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Oral Surg Oral Med Oral Pathol Oral Radiol. 2012 Dec;114(6):785-91. doi: 10.1016/j.oooo.2012.08.457.

Histopathological features of bisphosphonate-associated osteonecrosis: findings in patients treated with partial mandibulectomies.

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Department of Oral Pathology, School of Dentistry, Seoul National University, Seoul, Korea.


The present study investigated the histopathologic and radiographic features of stage 3 bisphosphonate-associated osteonecrosis of the jaw (BAONJ) in patients who were treated with partial mandibulectomies. Bisphosphonates had been orally administered to 10 patients with osteoporosis and intravenously administered to 1 patient with metastatic carcinoma. On radiographic images, massive osteolysis and periosteal bone formations were conspicuous, and a thin mandibular cortical width was observed in 5 of 10 osteoporosis patients despite the previous use of bisphosphonate. Microscopically, the mandibulectomy specimens of the patients could be divided into 4 distinct layers. Although there were few differences in overall histologic features between BAONJ and chronic suppurative osteomyelitis, a notable number of osteoclasts were found detached from the bony trabeculae in BAONJ.

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