Tooth alterations in areas of bisphosphonate-induced osteonecrosis

Author(s)

Moraes, Paulo de Camargo ^[1] ; Barcellos Silva, Carolina Amalia ^[1] ; Soares, Andresa Borges ^[1] ; Passador-Santos, Fabricio ^[1] ; Pizzigatti Correa, Maria Elvira ^[2] ; de Araujo, Ney Soares ^[1] ; de Araujo, Vera Cavalcanti ^[1]

Affiliation

^[1] Sao Leopoldo Mand Inst & Res Ctr, Dept Oral Pathol, BR-13045610 Campinas, SP - Brazil

^[2] Univ Estadual Campinas, Hematol & Blood Transfus Ctr, Campinas, SP - Brazil

• Document type: Journal article
• Source: CLINICAL ORAL INVESTIGATIONS; v. 19, n. 2, p. 489-495, MAR 2015.
• Web of Science Citations: 5

Abstract

Osteonecrosis of the jaw is a potential side effect when using bisphosphonates. Most studies on the effects of bisphosphonates on teeth have been conducted in vitro or in animal models of tooth development. Therefore, the aim of this study was to describe alterations found in human teeth extracted from areas of bisphosphonate-induced osteonecrosis. Using a retrospective study design, 16 teeth from 13 patients were extracted from areas of bisphosphonate-induced osteonecrosis during surgical debridement. The specimens were decalcified and embedded in paraffin. A series of 5-mu m sections were prepared, stained with hematoxylin and eosin (H\&E) and observed under a light microscope. The majority of the patients were female (53.85 %), with a mean age of 60.23 +/- 13.18 years. Zoledronate (IV) was the most common bisphosphonate used (92.3 %), over a mean period of 2 years. The commonest alteration observed was hypercementosis (87.5 %), followed by pulpar necrosis (81.25 %), pulp stones attached to the dentine and loose pulp stones in the pulp chamber and root canals in addition to linear calcifications (68.75 %), dentinoid/osteoid material formation (18.75 %), and dental ankylosis (6.25 %). Patients undergoing bisphosphonate therapy present diverse tooth alterations, which should be closely monitored by clinicians to prevent complications. It is paramount that the teeth involved in oral lesions are always examined. Attention should be drawn to the need to establish preventive measures, in terms of dental treatment, for patients prior to starting bisphosphonate therapy. (AU)

• FAPESP's process: 11/21157-0 - Study of apoptosis regulatory proteins expression in an in vitro model of in situ like malignant neoplastic areas.
• Grantee: Carolina Amália Barcellos Silva
• Support type: Scholarships in Brazil - Doctorate