Serologic Bone Markers for Predicting Development of Osteonecrosis of the Jaw in Patients Receiving Bisphosphonates

Autor: Hannah Kanety, Ran Yahalom, Navot Givol, Shlomit Mesilaty-Gross, Towy Sorel Lazarovici, Noam Yarom, Iris Vered, Clara Pariente, Shlomo Taicher
Rok vydání: 2010
Předmět:
Adult
Male
medicine.medical_specialty
Side effect
medicine.medical_treatment
Oral Surgical Procedures
Administration
Oral
Parathyroid hormone
Risk Assessment
Gastroenterology
Collagen Type I
Young Adult
N-terminal telopeptide
Predictive Value of Tests
Internal medicine
Odds Ratio
Humans
Medicine
Prospective Studies
Prospective cohort study
Aged
Aged
80 and over
Chi-Square Distribution
Bone Density Conservation Agents
Diphosphonates
business.industry
Osteonecrosis
Odds ratio
Middle Aged
Bisphosphonate
Alkaline Phosphatase
medicine.disease
Surgery
Logistic Models
Otorhinolaryngology
Parathyroid Hormone
Predictive value of tests
Injections
Intravenous
Multivariate Analysis
Female
Oral Surgery
Peptides
business
Osteonecrosis of the jaw
Biomarkers
Jaw Diseases
hormones
hormone substitutes
and hormone antagonists
Zdroj: Journal of Oral and Maxillofacial Surgery. 68:2241-2247
ISSN: 0278-2391
DOI: 10.1016/j.joms.2010.05.043
Popis: Purpose Osteonecrosis of the jaw is a well-documented side effect of bisphosphonate (BP) use. Attempts have recently been made to predict the development of bisphosphonate-related osteonecrosis of the jaw (BRONJ). We prospectively investigated the predictive value of serum levels of C-terminal telopeptide of collagen I (CTX), bone-specific alkaline phosphatase, and parathyroid hormone for the development of BRONJ. Patients and Methods Data on the demographics, comorbidities, and BP treatment were collected from 78 patients scheduled for dentoalveolar surgery. Of the 78 patients, 51 had been treated with oral BPs and 27 had been treated with frequent intravenous infusions of BPs. Blood samples for CTX, bone-specific alkaline phosphatase, and parathyroid hormone measurements were taken preoperatively. Surgery was performed conservatively, and antibiotic medications were prescribed for 7 days. Results Of the 78 patients, 4 patients taking oral BPs (7.8%) and 14 receiving intravenous BPs (51.8%) developed BRONJ. A CTX level less than 150 pg/mL was significantly associated with BRONJ development, with an increased odds ratio of 5.268 (P = .004). The bone-specific alkaline phosphatase levels were significantly lower in patients taking oral BPs who developed BRONJ. The parathyroid hormone levels were similar in patients who did and did not develop BRONJ. Conclusion The incidence of BRONJ after oral surgery involving bone is greater among patients receiving frequent, intravenous infusions of BPs than among patients taking oral BPs. Although the measurement of serum levels of CTX is not a definitive predictor of the development of BRONJ, it might have an important role in the risk assessment before oral surgery.
Databáze: OpenAIRE
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