Aseptic-avascular osteonecrosis: local "silent inflammation" in the jawbone and RANTES/CCL5 overexpression

Of the definitions listed in the International Statistical Classification of Diseases and Related Health Problems, tenth revision (ICD-10), two disease descriptions can be found together: "idiopathic aseptic bone necrosis" and "avascular bone necrosis." The relevant literature on...

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Bibliographic Details
Published in:Clinical, cosmetic and investigational dentistry cosmetic and investigational dentistry, 2017-01, Vol.9, p.99-109
Main Authors: Lechner, Johann, Schuett, Sabine, von Baehr, Volker
Format: Article
Language:English
Subjects:
aseptic avascular ischemic bone necrosis
Bone marrow
Cancer
Care and treatment
Chemokines
Chronic fatigue syndrome
Chronic illnesses
Cytokines
Dental surgery
Development and progression
Disease
fatty degenerative jawbone
Gene expression
Genetic aspects
Health aspects
Immunology
Inflammation
Ischemia
Jaw
Morphology
Original Research
Osteonecrosis
Pain
Patients
radiodensity
RANTES/CCL5
silent inflammation
Teeth
Wound healing
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Summary:Of the definitions listed in the International Statistical Classification of Diseases and Related Health Problems, tenth revision (ICD-10), two disease descriptions can be found together: "idiopathic aseptic bone necrosis" and "avascular bone necrosis." The relevant literature on both the conditions abbreviates both as "aseptic ischemic osteonecrosis in the jawbone" (AIOJ). To shed light on the clinical details of this condition, osteolytic jawbone samples of 24 patients with different systemic immunological diseases were examined using four steps: presurgical dental X-ray, postsurgical histology, polymerase chain reaction DNA analysis (PCR DNA) of bacteria, and RANTES/CCL5 (R/C) expression. These four steps showed that neither X-ray nor histology delivered unambiguous results with respect to inflammatory processes; furthermore, the PCR results did not show evidence of any microbial load within the jaw samples. However, there is a striking, coherent overexpression of chemokine R/C in the AIOJ samples. This study proved the aseptic existence of "silent inflammation" within the jawbone. The ICD-10 (AIOJ) definition, which is hard to interpret, can now be substantiated with clinical evidence, while the cytokine expressions described in this report can explain the systemic immunological effects observed within the group of examined patients.
ISSN:1179-1357
1179-1357
DOI:10.2147/CCIDE.S149545