Jaw bone death may be due to combination of bisphosphonates, vitamin D insufficiency

A team of scientists from UCLA's School of Dentistry, Jane and Jerry Weintraub Center for Reconstructive Biotechnology, School of Public Health and David Geffen School of Medicine has performed experiments that suggest that the mechanism underpinning osteonecrosis of the jaw — the death of the jaw bone — may involve an interaction between nitrogen-containing bisphosphonates and compromised vitamin D function.

      

In recent years, an increased incidence of osteonecrosis of the jaw has been linked to the use of bisphosphonates, which are ordinarily prescribed to patients with breast and prostate cancer and myeloma, as well as those suffering from osteoporosis. Dentists typically see severe bone necrosis in the maxillae and/or mandibles of these patients following dental procedures. Osteonecrosis of the jaw is debilitating and painful and at present is impossible to reverse. Treatment is individualized and can include the cessation of bisphosphonate therapy, the surgical removal of dead bone and tissue, and pain and infection management.

The creation of an animal (rat) model of bisphosphonate-related osteonecrosis of the jaw that resembles the human disease suggests that vitamin D insufficiency plays a crucial role in the disease's manifestation and severity. The scientists are hopeful that follow-up investigations into the role of vitamin D will provide further clues to the prevention and treatment of the disease in patients for whom bisphosphonate treatment is clinically necessary.

 

Authors included Akishige Hojugo, Russell Christensen, Evelyn M. Chung, Eric C. Sung, Alan L. Felsenfeld, James W. Sayre, Neal Garrett, John S. Adams and Ichiro Nishimura.

 

Dr. Nishimura, a researcher at the Jane and Jerry Weintraub Center for Reconstructive Biotechnology at the UCLA School of Dentistry and a professor in the school's division of advanced prosthodontics, biomaterials and hospital dentistry, is available for interviews.

 

This work was funded by grants from the National Institutes of Health, the Stein-Oppenheimer Foundation, the UCLA Academic Senate and the Japan Society for the Promotion of Science.

The research study appears in the June issue of the Journal of Bone and Mineral Research and is available online (with images).