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ObjectivesTo analyze whether oxidative stress (OS) changes are present in patients with bisphosphonate-related osteonecrosis of the jaw (BRONJ) versus controls.Materials and methodsOxidative stress was analyzed in serum and unstimulated saliva of three groups: Group 1 consisted of 24 patients who had been treated with intravenous bisphosphonates (ivBPs) and developed BRONJ, group 2 consisted of 20 patients who had received ivBPs and did not develop BRONJ, and group 3 comprised 17 control subjects. Reduced glutathione (GSH), malondialdehyde (MDA), oxidized glutathione (GSSG), and 8-oxo-7,8-dihydro-2-deoxyguanosine (8-oxo-dG) levels, as well as the GSSG/GSH ratio, were measured.ResultsMean serum and saliva levels of MDA, GSSG, and 8-oxo-dG and the GSSG/GSH ratio were significantly higher in patients with BRONJ than in controls. We found no significant difference in OS according to BRONJ stage, sex, or location in the jaws. Logistic regression analysis revealed that the GSSG/GSH ratio was a significant factor predicting the development of BRONJ (P = 0.01).ConclusionsOxidative stress was detected in patients with BRONJ, and the GSSG/GSH ratio was the most significant OS variable found; it was a significant factor predicting the development of BRONJ.

Original publication




Journal article


Journal of oral pathology & medicine : official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology

Publication Date





371 - 377


Department of Oral Medicine, Valencia University, Valencia, Spain; Service of Stomatology and Maxillofacial Surgery, University General Hospital, Valencia, Spain.


Saliva, Humans, Multiple Myeloma, Breast Neoplasms, Malondialdehyde, Diphosphonates, Adrenal Cortex Hormones, Glutathione, Glutathione Disulfide, Deoxyguanosine, Antineoplastic Agents, Dental Plaque Index, DMF Index, Oral Hygiene Index, Case-Control Studies, Sex Factors, Oxidative Stress, Aged, Middle Aged, Female, Male, Bisphosphonate-Associated Osteonecrosis of the Jaw, Administration, Intravenous, Biomarkers, 8-Hydroxy-2'-Deoxyguanosine