Comparative clinical study of phosphorous necrosis and medical-related osteonecrosis of the jaws

• Published in: Clinical oral investigations 2024-02, Vol.28 (2), p.147-147, Article 147
• Main Authors: Xie, Rongju, Wang, Weihong, Bian, Longchun, Qian, Yemei, Li, Jingyi, Zhang, Hongrong
• Format: Article
• Language: English
• Subjects: Ankylosis; Bone growth; Bone imaging; Bones; Cancellous bone; Cbfa-1 protein; Comparative analysis; Dentistry; Gene expression; Immunohistochemistry; Jaw; Medical diagnosis; Medical imaging; Medicine; Molecular modelling; Necrosis; Osteogenesis; Osteonecrosis; Osteoprotegerin; Patients; TRANCE protein; Transcription factors
• ISSN: 1436-3771; 1432-6981; 1436-3771
• DOI: 10.1007/s00784-024-05539-z

Background Phosphorous necrosis of the jaw (PNJ) exhibits similar clinical and pathological features as medical-related osteonecrosis of the jaw (MRONJ). This study aims at comparing the similarities and differences between PNJ and MRONJ regarding pathological features and to provide a theoretical basis for the clinical diagnosis and management of PNJ. Material and methods A retrospective analysis was conducted to assess clinical differences among 38 PNJ patients and 31 MRONJ patients, who were diagnosed and treated between January 2009 and October 2022. Pathological alterations in bone tissue were evaluated using EDS, H&E, Masson, and TRAP staining on five specimens from both MRONJ and PNJ cases; furthermore, immunohistochemistry was used to determine the expression levels of OPG, RANKL, and Runx2. The mandibular coronoid process was removed from individuals with temporomandibular joint ankylosis to serve as a control. Results CBCT imaging demonstrated necrotic bone formation in block, strip, or plaque shapes. EDS analysis showed that the calcium/phosphorus ratio in the bone tissue of PNJ and MRONJ was significantly lower than that of the control group ( P