Impact of Soft Tissue Pathophysiology in the Development and Maintenance of Bisphosphonate-Related Osteonecrosis of the Jaw (BRONJ)

Since the first description of bisphosphonate-related osteonecrosis of the jaw (BRONJ), numerous research groups have focused on possible pathological mechanisms including the suppression of the bone turnover of the jaw, antiangiogenic effects and soft tissue toxicity. In our review we focused on su...

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Main Authors: Thomas Ziebart, Frank Halling, Paul Heymann, Andreas Neff, Sebastian Blatt, Junho Jung, Andreas Pabst, Leonardo Righesso, Christian Walter
Format: Article
Language:English
Published: MDPI AG 2016-10-01
Series:Dentistry Journal
Subjects:
Online Access:http://www.mdpi.com/2304-6767/4/4/36
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spelling doaj-0f9d95c663064ba5868f81471ef7eba02020-11-25T00:35:00ZengMDPI AGDentistry Journal2304-67672016-10-01443610.3390/dj4040036dj4040036Impact of Soft Tissue Pathophysiology in the Development and Maintenance of Bisphosphonate-Related Osteonecrosis of the Jaw (BRONJ)Thomas Ziebart0Frank Halling1Paul Heymann2Andreas Neff3Sebastian Blatt4Junho Jung5Andreas Pabst6Leonardo Righesso7Christian Walter8Department of Maxillofacial Surgery, University Hospital, Baldingerstraße, D-35043 Marburg, GermanyDepartment of Maxillofacial Surgery, University Hospital, Baldingerstraße, D-35043 Marburg, GermanyDepartment of Maxillofacial Surgery, University Hospital, Baldingerstraße, D-35043 Marburg, GermanyDepartment of Maxillofacial Surgery, University Hospital, Baldingerstraße, D-35043 Marburg, GermanyDepartment of Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, D-55131 Mainz, GermanyDepartment of Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, D-55131 Mainz, GermanyDepartment of Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, D-55131 Mainz, GermanyDepartment of Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, D-55131 Mainz, GermanyDepartment of Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, D-55131 Mainz, GermanySince the first description of bisphosphonate-related osteonecrosis of the jaw (BRONJ), numerous research groups have focused on possible pathological mechanisms including the suppression of the bone turnover of the jaw, antiangiogenic effects and soft tissue toxicity. In our review we focused on summarizing the role of the soft tissues in the development and progression of BRONJ. The biological behavior of fibroblasts can be significantly influenced by bisphosphonates (BP) such as a concentration dependent reduction of cell viability. High concentrations of BP can induce apoptosis and necrosis of the cells. Comparable effects could be detected for keratinocytes. Compared to non-nitrogen containing bisphosphonates, nitrogen-containing BP have worse effects on cell biology by blocking the mevalonate pathway. Further, the cell architecture and expression levels of several genes and proteins are significantly disturbed by BP. These inhibitory effects of BP are in accordance with BP-related reduced angiogenesis and neovascularization and could underline the hypothesis that inhibition of fibroblasts and keratinocytes results in delayed wound healing and can induce and trigger BRONJ.http://www.mdpi.com/2304-6767/4/4/36gingivabisphosphonatesoft tissuefibroblastskeratinocytesbisphosphonate associated osteonecrosis of the jaws
collection DOAJ
language English
format Article
sources DOAJ
author Thomas Ziebart
Frank Halling
Paul Heymann
Andreas Neff
Sebastian Blatt
Junho Jung
Andreas Pabst
Leonardo Righesso
Christian Walter
spellingShingle Thomas Ziebart
Frank Halling
Paul Heymann
Andreas Neff
Sebastian Blatt
Junho Jung
Andreas Pabst
Leonardo Righesso
Christian Walter
Impact of Soft Tissue Pathophysiology in the Development and Maintenance of Bisphosphonate-Related Osteonecrosis of the Jaw (BRONJ)
Dentistry Journal
gingiva
bisphosphonate
soft tissue
fibroblasts
keratinocytes
bisphosphonate associated osteonecrosis of the jaws
author_facet Thomas Ziebart
Frank Halling
Paul Heymann
Andreas Neff
Sebastian Blatt
Junho Jung
Andreas Pabst
Leonardo Righesso
Christian Walter
author_sort Thomas Ziebart
title Impact of Soft Tissue Pathophysiology in the Development and Maintenance of Bisphosphonate-Related Osteonecrosis of the Jaw (BRONJ)
title_short Impact of Soft Tissue Pathophysiology in the Development and Maintenance of Bisphosphonate-Related Osteonecrosis of the Jaw (BRONJ)
title_full Impact of Soft Tissue Pathophysiology in the Development and Maintenance of Bisphosphonate-Related Osteonecrosis of the Jaw (BRONJ)
title_fullStr Impact of Soft Tissue Pathophysiology in the Development and Maintenance of Bisphosphonate-Related Osteonecrosis of the Jaw (BRONJ)
title_full_unstemmed Impact of Soft Tissue Pathophysiology in the Development and Maintenance of Bisphosphonate-Related Osteonecrosis of the Jaw (BRONJ)
title_sort impact of soft tissue pathophysiology in the development and maintenance of bisphosphonate-related osteonecrosis of the jaw (bronj)
publisher MDPI AG
series Dentistry Journal
issn 2304-6767
publishDate 2016-10-01
description Since the first description of bisphosphonate-related osteonecrosis of the jaw (BRONJ), numerous research groups have focused on possible pathological mechanisms including the suppression of the bone turnover of the jaw, antiangiogenic effects and soft tissue toxicity. In our review we focused on summarizing the role of the soft tissues in the development and progression of BRONJ. The biological behavior of fibroblasts can be significantly influenced by bisphosphonates (BP) such as a concentration dependent reduction of cell viability. High concentrations of BP can induce apoptosis and necrosis of the cells. Comparable effects could be detected for keratinocytes. Compared to non-nitrogen containing bisphosphonates, nitrogen-containing BP have worse effects on cell biology by blocking the mevalonate pathway. Further, the cell architecture and expression levels of several genes and proteins are significantly disturbed by BP. These inhibitory effects of BP are in accordance with BP-related reduced angiogenesis and neovascularization and could underline the hypothesis that inhibition of fibroblasts and keratinocytes results in delayed wound healing and can induce and trigger BRONJ.
topic gingiva
bisphosphonate
soft tissue
fibroblasts
keratinocytes
bisphosphonate associated osteonecrosis of the jaws
url http://www.mdpi.com/2304-6767/4/4/36
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