Pathomorphological characteristics of bisphosphonate osteonecrosis of the jaws

Abstract

The article is devoted to the bisphosphonate osteonecrosis of the jaw, which is a complication of bisphosphonate therapy in cancer patients. The article presents the results of a study of osteonecrosis of the jaw in 40 patients with a history of antiresorptive therapy. This group of patients is formed by a retrospective analysis of inpatient and outpatients department patients chemotherapy Stavropol clinical advisory diagnostic Oncology Center and the Department of Maxillofacial Surgery Municipal Clinical Emergency Hospital of Stavropol for the years 2011-2015. The distribution of patients was by sex, age, urbanization, type of primary cancer pathology. In 30 patients (75%) decided to hold the surgical treatment - curettage (n = 10), sequestrectomy (n = 11), partial resection of the jaw (n = 9), with the result that received the opportunity to specify a unique pathologic pattern bisphosphonate osteonecrosis of the jaw in a three histological types: total osteonecrosis (43,33 ± 9,05%), aseptic osteonecrobiosis (33,33 ± 8,61%), osteonecrosis with regeneration phenomena (23,33 ± 7,72%). Informative value of this method in terms of predicting disease outcome. Using Fisher’s exact test (two-way) found that the likelihood of clinical cure was significantly higher (p <0.05) among patients whose tissue samples obtained were identified osteonecrosis regeneration phenomena, than among patients with osteonecrobiosis. In the group with total osteonecrosis failed after a single surgical intervention to eliminate the portion of bone denudation. It was found that the clinical course of bisphosphonate osteonecrosis histologically comparable with degenerative and regenerative manifestations of varying degrees of severity, and the detailed study of the surgical specimens allows to predict the success of treatment of this disease.