Bisphosphonate-related osteonecrosis of the jaw

Loading...

View/Download File

ThumbigereMath_umn_0130E_13693.pdf (11.17 MB)

Persistent link to this item

https://hdl.handle.net/11299/154579

Statistics

View Statistics

Journal Title

Journal ISSN

Volume Title

Title

Bisphosphonate-related osteonecrosis of the jaw

Authors

Thumbigere Math, Vivek

Published Date

2013-05

Publisher

Type

Thesis or Dissertation

Abstract

Bisphosphonates (BP), potent osteoclast inhibitors, play a key role in managing patients with osteoporosis, Paget’s disease, bone metastasis, and multiple myeloma. BP’s anti-resorptive activity substantially reduce fracture risk by 40%-70% in osteoporosis patients, and improve quality of life in cancer patients by preventing skeletal complications. However, prolonged BP use is associated with a significant dental complication termed “Bisphosphonate-Related Osteonecrosis of the Jaw (BRONJ)”. To date, the true incidence, etiology, and risk factors that contribute to BRONJ pathogenesis are unknown. In this dissertation, we assessed the frequency, etiology and risk factors that contribute to BRONJ pathogenesis. We noted that the BRONJ frequency in cancer patients is around 3.1%. Factors such as poor periodontal status, diabetes, smoking, prolonged duration of BP therapy, and higher numbers of BP infusions significantly increase the risk of developing BRONJ. In addition, long-term BP administration adversely affects jawbone mechanical properties that could result in increased microdamage accumulation within the jaw bones. Furthermore, using proteomic analysis we identified 200 salivary proteins that were differentially expressed in BRONJ subjects. A majority of the differentially expressed proteins were predicted to have a role in dermatological diseases, genetic disorders, immunological diseases, and inflammatory responses. Finally, analysis of serum samples revealed that VEGF levels are significantly suppressed in patients undergoing BP therapy. In summary, results from this dissertation provide insight into the pathogenesis of BRONJ development.

Keywords

Bisphosphonates

Cancer

Clinical study

Osteonecrosis of the jaw

Periodontitis

Proteom

Description

University of Minnesota Ph.D. dissertation. May 2013. Major: Oral Biology. Advisor: Rajaram Gopalakrishnan. 1 computer file (PDF); vii, 185 pages.

Related to

Replaces

License

Collections

Dissertations

Series/Report Number

Funding information

Isbn identifier

Doi identifier

Previously Published Citation

Suggested citation

Thumbigere Math, Vivek. (2013). Bisphosphonate-related osteonecrosis of the jaw. Retrieved from the University Digital Conservancy, https://hdl.handle.net/11299/154579.

Content distributed via the University Digital Conservancy may be subject to additional license and use restrictions applied by the depositor. By using these files, users agree to the Terms of Use. Materials in the UDC may contain content that is disturbing and/or harmful. For more information, please see our statement on harmful content in digital repositories.