. New avenues for targeting osteoporosis will emerge as our knowledge of the regulatory mechanisms of bone remodelling increases, although issues of tissue specificity may remain to be solved.
Alendronate ; Bone and Bones ; Bone Density ; Bone Resorption ; Calcitonin ; Diet ; Diphosphonates ; Estrogens ; Female ; Glucocorticoids ; Health Personnel ; Humans ; Incidence ; Inflammation ; Male ; Motor Activity ; Organ Specificity ; Osteogenesis ; Osteoporosis ; Osteoporosis, Postmenopausal* ; Public Health ; Raloxifene Hydrochloride ; Risedronate Sodium ; Risk Factors ; Smoking Cessation ; Teriparatide