The aim of the study was to evaluate bone metabolism in cancer patients with bisphosphonate osteonecrosis of the jaws. The study included 45 people of the main group (patients with cancer with osteonecrosis of the jaw in patients receiving bisphosphonates) and 25 in the control group (cancer patients treated with bisphosphonates, but did not have osteonecrosis of the jaw), which had a stabilization of the underlying disease. Bone metabolism was evaluated by the level of osteocalcin (OC), bone-specific alkaline phosphatase (bALP), aminoterminal of propeptide of procollagen type I (P1NP), tartrate-resistant acid phosphatase (TRAP5b), calcium (Cа), phosphorus (P) in blood serum before treatment and after 6 months. Compared to the average levels of marker patients of the main and control groups using the Mann-Whitney test for p < 0,05. A baseline level of СТХ (0,23±0,02 ng/ml) and OС (11,58±0,54 ng/ml) in the treatment group was significantly (p < 0.05) lower than control group (0,43±0,01 ng/ml and 17,94±0,83 ng/ml), and the level of osteocalcin in the main group (11,58±0,54 ng/ml) was on average below normal 2,59 times. Recorded significantly higher (p < 0,05) levels bALP (133,24±14,03 U/l) and TRAP5b (3,54±0,38 U/l) in patients with osteonecrosis compared with a control group (73,32±3,41 U/l and 3,12±0,12 U/l). Reliably detected differences in the levels of P1NP, Ca and P were not detected (p > 0,05). In the main group after 6 months of treatment was observed a tendency of growth of СТХ, TRAP5b, OK, bALP, P1NP, Ca, but only for the markers of resorption and СТХ, TRAP5b these differences were significant. Indicators of patients in the control group were stable and did not differ in the dynamics. The development of bisphosphonate osteonecrosis of the jaws is directly related to bone metabolism and occurs with predominance of the processes of bone resorption and inhibition of bone formation processes.
Curious Case of Rodent Poison: A Case Report
