***Bisphosphonates***

[zoralsurgeon]

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Hey everyone...I have a couple questions in regard to BP's...please correct me if I'm wrong!

1.) Does anyone have any idea why there have been no reported cases of Bisphosphonate induced osteonecrosis of the jaw in children? Is it because children have more osteoblasts than osteoclasts???
2.) How do BP's lead to a decreased blood supply?
3.) Why are non-nitrogen containing BP's potent to osteoclasts and not osteoblasts?

 

[Rollo]

According to Katzung, bisphosphos are potent to osteoclasts because they are analogs of pyrophosphates and block pyrophosphate snythase which is found in mevalonate pathway that is critical for osteoclast survival.

Although it also goes on to say that only amino bisphosphos (which would, obviously, contain nitrogen) have this property.

 

[zoralsurgeon]

According to Katzung, bisphosphos are potent to osteoclasts because they are analogs of pyrophosphates and block pyrophosphate snythase which is found in mevalonate pathway that is critical for osteoclast survival.

Although it also goes on to say that only amino bisphosphos (which would, obviously, contain nitrogen) have this property.

Sweet, giving me Katzung's name let me research some things and clear up that confusion.

Any idea why there have been no reported cases of Bisphosphonate induced osteonecrosis of the jaw in children? Is it because children have more osteoblasts than osteoclasts???

 

[jdh71]

this smells like homework

 

[zoralsurgeon]

this smells like homework

ha. No, actually out of personal curiosity...saw a sign at the dentist

 

[Tygacil]

I don't really have any sources to back this statement up, but it's probably a numbers game. Children don't normally ever receive bisphosphonates, and if they did it'd probably be for isolated cases of hypercalcemia, so.. like a one time dose. Most (significant) side effects come after thousands of exposures.

My theory anyways.