AO Research Institute Davos, Davos Platz, Switzerland.
Department of Oral and Maxillofacial Surgery, University of Munich, Munich, Germany.
J Craniomaxillofac Surg. 2019 Jul;47(7):1162-1169. doi: 10.1016/j.jcms.2019.03.002. Epub 2019 Mar 18.
To devise a macroscopic, radiological, and histological scale for assessing pathological changes associated with medication-related osteonecrosis of the jaw in a minipig model.
Medication-related osteonecrosis of the jaw was induced in Göttingen minipigs by weekly intravenous administration of bisphosphonate (zoledronic acid) combined with a tooth extraction procedure. Controls either did not receive zoledronic acid or did not undergo tooth extraction. After 20 weeks, minipigs were euthanized and underwent computed tomography and micro-computed tomography scanning. The mandible underwent additional histological examination.
The most consistent macroscopic findings in animals that had developed bisphosphonate-related osteonecrosis of the jaw (BRONJ) were necrotic, denuded bone, and formation of fistula and pus. Under radiological examination, impaired extraction socket healing, decrease in attenuation of bone beneath the extraction site, and periosteal reaction were observed. Under histological examination, demineralization of the extracellular bone matrix, denuding of bone, and osteonecrosis were recorded.
These parameters were used to develop a scoring system for grading BRONJ.
设计一种宏观、放射学和组织学评分标准，以评估小型猪模型中与药物相关性下颌骨坏死相关的病变。
通过每周静脉内给予双膦酸盐（唑来膦酸）联合拔牙程序，在哥廷根小型猪中诱导药物相关性下颌骨坏死。对照组既未接受唑来膦酸治疗，也未进行拔牙。20 周后，处死小型猪并进行计算机断层扫描和微计算机断层扫描。下颌骨还进行了额外的组织学检查。
发生双膦酸盐相关性下颌骨坏死（BRONJ）的动物最一致的宏观表现为坏死、裸露的骨以及瘘管和脓液的形成。在放射学检查中，观察到拔牙窝愈合受损、拔牙部位下方骨衰减减少和骨膜反应。在组织学检查中，记录了细胞外骨基质脱矿、骨裸露和骨坏死。
这些参数用于开发 BRONJ 分级的评分系统。
