Differential impairment of vascularization and angiogenesis in bisphosphonate-associated osteonecrosis of the jaw-related mucoperiosteal tissue

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011 Aug;112(2):216-21. doi: 10.1016/j.tripleo.2011.02.028. Epub 2011 Jun 12.

Abstract

Objectives: Impaired vascularization in the etiopathology of aminobisphosphonate-associated osteonecrosis of the jaw (BONJ) is assumed, but evidence is lacking. This immunohistochemical study differentiated vascularization and angiogenesis in BONJ-adjacent mucoperiosteal tissue.

Study design: Twenty BONJ (after zoledronate treatment) and 20 control mucoperiosteal tissue samples were processed with an autostaining-based alkaline phosphatase-antialkaline phosphatase staining kit. Vascularization was assessed by CD31 staining and angiogenesis-related neovessels by CD105 staining. The ratio of stained capillary area to total area of visible field was assessed. Statistics included Bonferroni adjustment.

Results: CD31-stained microvessels were detected in each section and CD105-stained neovessels in each control. BONJ-adjacent mucoperiosteal tissue showed significantly fewer CD105-positive vessels in capillary areas (P < .05) than control samples. CD31-stained capillary area was not significantly reduced in mucoperiosteal BONJ-samples.

Conclusions: Angiogenesis is impaired in BONJ-related mucoperiosteal tissue, but vascularization remains unaffected. Vessel remodeling and neovessel formation is delayed in BONJ, resulting in impaired tissue regeneration of bisphosphonate-exposed oral mucosa.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alkaline Phosphatase / analysis
  • Alveolar Process / blood supply*
  • Alveolar Process / drug effects
  • Antigens, CD / analysis
  • Bone Density Conservation Agents / adverse effects*
  • Capillaries / drug effects
  • Capillaries / pathology
  • Coloring Agents
  • Connective Tissue / blood supply
  • Connective Tissue / drug effects
  • Diphosphonates / adverse effects*
  • Endoglin
  • Endothelial Cells / drug effects
  • Endothelial Cells / pathology
  • Endothelium, Vascular / drug effects
  • Endothelium, Vascular / pathology
  • Humans
  • Image Processing, Computer-Assisted / methods
  • Imidazoles / adverse effects
  • Immunohistochemistry
  • Jaw Diseases / chemically induced*
  • Jaw Diseases / pathology
  • Mouth Mucosa / blood supply
  • Mouth Mucosa / drug effects
  • Neovascularization, Physiologic / drug effects*
  • Osteonecrosis / chemically induced*
  • Osteonecrosis / pathology
  • Periosteum / blood supply
  • Periosteum / drug effects
  • Platelet Endothelial Cell Adhesion Molecule-1 / analysis
  • Receptors, Cell Surface / analysis
  • Zoledronic Acid

Substances

  • Antigens, CD
  • Bone Density Conservation Agents
  • Coloring Agents
  • Diphosphonates
  • ENG protein, human
  • Endoglin
  • Imidazoles
  • Platelet Endothelial Cell Adhesion Molecule-1
  • Receptors, Cell Surface
  • Zoledronic Acid
  • Alkaline Phosphatase