Aim: The overall aim is to (i) analyze the prognosis of dental implant treatment concerning marginal bone loss (MBL) in patients undergoing or have undergone treatment with bone antiresorptive or antiangiogenic medication for osteoporosis (ii) and additional purpose to assess the available scientific literature in the first aim concerning the risk of getting medication-related osteonecrosis of the jaw (MRONJ) associated with dental implant installation.  Material and methods: A systematic literature search was conducted in October 2021 in the following three databases; MEDLINE/PubMed, Cochrane Library and Web of Science. PRISMA 2009 Flow Diagram were used for the selection process, whereas the included studies were evaluated for quality assessment using Newcastle Ottawa Scale (NOS).  Results: The search resulted in four included studies considering the eligibility criteria. The studies evaluated MBL in osteoporotic patients undergoing or have undergone oral bisphosphonate (BP) treatment before and/or during implant placement. MRONJ was also assessed in all four articles.  Conclusions: The results of this present study do not indicate that patients undergoing or have undergone antiresorptive or antiangiogenic medication for osteoporosis are at an increased risk of MBL in dental implants during follow-up periods. The present data assessing the risk for developing MRONJ remains low for osteoporotic patients. Therefore, dental implant surgery is considered possible with success in osteoporotic patients receiving earlier mentioned medications. However additional studies are required to evaluate the effects on this patient group concerning osseointegration of dental implant regarding MBL. / Syfte: Syftet med denna studie är att analysera prognosen för implantatbehandling avseende marginell benförlust (MBL) hos patienter som genomgår eller har genomgått behandling med benantiresorptiv eller antiangiogen medicin för osteoporos. Ytterligare utförs en bedömning av tillgänglig vetenskaplig litteratur gällande risken för läkemedelsrelaterad käkbensnekros (MRONJ) associerat med implantatinstallation hos patienter som genomgår eller har genomgått behandling med benantiresorptiv eller antiangiogen medicin. Material och metod: En systematisk elektronisk litteratursökning genomfördes i oktober 2021 i följande tre databaser; MEDLINE/PubMed, Cochrane Library och Web of Science. PRISMA 2009 Flow Diagram användes för urvalsprocessen, varav de inkluderande studierna kvalitetsgranskades enligt Newcastle Ottawa Scale (NOS). Resultat: Sökningen resulterade i fyra studier, enligt inklusions- och exklusionskriterier. Studierna utvärderade MBL hos osteoporospatienter som går eller har gått behandling med orala bisfosfonater före eller under implantatinstallationen. MRONJ fastställdes i alla fyra artiklar. Slutsats: Resultatet av denna studie indikerar inte att patienter som genomgår eller har genomgått behandling med benantiresorptiv eller antiangiogen medicin för osteoporos löper en ökad risk för MBL av dentala implantat under uppföljningsperioder. Nuvarande data bedömer att risken för att utveckla MRONJ är fortfarande låg för osteoporos patienter. Därför antas implantatkirurgi kunna utföras på osteoporos patienter som står på denna medicinering. Dock krävs ytterligare studier för att utvärdera effekterna av denna patientgrupp gällande osseointegration av dentala implantat avseende MBL.

<p>Background: Previous studies have found that diabetes is associated with increased risk of fracture; however, the risk of non-traumatic fracture (of any bone) specific to individuals with diabetes across the Canadian population has not been studied.</p> <p>Methods: Ten years of data from the Canadian Multicenter Osteoporosis study was explored. Logistic regression models were used to study factors associated with a history of previous non-traumatic fracture at study baseline. Cox proportional hazards models were used to explore time-to-incident-fracture during the 10 years of study.</p> <p>Results: All women and men ≥ 50 years were included in the analyses (n=7753). This included 508 individuals with NIDDM and 98 with IDDM. Mean age was 67 (±9) years and 72% were female. Individuals with diabetes were found to be more likely to have a history of fragility fracture then non-diabetic CaMos participants (odds ratio [OR] =1.21, 95% confidence interval [CI] 1.00,1.46; p=0.04), but were less likely to be treated with bisphosphonate therapy during the 10 year study (OR: 0.58; 95% CI 0.46,0.75; p<0.001). History of a stroke/TIA or hypertension were found to be associated with previous non-traumatic fracture amongst the diabetic population (OR: 1.51; 95% CI 1.20,1.91; p<0.001; and, OR: 1.16; 95% CI 1.04,1.29; p=0.01 respectively).</p> <p>Conclusions: A treatment care gap exists amongst diabetics in Canada. Individuals with diabetes are at increased risk of non-traumatic fracture, but are less likely to be treated with bisphosphonate therapy. Clinicians can use specific fracture risk factors to identify which diabetics are at highest risk and target interventions accordingly.</p> / Master of Science (MSc)

No description available.

No description available.

Os bisfosfonatos (BF) são amplamente utilizados no tratamento de doenças osteolíticas como metástases ósseas e osteoporose. A osteonecrose dos maxilares associada ao uso de BF (OMAB) é caracterizada pela presença de osso exposto ou que pode ser sondado através de uma fístula que persiste por mais de oito semanas em pacientes com história de terapia de BF e sem história de radioterapia na região de cabeça e pescoço e/ou sem doença metastática nos maxilares. A incidência de OMAB aumenta com a potência, duração do tratamento e dose de BF recebida. Até o presente momento, a fisiopatologia da OMAB não está clara, dificultando a prevenção e o tratamento. O objetivo deste estudo foi avaliar o efeito da administração de altas doses Ácido Zoledrônico (AZ) por período prolongado no osso esponjoso da mandíbula e da metáfise proximal do fêmur de ratos Wistar. Para relacionar as descobertas à fisiopatologia da OMAB, o regime de administração de BF de um modelo animal relevante desta lesão foi reproduzido. Seis animais receberam AZ (0,6 mg / kg) e seis receberam solução salina no mesmo volume (Controles). Os compostos foram administrados por via intraperitoneal em cinco doses a cada 28 dias. A eutanásia dos animais ocorreu após 150 dias de início da terapia. As hemimandíbulas e fêmures direitos foram escaneados usando Micro-tomografia computadorizada (Micro-CT) de alta resolução (14 m). Para a primeira análise realizada neste estudo, os dados morfométricos do osso esponjoso foram calculados na região do segundo e primeiro molar na mandíbula e na metáfise do fêmur usando CTAnalyzer (Bruker, Bélgica). Para a segunda análise, cinco amostras de hemimandíbulas de cada grupo foram cortadas em lâminas histológicas (5 m) e coradas com Hematoxilina e Eosina. Para comparar os parâmetros morfométricos na Micro-CT e histologia, as imagens de Micro-CT foram espacialmente alinhadas à histologia. Os dados morfométricos do osso alveolar foram calculados usando o software CTAnalyzer (Bruker, Bélgica) na região entre as raízes mesial e distal do primeiro molar. A densidade da área vascular (área vascular/área total; VA/TA) e os dados histomorfométricos ósseos foram estimados usando Axiovision na mesma região (entre as raízes mesial e distal do primeiro molar). Foi adotada significância estatística de 5% ( = 0,05). Os animais tratados com AZ apresentaram aumento significativo na porcentagem de volume ósseo (p <0,05) com trabéculas mais espessas, osso mais compacto com menor separação trabecular na mandíbula e no fêmur. Na mandíbula, o aumento da densidade óssea e diminuição da separação trabecular foram fortemente correlacionados com a diminuição da área vascular observada no grupo AZ (p <0,05). Em conclusão, o tratamento de longa duração com altas doses de AZ foi significativamente associado ao aumento na densidade óssea e à diminuição dos espaços medulares, canais nutritivos e vasculatura do osso alveolar. A análise com Micro-CT revelou alterações semelhantes na estrutura óssea tanto na mandíbula quanto no fêmur do grupo AZ. / Bisphosphonates (BFs) are widely used in the treatment of osteolytic diseases such as bone metastases and osteoporosis. The osteonecrosis of the jaws related to BF (ONB) is characterized by the presence of exposed bone or bone that can be probed through a fistula that persists for more than eight weeks in patients with a history of BF therapy and without history of head and neck radiotherapy and / or without metastatic disease in the jaws. The incidence of ONB increases with potency, duration of treatment and dose of BF received. Thus far, the pathophysiology of ONB is unclear, hampering prevention and treatment. The aim of this study was to objectively assess the effect of long-term high-dose Zoledronic Acid (ZA) on cancellous bone in the jaw and femur of Wistar rats. In order to link our findings to the physiopathology of ONB, the therapeutic regiment of a relevant ONB animal model was reproduced. Twelve Wistar rats were randomly divided in two groups: six received Zoledronic acid (ZA; 0.6 mg / kg) and six (Controls) received saline solution in the same volume. The compounds were administrated intraperitoneally in five doses each 28 days. The rats were killed after 150 days of the therapy onset. Mandibles and femurs were scanned using a high-resolution (14m) micro-computerized tomography (Micro-CT). For the first analysis carried in this study, cancellous bone morphometric data were calculates in the region of the second and first molar in the mandible and in the proximal femur using CTAnalyzer (Bruker, Belgium). For the second analysis five samples were cut into histological slices (5m) and stained with Hematoxylin and Eosin. In order to compare the same morphological structures in Micro-CT and histology, the Micro-CT images were aligned to histology. Alveolar bone morphometric data (Micro-CT) was calculated using CTAnalyzer (Bruker, Belgium) in the region between the mesial and distal roots of the first molar. Blood vessels density and bone histomorphometric data were calculated using Axiovision (Carl Zeiss, Germany) in the same region used for Micro-CT evaluation. Statistical significance of 5% (=0.05) was adopted. ZA treated rats presented significant increase in the percentage of bone volume (p<0.05) with thicker trabeculae and more compact bone with smaller marrow spaces in the mandible and femur. In the mandible, the increase in bone density and decrease of marrow spaces size was strongly correlated with the decrease in the vascular area noticed in the ZA group (p<0.05). In conclusion, long-term high-dose ZA treatment was significant associated with the increase of bone density and the diminution of medullary spaces and nutritive canals size as well as decrease in vascularity of the alveolar bone. Micro-CT investigation showed similar changes in bone structure in the mandible and femur in the ZA group.

Improving the functionality and reducing revision rates are important driving forces in the development of orthopaedic implants. FibMat is a fibrinogen based matrix developed towards commercialisation by the company Optovent AB. This matrix can be coated on implants and act as a local drug delivery system for bisphosphonates (BPs). BPs are drugs inhibiting bone resorption, and applied with FibMat to improve stability of implants in bone, e.g. when fixing bone fractures. In this thesis, FibMat loaded with BP (FibMat/BP) was coated on stainless-steel screws and titanium screws in order to investigate some technology properties relevant to its clinical applicability. Bone-mimicking materials were used to study scrape-off effect upon insertion. The coagulation properties of fibrinogen as well as the structural properties of BPs were studied after exposure to gamma radiation. The screws were coated with FibMat and BP (alendronate and 14C-alendronate) using standard coupling techniques. The total amount and distribution of BP after insertion was measured by liquid scintillation and autoradiography. Coagulation assays were performed in order to determine the coagulation properties of fibrinogen, exposed to doses up to 35 kGy, mixed with thrombin. The structural properties of four different BPs (alendronate, pamidronate, zoledronate and ibandronate), exposed to doses up to 35 kGy were analysed by transmission infrared spectroscopy. The results show that FibMat/BP coating on porous stainless-steel screws is virtually unaffected by insertion into bone materials. The anodised, planar titanium screws are more affected by the insertion process, but an even BP distribution in the cancellous material is indicated. The coagulation assays show that gamma-irradiated fibrinogen has a slower coagulation process compared to non-irradiated fibrinogen and form interrupted network unable to clot. The chemical structures of the BPs seem unaffected by exposure to gamma irradiation. In conclusion, the FibMat/BP is a promising technology for local distribution of BP in conjunction with bone implants.

<p>Improving the functionality and reducing revision rates are important driving forces in the development of orthopaedic implants. FibMat is a fibrinogen based matrix developed towards commercialisation by the company Optovent AB. This matrix can be coated on implants and act as a local drug delivery system for bisphosphonates (BPs). BPs are drugs inhibiting bone resorption, and applied with FibMat to improve stability of implants in bone, e.g. when fixing bone fractures. In this thesis, FibMat loaded with BP (FibMat/BP) was coated on stainless-steel screws and titanium screws in order to investigate some technology properties relevant to its clinical applicability. Bone-mimicking materials were used to study scrape-off effect upon insertion. The coagulation properties of fibrinogen as well as the structural properties of BPs were studied after exposure to gamma radiation.</p><p>The screws were coated with FibMat and BP (alendronate and 14C-alendronate) using standard coupling techniques. The total amount and distribution of BP after insertion was measured by liquid scintillation and autoradiography. Coagulation assays were performed in order to determine the coagulation properties of fibrinogen, exposed to doses up to 35 kGy, mixed with thrombin. The structural properties of four different BPs (alendronate, pamidronate, zoledronate and ibandronate), exposed to doses up to 35 kGy were analysed by transmission infrared spectroscopy.</p><p>The results show that FibMat/BP coating on porous stainless-steel screws is virtually unaffected by insertion into bone materials. The anodised, planar titanium screws are more affected by the insertion process, but an even BP distribution in the cancellous material is indicated. The coagulation assays show that gamma-irradiated fibrinogen has a slower coagulation process compared to non-irradiated fibrinogen and form interrupted network unable to clot. The chemical structures of the BPs seem unaffected by exposure to gamma irradiation. In conclusion, the FibMat/BP is a promising technology for local distribution of BP in conjunction with bone implants.</p>

Submitted by THAYS CRISTINA OLIVEIRA DE QUADROS null (thays_quadros@hotmail.com) on 2016-03-02T18:32:42Z No. of bitstreams: 1 Tese completa thays 02.03.16.pdf: 1989348 bytes, checksum: 75edcaa9e80015e2965931de58d7c03e (MD5) / Approved for entry into archive by Juliano Benedito Ferreira (julianoferreira@reitoria.unesp.br) on 2016-03-04T13:38:45Z (GMT) No. of bitstreams: 1 quadros_tco_dr_jabo.pdf: 1989348 bytes, checksum: 75edcaa9e80015e2965931de58d7c03e (MD5) / Made available in DSpace on 2016-03-04T13:38:45Z (GMT). No. of bitstreams: 1 quadros_tco_dr_jabo.pdf: 1989348 bytes, checksum: 75edcaa9e80015e2965931de58d7c03e (MD5) Previous issue date: 2016-02-05 / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Foram avaliados os efeitos da nutrição in ovo com vitamina D3 e da dieta hídrica contendo alendronato de sódio sobre o desenvolvimento ósseo e parâmetros zootécnicos. O experimento foi constituído de duas fases (incubação e criação). No período de incubação, o delineamento experimental foi inteiramente casualizado com cinco tratamentos (ovos não injetados, injetados somente com óleo de oliva, 1,2μg, 2,4 µg e 3,6 µg de vitamina D3 / 100 µL de óleo de oliva) de injeção de vitamina D3 em 600 ovos férteis de matrizes de frango de corte, favorecendo desafio para fase seguinte, ou seja, promovendo menor desenvolvimento embrionário ósseo, gerando o desafio para a fase de criação para testar os níveis de alendronato de sódio. Na fase de criação o delineamento foi inteiramente casualizado, em esquema fatorial 2 x 5 (vitamina D3 durante o período de incubação e diferentes concentrações de AS no período de criação). A nutrição in ovo de vitamina D3 não afeta a eclodibilidade (P>0,05), no entanto, afeta de maneira negativa a densidade óssea de pintos pós-eclosão. O alendronato de sódio não apresentou dados significativos (P>0,05) para parâmetros de desenvolvimento ósseo. Portanto, conclui-se que se tornam necessárias novas pesquisas a fim de determinar níveis ideais deste fármaco com o intuito de melhorar a condição óssea de frangos de corte. / The effects of nutrition in ovo with vitamin D3 and hydro diet containing sodium alendronate on bone development and performance parameters were evaluated on this study. The experiment consisted in two stages (hatching and growing). The incubation period and the experimental design was completely randomized with five treatments (not injected eggs; injected only with olive oil; 1.2μg; 2.4 μg and 3.6 μg of vitamin D3 / 100 μL of olive oil) injection of vitamin D3 in 600 fertile eggs of matrices broilers, favoring a challenge to the next stage, ie, a lower bone promoting embryonic development, generating a challenge for the growing phase to test the levels of AS. The stage of growing design was completely randomized in a factorial 2 x 5 (vitamin D3 during the incubation period and different concentrations of AS in the growing period). The vitamin D3 nutrition in egg hatchability did not affect (P> 0.05), however, negatively affected the bone densitometry post-hatch chicks, as the sodium alendronate showed no significant data (P> 0.05) for bone development parameters. However, it is concluded that further studies are necessary to determine the levels of this drug in order to improve the bone condition of broilers. / FAPESP: 2012/15365-1

Os bisfosfonatos (BF) são amplamente utilizados no tratamento de doenças osteolíticas como metástases ósseas e osteoporose. A osteonecrose dos maxilares associada ao uso de BF (OMAB) é caracterizada pela presença de osso exposto ou que pode ser sondado através de uma fístula que persiste por mais de oito semanas em pacientes com história de terapia de BF e sem história de radioterapia na região de cabeça e pescoço e/ou sem doença metastática nos maxilares. A incidência de OMAB aumenta com a potência, duração do tratamento e dose de BF recebida. Até o presente momento, a fisiopatologia da OMAB não está clara, dificultando a prevenção e o tratamento. O objetivo deste estudo foi avaliar o efeito da administração de altas doses Ácido Zoledrônico (AZ) por período prolongado no osso esponjoso da mandíbula e da metáfise proximal do fêmur de ratos Wistar. Para relacionar as descobertas à fisiopatologia da OMAB, o regime de administração de BF de um modelo animal relevante desta lesão foi reproduzido. Seis animais receberam AZ (0,6 mg / kg) e seis receberam solução salina no mesmo volume (Controles). Os compostos foram administrados por via intraperitoneal em cinco doses a cada 28 dias. A eutanásia dos animais ocorreu após 150 dias de início da terapia. As hemimandíbulas e fêmures direitos foram escaneados usando Micro-tomografia computadorizada (Micro-CT) de alta resolução (14 m). Para a primeira análise realizada neste estudo, os dados morfométricos do osso esponjoso foram calculados na região do segundo e primeiro molar na mandíbula e na metáfise do fêmur usando CTAnalyzer (Bruker, Bélgica). Para a segunda análise, cinco amostras de hemimandíbulas de cada grupo foram cortadas em lâminas histológicas (5 m) e coradas com Hematoxilina e Eosina. Para comparar os parâmetros morfométricos na Micro-CT e histologia, as imagens de Micro-CT foram espacialmente alinhadas à histologia. Os dados morfométricos do osso alveolar foram calculados usando o software CTAnalyzer (Bruker, Bélgica) na região entre as raízes mesial e distal do primeiro molar. A densidade da área vascular (área vascular/área total; VA/TA) e os dados histomorfométricos ósseos foram estimados usando Axiovision na mesma região (entre as raízes mesial e distal do primeiro molar). Foi adotada significância estatística de 5% ( = 0,05). Os animais tratados com AZ apresentaram aumento significativo na porcentagem de volume ósseo (p <0,05) com trabéculas mais espessas, osso mais compacto com menor separação trabecular na mandíbula e no fêmur. Na mandíbula, o aumento da densidade óssea e diminuição da separação trabecular foram fortemente correlacionados com a diminuição da área vascular observada no grupo AZ (p <0,05). Em conclusão, o tratamento de longa duração com altas doses de AZ foi significativamente associado ao aumento na densidade óssea e à diminuição dos espaços medulares, canais nutritivos e vasculatura do osso alveolar. A análise com Micro-CT revelou alterações semelhantes na estrutura óssea tanto na mandíbula quanto no fêmur do grupo AZ. / Bisphosphonates (BFs) are widely used in the treatment of osteolytic diseases such as bone metastases and osteoporosis. The osteonecrosis of the jaws related to BF (ONB) is characterized by the presence of exposed bone or bone that can be probed through a fistula that persists for more than eight weeks in patients with a history of BF therapy and without history of head and neck radiotherapy and / or without metastatic disease in the jaws. The incidence of ONB increases with potency, duration of treatment and dose of BF received. Thus far, the pathophysiology of ONB is unclear, hampering prevention and treatment. The aim of this study was to objectively assess the effect of long-term high-dose Zoledronic Acid (ZA) on cancellous bone in the jaw and femur of Wistar rats. In order to link our findings to the physiopathology of ONB, the therapeutic regiment of a relevant ONB animal model was reproduced. Twelve Wistar rats were randomly divided in two groups: six received Zoledronic acid (ZA; 0.6 mg / kg) and six (Controls) received saline solution in the same volume. The compounds were administrated intraperitoneally in five doses each 28 days. The rats were killed after 150 days of the therapy onset. Mandibles and femurs were scanned using a high-resolution (14m) micro-computerized tomography (Micro-CT). For the first analysis carried in this study, cancellous bone morphometric data were calculates in the region of the second and first molar in the mandible and in the proximal femur using CTAnalyzer (Bruker, Belgium). For the second analysis five samples were cut into histological slices (5m) and stained with Hematoxylin and Eosin. In order to compare the same morphological structures in Micro-CT and histology, the Micro-CT images were aligned to histology. Alveolar bone morphometric data (Micro-CT) was calculated using CTAnalyzer (Bruker, Belgium) in the region between the mesial and distal roots of the first molar. Blood vessels density and bone histomorphometric data were calculated using Axiovision (Carl Zeiss, Germany) in the same region used for Micro-CT evaluation. Statistical significance of 5% (=0.05) was adopted. ZA treated rats presented significant increase in the percentage of bone volume (p<0.05) with thicker trabeculae and more compact bone with smaller marrow spaces in the mandible and femur. In the mandible, the increase in bone density and decrease of marrow spaces size was strongly correlated with the decrease in the vascular area noticed in the ZA group (p<0.05). In conclusion, long-term high-dose ZA treatment was significant associated with the increase of bone density and the diminution of medullary spaces and nutritive canals size as well as decrease in vascularity of the alveolar bone. Micro-CT investigation showed similar changes in bone structure in the mandible and femur in the ZA group.

Background: Using a nude rat model of site-specific metastatic bone disease (MBD), we developed a semiquantitative histological score for rapid assessment of lytic lesions in bone. This provides additional information to conventional histological measurement by clarifying the extent and location of metastatic infiltration and the tumor growth pattern. The score can also be used to assess the action of bisphosphonates on bone metastases. Materials and Methods: Male nude rats (n = 12 per group) were inoculated with the human breast cancer cell line MDA-MB-231 via the femoral artery. Following appearance of radiographically visible osteolytic lesions on day 18, the animals received phosphate-buffered saline (PBS; controls) or ibandronate (IBN, 10 µg P/kg) daily until day 30. Whole body radiographs were obtained on days 18 and 30, and osteolytic areas (OA) were determined by radiographic computer-based analysis (CBA). On day 30, MBD was assessed in both tibias using conventional histological CBA and the new scoring system. Results: Metastatic tumor area correlated with the total sum of the new score in both PBS- (r = 0.762) and IBN-treated animals (r = 0.951; p < 0.001). OA correlated well with the total sum in both groups (r = 0.845 and 0.854, respectively; p < 0.001). Conclusion: Significant reduction of bone marrow and cortical infiltration of tumor cells with IBN suggested local control of metastases. / Hintergrund: Mit Hilfe eines etablierten Tiermodells zur Erzeugung lokalisationsspezifischer Knochenmetastasen in der Nacktratte wurde ein semiquantitatives histologisches Graduierungssystem zur schnellen Bewertung osteolytischer Knochenmetastasen entwickelt. Das Graduierungssystem liefert hinsichtlich der Metastasenlokalisation, deren Ausmaß und Infiltrationsmuster wertvolle Zusatzinformationen zu den konventionellen histologischen Untersuchungsmethoden. Damit kann beispielsweise auch die pharmakologische Wirkung von Bisphosphonaten auf die Knochenmetastasierung beurteilt werden. Material und Methoden: Männlichen Nacktratten (n = 12 pro Gruppe) wurden Zellen der humanen Brustkrebszellinie MDA-MB-231 in die Oberschenkelarterie inokuliert. Ab dem Auftreten radiologisch erkennbarer Osteolysen 18 Tage nach Inokulation erhielten die Tiere bis zum Studienende (Tag 30) täglich entweder eine subkutane Applikation einer Phosphat-Puffer-Lösung (Kontrollgruppe) oder Ibandronat (IBN, 10 µg P/kg; Behandlungsgruppe). Konventionelle Röntgenaufnahmen wurden an den Tagen 18 und 30 nach Tumorinokulation angefertigt und die Osteolysenflächen mittels Computerauswertung bestimmt. Nach Studienende wurde der Metastasenbefall in beiden Tibiae sowohl konventionell histologisch als auch mittels des neuen Graduierungssystems ausgewertet. Ergebnisse: Die Metastasenfläche korrelierte mit der kummulativen Punktsumme des Graduierungssystems sowohl in der Kontrollgruppe (r = 0,762; p < 0,001) als auch in der Ibandronat- Gruppe (r = 0,951; p < 0,001). Ebenso war die Osteolysenfläche eng mit der Punktesumme in beiden Gruppen korreliert (r = 0,845 und 0,854; p < 0,001). Schlussfolgerung: Die signifikante Reduktion von Knochenmark- und Kortikalisbefall durch IBN deuten auf eine gute lokale Kontrolle des Metastasenwachstums hin. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.