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Medication-related osteonecrosis of the jaw in a minipig model: Parameters for developing a macroscopic,

B Nowicki1, D Nehrbass1, D Arens1

  • 1AO Research Institute Davos, Davos Platz, Switzerland.

Journal of Cranio-Maxillo-Facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery
|April 7, 2019
PubMed
Abstract

Insights

Researchers developed a new scoring system to assess medication-related osteonecrosis of the jaw (MRONJ) in minipigs. This system uses macroscopic, radiological, and histological findings to grade the condition, aiding in future research and treatment strategies.

Area of Science:

  • Oral and Maxillofacial Surgery
  • Pharmacology
  • Veterinary Pathology

Background:

  • Medication-related osteonecrosis of the jaw (MRONJ) is a serious adverse effect of certain medications, particularly bisphosphonates.
  • Accurate assessment and grading of MRONJ are crucial for understanding its progression and evaluating treatment efficacy.
  • Existing assessment methods may lack comprehensive integration of macroscopic, radiological, and histological features.

Purpose of the Study:

  • To develop and validate a novel scoring system for evaluating pathological changes in medication-related osteonecrosis of the jaw (MRONJ).
  • To establish a standardized method for assessing MRONJ in a preclinical minipig model, integrating multiple examination modalities.
  • To provide a quantitative tool for future research on MRONJ pathogenesis and therapeutic interventions.

Main Methods:

  • Medication-related osteonecrosis of the jaw (MRONJ) was induced in Göttingen minipigs using zoledronic acid and tooth extraction.
  • Control groups were established with either no zoledronic acid or no tooth extraction.
  • Post-mortem assessment included macroscopic, computed tomography (CT), micro-CT, and histological examination of the mandible after 20 weeks.

Main Results:

  • Macroscopic findings included necrotic bone, exposed bone, fistula formation, and pus.
  • Radiological signs encompassed impaired extraction socket healing, reduced bone attenuation, and periosteal reactions.
  • Histological analysis revealed bone demineralization, exposed bone, and osteonecrosis.

Conclusions:

  • The study successfully devised a scoring system integrating macroscopic, radiological, and histological parameters for grading bisphosphonate-related osteonecrosis of the jaw (BRONJ).
  • This scoring system provides a comprehensive approach to assessing MRONJ in a preclinical model.
  • The developed scale facilitates standardized evaluation and grading of MRONJ, supporting further research and clinical application.
Keywords:
BRONJBisphosphonateComputed tomographyHistopathologyMinipigOsteonecrosis

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