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Kpvsobm! Pg! Tupnbupmphz CBMLBO! KPVSOBM! PG! TUPNBUPMPHZ Pggjdjbm! qvcmjdbujpo! pg! uif! CBMLBO! TUPNBUPMPHJDBM! TPDJFUZ ! !Wpmvnf!24! !!!!!!!!!!!!!!!!Op!2! !!!!!!!!!!!!Nbsdi!!311:! JTTO!2218!.!2252 Z U F J D P T ! ! BALKAN JOURNAL OF STOMATOLOGY M ISSN 1107 - 1141 B JD H MP UP TUPNB Editor-in-Chief Ljubomir TODOROVIĆ, DDS, MSc, PhD Faculty of Dentistry University of Belgrade Dr Subotića 8 11000 Belgrade Serbia Editorial board ALBANIA ROMANIA Ruzhdie QAFMOLLA - Editor Address: Andrei ILIESCU - Editor Address: Emil KUVARATI Dental University Clinic Victor NAMIGEAN Faculty of Dentistry Besnik GAVAZI Tirana, Albania Cinel MALITA Calea Plevnei 19, sect. 1 70754 Bucuresti, Romania BOSNIA AND HERZEGOVINA Maida GANIBEGOVIĆ - Editor Address: Naida HADŽIABDIĆ Faculty of Dentistry SERBIA Mihael STANOJEVIĆ Bolnička 4a Vojislav LEKOVIĆ - Editor Address: 71000 Sarajevo, BIH Slavoljub ŽIVKOVIĆ Faculty of Dentistry BULGARIA Zoran STAJČIĆ Dr Subotića 8 Nikolai POPOV - Editor Address: 11000 Beograd, Serbia Nikola ATANASSOV Faculty of Dentistry Nikolai SHARKOV G. Sofiiski str. 1 TURKEY 1431 Sofia, Bulgaria Ender KAZAZOGLU - Editor Address: FYROM Pinar KURSOGLU Yeditepe University Julijana GJORGOVA - Editor Address: Arzu CIVELEK Faculty of Dentistry Ana STAVREVSKA Faculty of Dentistry Bagdat Cad. No 238 Ljuben GUGUČEVSKI Vodnjanska 17, Skopje Göztepe 81006 Republika Makedonija Istanbul, Turkey GREECE CYPRUS Anastasios MARKOPOULOS - Editor Address: George PANTELAS - Editor Address: Haralambos PETRIDIS Aristotle University Huseyn BIÇAK Gen. Hospital Nicosia Grigoris VENETIS Dental School Aikaterine KOSTEA No 10 Pallados St. Thessaloniki, Greece Nicosia, Cyprus International Editorial (Advisory) Board Christoph HÄMMERLE - Switzerland George SANDOR - Canada Barrie Kenney - USA Ario SANTINI - Great Britain Predrag Charles LEKIC - Canada Riita SUURONEN - Finland Kyösti OIKARINEN - Finland Michael WEINLAENDER - Austria Z U F J D P T ! BALKAN STOMATOLOGICAL SOCIETY ! M B JD H MP UP TUPNB Council: Members: R. Qafmolla A. Adžić President: Prof. M. Vulović P. Kongo B. Rašović M. Ganibegović A. Vucur Past President: Prof. A. Iliescu S. Kostadinović A. Creanga President Elect: Prof. P. Koidis N. Sharkov D. Stamenković Vice President: Prof. H. Bostanci V. Mihovska M. Barjaktarević M. Carčev E. Kazazoglu Secretary General: Prof. L. Zouloumis A. Minovska M. Akkaya Treasurer: Dr. E. Hassapis A. Pissiotis G. Pantelas Editor-in-Chief: Prof. Lj.Todorović S. Dalambiras S. Solyali The whole issue is available on-line at he web address of the BaSS (www.e-bass.org) CBMLBO! KPVSOBM! PG! TUPNBUPMPHZ Pggjdjbm! qvcmjdbujpo! pg! uif! CBMLBO! TUPNBUPMPHJDBM! TPDJFUZ ! !Wpmvnf!24! !!!!!!!!!!!!!!!!Op!2! !!!!!!!!!!!!Nbsdi!!311: JTTO!2218!.!2252 Z U F J D P T ! ! BALKAN JOURNAL OF STOMATOLOGY M ISSN 1107 - 1141 B JD H MP UP TUPNB VOLUME 13 NUMBER 1 March 2009 PAGES 1-64 Contents RP P. Papadopoulos Biphosphonates: A Concern for Dental Practice - 4 A. Kolokotronis A Review of the Literature 133 RP V. Boka Tooth Eruption: Topical and Systemic Factors that 11 A.K. Markopoulos Influence the Process A.K. Poulopoulos RP M. Carević Combating Early Childhood Caries 15 M. Vulović M. Šindolić OP Ç.E. Çubukçu Retention of Glass Ionomer Cement and 21 Resin-Based Fissure Sealant and Their Effect on Caries Outcome During Chemotherapy: A Pilot Study OP P. Beltes Shear Bond Strength of 2 Root Canal Sealers to 26 M. Pashali Human Dentin N. Economides C. Gogos OP K. Kodonas Intra-Tubular Reactions in Restored Human Teeth: 29 A SEM Study OP H. Gedik Cleaning Efficiency of Alkaline Peroxide Type Denture Cleansers on 35 Y.K. Özkan Silicone-Based Soft Lining Materials Colonized With Candida Albicans OP T. Koksal Effect of Shade and Thickness of Porcelain Veneers on 41 A. Civelek Depth of Cure of Light-Cured Resin-Based Luting Cement E. Kazazoglu M. Soyman OP F.N. Pekiner Burning Mouth Syndrome in a Sample of Turkish Population 46 B. Gümrü S. Özbayrak Balk J Stom, Vol 13, 2009 3 CR G. Özcan A Useful Approach to a Combined Implant Application: 52 H. Develioglu Report of a Case after a 13-Year Assessment B. Kurtis D. Nalbant CR K. Lyroudia Intraosseous Odontoma in the Maxilla and 56 G. Stephanopoulos Its Impact on Underlying Teeth. A Case Report CR D. Mangoudi Rhino-Orbito-Cerebral Mucormycosis: 60 E. Bourlidou A Case Report and Review of the Literature G. Venetis V. Antoniadis Z U F J D P T ! ! BALKAN JOURNAL OF STOMATOLOGY M ISSN 1107 - 1141 B JD H MP UP TUPNB Biphosphonates: A Concern for Dental Practice - A Review of the Literature Petros Papadopoulos1, SUMMARY 2 Objectives: To review current knowledge of biphosphonates with respect Alexandros Kolokotronis to oral cavity pathology and dental procedures. The scope is the chemistry, 1Private Practice properties, chemical uses and recommendations that refer to biphosphonates 2Department of Oral Medicine and Maxillofacial and are of oral and maxillofacial interest. Pathology, Dental School, Aristotle University Thessaloniki, Greece Sources: “PUBmed” and e-articles searched electronically with key words biphosphonates, oral cavity, oral pathology and manifestations. Conclusions: Biphosphonates are analogues of pyrophosphate, com- prising of 2 phosphate groups linked by a phospho-ether bond. This particu- lar structure is responsible for their resistance to hydrolysis and their great variation in biological and therapeutic background. There are nitrogen and non-nitrogen containing biphosphonates of 4 generation types: I, II, III and IV. Etidronate is the main representative of the first type and zoledronic acid, pamidronate and ibandronate are some of the newer ones. Biphosphonates act almost exclusively on bone in proximity to the osteoclasts. They aren’t metabolized and persist within the bone for long periods of time. The mecha- nisms that characterize their action are closely related to bone resorption and a decrease in bone turnover. Their action is explained on the basis of calci- fication, delay of the dissolution of calcium phosphate crystals, inhibition of formation and aggregation of calcium phosphate crystals. They are focused on the treatment of Paget’s disease, hypercalcemia, bone metastases and present an anti-osteolytic effect, counteract bone loss in chronic periodontitis or play an anti-neoplastic role. Osteonecrosis, avascular necrosis of the jaws, renal toxicity, fever, bone pain, hypocalcemia, mild gastrointestinal complains and jaw fracture after extraction can follow biphosphonate therapy. All these underline the need of certain preventive measures and recommendations. REVIEW PAPER (RP) Keywords: Bisphosphonates; Osteoclasts; Osteonecrosis; Prevention; Treatment Balk J Stom, 2009; 13:4-10 Introduction bone diseases that are able to put the success of dental procedures and not only. Biphosphonates have been known to chemists since the These facts designate the need of special refers to middle of the 19th century, when the first synthesis in 1865 the characteristics, properties of the medicine and their occurred in Germany1. Our knowledge of the biological correlation with bone diseases and dental practice. This is characteristics of biphosphonates dates back 30 years2. the goal of this review. They are a group of medication that have become increasingly and more widely used especially in the management of certain bone diseases, some of which are very common in our ageing population. However, Chemistry and Classification daily clinical practice and research reveal the existence of several side-effects of biphosphonates, as well as Biphosphonates are synthetic compounds, analogues an association between them and the implication or of pyrophosphate, an endogenous regulator of bone Balk J Stom, Vol 13, 2009 Dental Concern of the Use of Biphosphonates 5 mineralization. They are comprised of 2 phosphonate cells, cells of mononuclear phagocyte and immune system, groups linked by phospho-ether bonds (P-C-P structure). such as macrophages or tumour cells. This structure makes them resistant to hydrolysis in acid It is very important to mention that the 2 families conditions or by pyrophosphatases. The P-C-P structure of biphosphonates have different pathways of action. allows a great number of possible variations either Nitrogen containing ones act through the mevalonate by changing the 2 lateral chains on the carbon, or by pathway, but non-nitrogen containing biphosphonates, esterifying the phosphate groups; therefore, the biological such as etidronate, tiludronate and clodronate, are therapeutic and toxicological characteristics of different incorporated into phosphate chain of adenosine 3-5 generations of biphosphonate vary dramatically . triphosphate (ATP) containing compounds, so that they Currently there are 2 main types of biphosphonates: become non-hydrolysable. The new P-C-P containing ATP nitrogen-containing and non-nitrogen containing. According analogues inhibit cell function and lead to cell death by to evolution, literature classifies them in 4 generation types: apoptosis. I, II, III and IV. Etidronate is the main representative of the The cellular uptake of biphosphonates is mostly first, and zolendronic acid, pamidronate and ibandronate taking place in the cytosol, and the concentration are some of the newer ones. expressed in terms of cellular water can be several folds higher than in the medium. They have a very low bioavailability from a few % to Mechanism of Action 1% - mostly for the newer ones. This is explained by their low lipophilicity, which hampers trans-cellular transport Biphosphonates act almost exclusively on bone when and their
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