Abstract
Statistically, significant numbers of central bone specimens of suppurative osteomyelitis of the jaws (SOJ), bisphosphonate induced osteonecrosis of the jaws (BIONJ), and osteoradionecrosis of the jaws (ORNJ) were compared. All three evidenced the common finding of necrotic bone with empty osteocytic lacunae, Haversian and Volkmann canals, but each showed a distinctive histopathologic pattern indicating a different disease mechanism and treatment options. Suppurative osteomyelitis was characterized by intense marrow inflammation and marrow vessel thrombosis with retention of viable osteoclasts and periosteum. Bisphosphonate induced osteonecrosis was characterized by an empty marrow space with empty Howship's lacunae and an absence of osteoclasts but viable periosteum. Osteoradionecrosis was characterized by a collagenous hypocellular, hypovascular marrow space and nonviable periosteum. Histologic evidence in SOJ indicates a microorganism provoked intense inflammation and marrow vascular thrombosis creating an environment conducive to continual bacterial proliferation. BIONJ is seen as a non-inflammatory drug toxicity to bone by osteoclastic death leading to over suppression of bone renewal, and ORN as another non-inflammatory condition caused by a high linear energy transfer that impairs or kills numerous cell types in the field of radiation including periosteum, bone, and all soft tissue.
| Original language | English |
|---|---|
| Pages (from-to) | 283-289 |
| Number of pages | 7 |
| Journal | International Journal of Oral and Maxillofacial Surgery |
| Volume | 41 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 1 2012 |
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Keywords
- bisphosphonates
- osteomyelitis
- osteonecrosis
- osteoradionecrosis
ASJC Scopus subject areas
- Oral Surgery
- Otorhinolaryngology
- Surgery
Cite this
Suppurative osteomyelitis, bisphosphonate induced osteonecrosis, osteoradionecrosis : A blinded histopathologic comparison and its implications for the mechanism of each disease. / Marx, Robert; Tursun, R.
In: International Journal of Oral and Maxillofacial Surgery, Vol. 41, No. 3, 01.03.2012, p. 283-289.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Suppurative osteomyelitis, bisphosphonate induced osteonecrosis, osteoradionecrosis
T2 - A blinded histopathologic comparison and its implications for the mechanism of each disease
AU - Marx, Robert
AU - Tursun, R.
PY - 2012/3/1
Y1 - 2012/3/1
N2 - Statistically, significant numbers of central bone specimens of suppurative osteomyelitis of the jaws (SOJ), bisphosphonate induced osteonecrosis of the jaws (BIONJ), and osteoradionecrosis of the jaws (ORNJ) were compared. All three evidenced the common finding of necrotic bone with empty osteocytic lacunae, Haversian and Volkmann canals, but each showed a distinctive histopathologic pattern indicating a different disease mechanism and treatment options. Suppurative osteomyelitis was characterized by intense marrow inflammation and marrow vessel thrombosis with retention of viable osteoclasts and periosteum. Bisphosphonate induced osteonecrosis was characterized by an empty marrow space with empty Howship's lacunae and an absence of osteoclasts but viable periosteum. Osteoradionecrosis was characterized by a collagenous hypocellular, hypovascular marrow space and nonviable periosteum. Histologic evidence in SOJ indicates a microorganism provoked intense inflammation and marrow vascular thrombosis creating an environment conducive to continual bacterial proliferation. BIONJ is seen as a non-inflammatory drug toxicity to bone by osteoclastic death leading to over suppression of bone renewal, and ORN as another non-inflammatory condition caused by a high linear energy transfer that impairs or kills numerous cell types in the field of radiation including periosteum, bone, and all soft tissue.
AB - Statistically, significant numbers of central bone specimens of suppurative osteomyelitis of the jaws (SOJ), bisphosphonate induced osteonecrosis of the jaws (BIONJ), and osteoradionecrosis of the jaws (ORNJ) were compared. All three evidenced the common finding of necrotic bone with empty osteocytic lacunae, Haversian and Volkmann canals, but each showed a distinctive histopathologic pattern indicating a different disease mechanism and treatment options. Suppurative osteomyelitis was characterized by intense marrow inflammation and marrow vessel thrombosis with retention of viable osteoclasts and periosteum. Bisphosphonate induced osteonecrosis was characterized by an empty marrow space with empty Howship's lacunae and an absence of osteoclasts but viable periosteum. Osteoradionecrosis was characterized by a collagenous hypocellular, hypovascular marrow space and nonviable periosteum. Histologic evidence in SOJ indicates a microorganism provoked intense inflammation and marrow vascular thrombosis creating an environment conducive to continual bacterial proliferation. BIONJ is seen as a non-inflammatory drug toxicity to bone by osteoclastic death leading to over suppression of bone renewal, and ORN as another non-inflammatory condition caused by a high linear energy transfer that impairs or kills numerous cell types in the field of radiation including periosteum, bone, and all soft tissue.
KW - bisphosphonates
KW - osteomyelitis
KW - osteonecrosis
KW - osteoradionecrosis
UR - http://www.scopus.com/inward/record.url?scp=84858150450&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84858150450&partnerID=8YFLogxK
U2 - 10.1016/j.ijom.2011.12.016
DO - 10.1016/j.ijom.2011.12.016
M3 - Article
C2 - 22244079
AN - SCOPUS:84858150450
VL - 41
SP - 283
EP - 289
JO - International Journal of Oral and Maxillofacial Surgery
JF - International Journal of Oral and Maxillofacial Surgery
SN - 0901-5027
IS - 3
ER -