Chemical Effect of Bisphosphonates on the Bone Trabeculate of Jaws

Authors:Y. Guerrero-Sánchez, P. López-Jornet, F.J. Gómez García, M. Fernández-Martínez


The main goal of this paper is to throw some empirical evidence that patients who underwent bisphosphonate based treatments may experience changes in their trabecular bone densities that worsens whenever there are radiolucent injuries caused by invasive dental procedures. As such, we conducted a comparative study between two groups of subjects, namely, people who had general and dental health conditions, and patients with certain pathologies that were being treated with bisphosphonates and even had suffered osteonecrosis. We analysed a collection of CBCT images obtained routinely throughout the oral examination process. We use fractal dimension as an appropriate tool to detect changes in both trabecular structure and bone density. Our results highlighted significant differences between both groups. As a consequence, we postulate that bisphosphonate based treatments may provoke chemical reactions at a bone level whose changes could be quantified by routine radiological studies.

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Assaf, A.T., V. Amberg, R. Smeets, J. Wikner, H. Hanken, J. Semmusch, F. Ewald, A. Rashad and R.E. Friedrich. 2018. Evaluation of periodontal space widening in patients with antiresorptive drug-related osteonecrosis of the jaws (ARONJ) on panoramic radiographs. Anticancer Research, 38 (9): 5305-5314.

Drake, M.T., B.L. Clarke and S. Khosla. 2008. Bisphosphonates: Mechanism of action and role in clinical practice. Mayo Clinic Proceedings, 83 (9): 1032-1045.

Favia, G., A. Tempesta, L. Limongelli, V. Crincoli and E. Maiorano. 2018. Medication-related osteonecrosis of the jaw: Surgical or non-surgical treatment? Oral Diseases, 24 (1-2): 238-242.

Fernandez-Martinez, M., F.J. Gomez Garcia, Y. Guerrero Sanchez and P. Lopez Jornet. 2018. An intelligent system to study the fractal dimension of trabecular bones. Journal of Intelligent & Fuzzy Systems, 35 (4): 4533-4540.

Fleisch, H. 1998. Bisphosphonates: Mechanisms of action. Endocrine Reviews, 19 (1): 80-100.

Khan, A., A. Morrison, A. Cheung, W. Hashem and J. Compston. 2016. Osteonecrosis of the jaw (ONJ): Diagnosis and management in 2015. Osteoporosis International, 27 (3): 853-859.

Lo, J.C., F.S. O’Ryan, N.P. Gordon, J. Yang, R.L. Hui, D. Martin, M. Hutchinson, P.V. Lathon, G. Sanchez, P. Silver, M. Chandra, C.A. McCloskey, J.A. Staffa, M. Willy, J.V. Selby and A.S. Go. 2010. Prevalence of osteonecrosis of the jaw in patients with oral bisphosphonate exposure. Journal of Oral and Maxillofacial Surgery, 68 (2): 243-253.

Ruggiero, S.L., T.B. Dodson, L.A. Assael, R. Landesberg, R.E. Marx and B. Mehrotra. 2009. American association of oral and maxillofacial surgeons position paper on Bisphosphonate-Related osteonecrosis of the jaw-2009 update. Australian Endodontic Journal, 35 (3): 119-130.

Russell, R.G.G., N.B. Watts, F.H. Ebetino and M.J. Rogers. 2008. Mechanisms of action of bisphosphonates: Similarities and differences and their potential influence on clinical efficacy. Osteoporosis International, 19 (6): 733-759.

Soundia, A., D. Hadaya, N. Esfandi, R.S. de Molon, O. Bezouglaia, S.M. Dry, F.Q. Pirih, T. Aghaloo and S. Tetradis. 2016. Osteonecrosis of the jaws (ONJ) in mice after extraction of teeth with periradicular disease. Bone, 90: 133-141.


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