Evaluation of mandibular morphometry in the bisphosphonate users / Evaluación de la morfometría mandibular en los usuarios de bifosfonatos

This study aimed to evaluate the effects of bisphosphonates on the mandibular bone. Bisphosphonates are drugs which are commonly used in the treatment of many diseases related to bone metabolism such as osteoporosis, breast cancer capable of bone metastasis, prostate and lung cancer and bone cancer such as multiple myeloma. Our study group consisted of a total of 100 panoramic radiographs which were obtained from the examinations of 50 individuals using bisphosphonate and 50 individuals in the control group who applied for routine dental examination to the Department of Oral and Maxillofacial Radiology of Akdeniz University Dentistry Faculty between years 2015 and 2016.The calculations of the mandibular cortical thickness (MCT), mandibular cortical index (MCI), panoramic mandibular index (PMI), condylar angle (CA), gonial angle (GA), antegonial angle (AGA), antegonial depth (AGD) and antegonial index (AGI) were made for each patient. It was found that both left and the right MCT and only the left PMI were affected by age. Only the left AGA and both the left and right MCT and AGD were affected by gender. The left and right AGI measurements of the patients using bisphosphonates were statistically lower than those of the individuals in the control group. Our results suggested that bisphosphonates had various effects on the jaw bones. However, further comprehensive studies need to be made to evaluate the longterm effect of bisphosphonates on bone metabolism.

Este estudio tuvo como objetivo evaluar los efectos de los bifosfonatos en el hueso mandibular. Los bifosfonatos son medicamentos que se usan comúnmente en el tratamiento de muchas enfermedades relacionadas con el metabolismo óseo, como la osteoporosis, el cáncer de mama, metástasis óseas, cáncer de próstata y pulmón y el cáncer de hueso como el mieloma múltiple. Nuestro grupo de estudio consistió en un total de 100 radiografías panorámicas que se obtuvieron de los exámenes de 50 individuos que utilizaron bisfosfonato y 50 individuos en el grupo de control que solicitaron un examen dental de rutina al Departamento de Radiología Oral y Maxilofacial de la Facultad de Odontología de la Universidad de Akdeniz, entre los años 2015 y 2016. En cada paciente se realizaron los cálculos del grosor cortical mandibular (GCM), índice cortical mandibular (ICM), índice mandibular panorámico (IMP), ángulo condilar (AC), ángulo gonial (AG), ángulo antegonial (AAG), profundidad antegonial ( PAG) y el índice antegonial (IAG). Se encontró que tanto el GCM izquierdo como el derecho y solo el IMP izquierdo estaban afectados por la edad. Solo el AAG izquierdo y el GCM izquierdo y derecho y el AGD fueron afectados de acuerdo al sexo. Las mediciones de IAG izquierdo y derecho de los pacientes que utilizan bifosfonatos fueron estadísticamente más bajas que las de los individuos en el grupo de control. Nuestros resultados sugirieron que los bifosfonatos tienen varios efectos en los huesos de la mandíbula. Sin embargo, es necesario realizar estudios más exhaustivos para evaluar el efecto a largo plazo de los bifosfonatos en el metabolismo óseo.

Facial symmetry evaluation after experimentally displaced condylar process fracture in methotrexate treated rats / Avaliação da simetria facial após fratura experimental com desvio do processo condilar em ratos tratados com metotrexato

PURPOSE: To investigate the facial symmetry of high and low dose methotrexate (MTX) treated rats submitted to experimentally displaced mandibular condyle fracture through the recording of cephalometric measurements. METHODS: One hundred male Wistar rats underwent surgery using an experimental model of right condylar fracture. Animals were divided into four groups: A - saline solution (1mL/week); B - dexamethasone (DEX) (0,15mg/Kg); C - MTX low dose (3 mg/Kg/week); D - MTX high dose (30 mg/Kg). Animals were sacrificed at 1, 7, 15, 30 and 90 days postoperatively (n=5). Body weight was recorded. Specimens were submitted to axial radiographic incidence, and cephalometric mensurations were made using a computer system. Linear measurements of skull and mandible, as well as angular measurements of mandibular deviation were taken. Data were subjected to statistical analyses among the groups, periods of sacrifice and between the sides in each group (α=0.05). RESULTS: Animals regained body weight over time, except in group D. There was reduction in the mandibular length and also changes in the maxilla as well as progressive deviation in the mandible in relation to the skull basis in group D. CONCLUSION: Treatment with high dose methotrexate had deleterious effect on facial symmetry of rats submitted to experimentally displaced condylar process fracture.

OBJETIVO: Avaliar a simetria facial de ratos tratados com metotrexato (MTX), em dose alta e baixa, submetidos à fratura experimental do processo condilar com desvio por meio de mensurações cefalométricas. MÉTODOS: Cem ratos Wistar machos foram submetidos a procedimento cirúrgico utilizando modelo experimental de fratura de côndilo do lado direito. Os animais foram distribuídos em quatro grupos: A - soro fisiológico (1mL/semana); B - dexametasona (DEX) (0,15mg/Kg); C - MTX baixa dose (3mg/Kg/semana); D - MTX alta dose (30mg/Kg). Os períodos de sacrifício foram de 1, 7, 15, 30 e 90 dias de pós-operatório (n=5). O peso dos animais foi documentado. Foram realizadas mensurações lineares da maxila e da mandíbula, bem como angulares do desvio mandibular. Os dados foram submetidos a análises estatísticas entre os grupos, períodos de sacrifício e entre os lados em cada grupo (α=0,05). RESULTADOS: Os animais recuperaram peso ao longo do tempo, exceto no grupo D. Houve redução no comprimento mandibular com alterações também na maxila e desvio progressivo da mandíbula em relação à base do crânio no grupo D. CONCLUSÃO: O tratamento com metotrexato em alta dose teve efeito deletério na simetria facial de ratos submetidos à fratura do processo condilar.