Electron microscopic analysis of necrotic bone and failed implant surface in a patient with medication-related osteonecrosis of the jaw.

IF 2 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Maxillofacial Plastic and Reconstructive Surgery Pub Date : 2023-10-03 DOI:10.1186/s40902-023-00402-9
Ji Young Ha, Mi Young Eo, Buyanbileg Sodnom-Ish, Kezia Rachellea Mustakim, Hoon Myoung, Soung Min Kim
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Abstract

Background: Bisphosphonates (BP), a commonly used medication for various bone diseases, have been known to have severe complications such as bisphosphonate-related osteonecrosis of the jaw (BRONJ). Failure of dental implants has also been found in patients with medication-related osteonecrosis of the jaw (MRONJ). In this study, we analyzed the necrotic bone tissues and the surface of the failed implants removed from the jaw in patients treated with BPs and antiresorptive agents.

Results: Chronic inflammatory cells with collagen and fibrous tissues and bone sequestrum were shown at 5.0 × , 10.0 × , 20.0 × , and 40.0 × magnified histologic sections in the bone and fibrotic scar tissues removed from patients with MRONJ due to osteonecrosis. Hardened bone tissues with microcracked bony resorbed lacunae were observed in SEM. Unlike the previously published comparative data where immune cells, such as dendritic cells, were found in the failed implant surface, these immune cells were not identified in the BRONJ-related peri-implantitis tissues through the TEM investigations. Furthermore, EDS revealed that in addition to the main titanium element, gold, carbon, oxygen, calcium, phosphorus, silicon, and sulfur elements were found.

Conclusion: Hardened bone tissues with microcracked bony resorbed lacunae were observed in the SEM findings, which were considered as the main characteristic of the osteonecrosis of the jaw. Immune cells, such as dendritic cells were not identified in the TEM. EDS showed that in addition to the main titanium element, gold, carbon, oxygen, calcium, phosphorus, and silicon elements were found. Furthermore, it was revealed that sulfur was found, which was considered to be one of the complicated causes of implant failure in patients with BRONJ.

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一位患有药物相关颌骨坏死的患者的坏死骨和失败的植入物表面的电子显微镜分析。
背景:双磷酸盐(BP)是一种常用的治疗各种骨病的药物,已知其具有严重的并发症,如双磷酸盐相关的颌骨坏死(BRONJ)。在与药物相关的颌骨坏死(MRONJ)患者中也发现了牙科植入物的失败。在这项研究中,我们分析了接受BPs和抗再吸收剂治疗的患者的坏死骨组织和从颌骨移除的失败植入物的表面。结果:具有胶原、纤维组织和骨隔离的慢性炎症细胞在5.0 × , 10 × , 20 × , 和40.0 × 由于骨坏死而从MRONJ患者身上切除的骨和纤维瘢痕组织的放大组织学切片。扫描电镜观察到硬化的骨组织中有微裂纹的骨吸收腔隙。与之前发表的比较数据不同,在失败的植入物表面发现了免疫细胞,如树突细胞,通过TEM研究,这些免疫细胞在BRONJ相关的植入物周围组织中没有被识别。此外,EDS显示,除了主要的钛元素外,还发现了金、碳、氧、钙、磷、硅和硫元素。结论:扫描电镜观察到硬骨组织中有微裂纹的骨吸收腔隙,这是颌骨坏死的主要特征。在TEM中未鉴定出免疫细胞,例如树突细胞。EDS显示,除主要的钛元素外,还发现了金、碳、氧、钙、磷和硅元素。此外,还发现了硫,这被认为是BRONJ患者植入失败的复杂原因之一。
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来源期刊
Maxillofacial Plastic and Reconstructive Surgery
Maxillofacial Plastic and Reconstructive Surgery DENTISTRY, ORAL SURGERY & MEDICINE-
CiteScore
4.30
自引率
13.00%
发文量
37
审稿时长
13 weeks
期刊最新文献
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