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Depression: 21st Century Solutions + The Dark Side of Wheat

Abstract Title:

Bisphosphonate-related osteonecrosis of the jaw: is pH the missing part in the pathogenesis puzzle?

Abstract Source:

J Oral Maxillofac Surg. 2010 May;68(5):1158-61. PMID: 20138420

Abstract Author(s):

Sven Otto, Sigurd Hafner, Gerson Mast, Thomas Tischer, Elias Volkmer, Matthias Schieker, Stephen R Stürzenbaum, Emmo von Tresckow, Andreas Kolk, Michael Ehrenfeld, Christoph Pautke

Article Affiliation:

Department of Oral and Maxillofacial Surgery, Ludwig Maximilians University of Munich, Munich, Germany. Sven.Otto@med.uni-muenchen.de

Abstract:

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a side effect of bisphosphonate therapy, primarily diagnosed in patients with cancer and metastatic bone disease and receiving intravenous administrations of nitrogen-containing bisphosphonates. If diagnosis or treatment is delayed, BRONJ can develop to a severe and devastating disease. Numerous studies have focused on BRONJ, with possible pathomechanisms identified to be oversuppression of bone turnover, ischemia due to antiangiogenetic effects, local infections, or soft tissue toxicity. However, the precise pathogenesis largely remains elusive and questions of paramount importance await to be answered, namely 1) Why is only the jaw bone affected? 2) Why and how do the derivatives differ in their potency to induce a BRONJ? and 3) Why and when is BRONJ manifested? The present perspective reflects on existing theories and introduces the hypothesis that local tissue acidosis in the jaw bone offers a conclusive pathogenesis model and may prove to be the missing link in BRONJ.

Study Type : Human Study

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Sayer Ji
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Depression: 21st Century Solutions + The Dark Side of Wheat

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