Zoledronic acid is associated with jaw osteonecrosis, whereas alendronate did not produce a condition sufficient for osteonecrosis after tooth extraction. Neither zoledronic acid nor alendronate was associated with a reduced immunohistochemical expression of VEGF in vital bone at the tooth extraction site.

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Both of the bisphosphonates zoledronic acid and clodronate are capable of inducing maxillary osteonecrosis. Immunohistochemical analysis suggests that the involvement of soft tissues as the initiator of osteonecrosis development is less probable than has been pointed out.

Treatment of bisphosphonate-related osteonecrosis of the jaw (BRONJ) has been a challenging task, where the effectiveness of HBOT is controversial. This study reports important effects of HBOT on the maxillae of rats subjected to bisphosphonate treatment, making an important contribution to the knowledge about the applicability of HBOT in BRONJ.

Os bisfosfonatos são medicamentos amplamente administrados a pacientes portadores de metástases tumorais em tecido ósseo e a pacientes com osteoporose. A droga reduz a reabsorção óssea, estimula a atividade osteoblástica, assim como inibe o recrutamento e promove a apoptose de osteoclastos. A associação entre o uso dos bisfosfonatos e uma forma peculiar de osteonecrose dos maxilares tem sido relatada, principalmente, em pacientes submetidos a exodontias. No presente estudo, são apresentados dois casos de pacientes em uso de bisfosfonatos para tratamento de metástases ósseas, que desenvolveram osteonecrose maxilar. Na literatura, não há relatos de um tratamento eficaz para a enfermidade, porém o uso de antibióticos por um longo período parece apresentar os melhores resultados. Ainda, a possibilidade de substituição do medicamento deve ser considerada dentro de uma equipe multidisciplinar. Tendo em vista a dificuldade de tratamento e o risco representado pelas intervenções cirúrgicas dos maxilares, pacientes que serão submetidos ao uso de bisfosfonatos devem passar por um criterioso exame odontológico, e todos os procedimentos cirúrgicos necessários devem ser realizados previamente ao início da terapia com o medicamento.

Cisplatin is one of the most active cytotoxic agents in the treatment of cancer, but its clinical use is frequently limited by nephrotoxicity. The study presented here attempted to evaluate the effect of fructose-1,6-bisphosphate in the cisplatin-induced nephrotoxicity in rats. The drugs were administered intraperitoneally as a single dose: sodium chloride 0.9%, cisplatin (6 mg/kg), fructose-1,6-bisphosphate (500 mg/kg), and cisplatin plus fructose-1,6-bisphosphate (6 and 500 mg/kg, respectively). The use of cisplatin resulted in significant elevation of serum creatinine and urea. The group that received cisplatin plus fructose-1,6-bisphosphate presented a significantly lower level of creatinine and urea compared to the cisplatin group. Acute tubular necrosis was demonstrated in the animals that received cisplatin and a less severe one in the cisplatin plus fructose-1,6-bisphosphate group. Fructose-1,6-bisphosphate has a protective effect over renal function and renal parenchyma in a rat experimental model of cisplatin-induced nephrotoxicity. The anti-inflammatory effect of fructose-1,6-bisphosphate confirms its protective effect in cases of cellular injury.

Oral squamous cell carcinoma (OSCC) is a public health problem. The hamster buccal pouch model is ideal for analyzing the development of OSCC. This research analysed the effects of sunitinib (tyrosine kinase inhibitor) in precancerous lesions induced by 7,12-dimethylbenz(a)anthracene (DMBA) in this model. Thirty-four male hamsters, divided into six groups: control—C (n = 7), acetone—A (n = 12), carbamide peroxide—CP (n = 5 ), acetone and CP—A+CP (n = 8), 1% DMBA in acetone and CP—DA+CP (n = 6), and 1% DMBA in acetone and CP and 4-week treatment with sunitinib—DA+CP+S (n = 7). The aspects evaluated were anatomopathological features (peribuccal area, paws, nose, and fur), histological sections of the hamster buccal pouches (qualitatively analyzed), epithelium thickness, and the rete ridge density (estimated). Sunitinib was unable to attenuate the decrease in weight gain induced by DMBA; no increase in volume was detected in the pouch and/or ulceration, observed in 43% of the animals in the DA+CP group. DA+CP groups presented a significant increase in rete ridge density compared to the control groups (P < 0.01) which was reverted by sunitinib in the DA+CP+S group. Sunitinib seems to have important benefits in early stage carcinogenesis and may be useful in chemoprevention.

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