Is Bisphosphonate Use For The Treatment Of Benign Bone Disease Associated With Impaired Dental Healing?
Funder
National Health and Medical Research Council
Funding Amount
$238,160.00
Summary
Osteoporosis (OSP) is a common condition where bones are thin and may break (fracture). Currently, approximately 2 million Australians suffer from OSP. This figure will rise over the next 20 years as people age. Recommended drug treatment of OSP involves medication called bisphosphonates. Recent research, including a warning from the National Adverse Drug Reaction Committee, has suggested a possible association between bisphosphonates and bone breakdown in the jaw (osteonecrosis) - a devastating ....Osteoporosis (OSP) is a common condition where bones are thin and may break (fracture). Currently, approximately 2 million Australians suffer from OSP. This figure will rise over the next 20 years as people age. Recommended drug treatment of OSP involves medication called bisphosphonates. Recent research, including a warning from the National Adverse Drug Reaction Committee, has suggested a possible association between bisphosphonates and bone breakdown in the jaw (osteonecrosis) - a devastating condition for which no effective treatment exists. This study seeks to determine if bisphosphonate use for the treatment of OSP or other non-cancerous (benign) bone disease (eg Paget's disease) slows dental healing and increases the risk of jaw osteonecrosis. This has major implications and significant potential benefits for the large numbers of people with OSP taking bisphosphonates. Currently, the chance of dental complications during bisphosphonate therapy and what factors predispose to such complications remains unclear. Given the large numbers of people at risk, these are important issues that require urgent careful investigation. We want to determine if long-term (more than 2 years' duration) bisphosphonate treatment of OSP or other benign bone disease slows dental healing and leads to jaw osteonecrosis. We will use a case-control study design given the expected low likelihood of slowed dental healing. This design involves identifying patients with slowed dental healing (cases), and patients with normal dental healing (controls). Cases and controls will then be compared for bisphosphonate use to see if it is more likely that cases have been taking bisphosphonates. Our results will help guide treatment recommendations for these drugs both nationally and internationally.Read moreRead less
A Randomised Controlled Trial To Evaluate The Effectiveness Of Zoledronate Therapy In Osteonecrosis Of The Hip.
Funder
National Health and Medical Research Council
Funding Amount
$535,441.00
Summary
Osteonecrosis of the hip is an important cause of musculoskeletal disability and finding therapeuticsolutions has proven to be challenging. A wide range of surgical treatments with variable success rates ahve been proposed for the treatment. Non-surgical treatment options are limited and usually result in a poor prognosis. This novel clinical trial research will study the protective value of a bisphosphonate in patients with osteonecrosis of the hip and evaluate the cost-effectiveness.
Control Of Mastication By Periodontal Mechanoreceptors In Man
Funder
National Health and Medical Research Council
Funding Amount
$169,990.00
Summary
Despite the importance in chewing and speech, very little is known regarding the fine control of jaw muscles. A thorough understanding of the control of the jaw muscles is at the base of improved diagnosis and treatment of many chewing disorders. For example: We still do not understand the causes of the jaw muscle-joint pain disorder (temporomandibular dysfunction) which accounts for about 5 % of total dental patients. The current treatments, including pain killers, night plates and massage cure ....Despite the importance in chewing and speech, very little is known regarding the fine control of jaw muscles. A thorough understanding of the control of the jaw muscles is at the base of improved diagnosis and treatment of many chewing disorders. For example: We still do not understand the causes of the jaw muscle-joint pain disorder (temporomandibular dysfunction) which accounts for about 5 % of total dental patients. The current treatments, including pain killers, night plates and massage cure only about half of all patients. Improved diagnosis and treatment techniques require more precise elaboration of the neural and muscular mechanisms of chewing. Why do the chewing forces in toothless individuals, despite well fitting dentures, fall to about 20 % of the value in teethed individuals? Do jaw muscles in these subjects weaken because they get less feedback from the receptors around the teeth? How does the chewing force automatically adjust to overcome sudden or gradual changes in the characteristics of foodstuff? Although bite to bite changes in the chewing force is observed in subjects with natural teeth, no such changes occur in toothless subjects or subjects chewing with implanted bridges. How do the receptors adjust the activation of jaw muscles so that bite force is applied in the right direction and right amount at each bite? The aim of this study is to define the importance of the periodontal mechanoreceptors (tiny nerve cells that are situated between the roots of the teeth and the jaw bone that signal bite force to the brain) in the control of jaw muscles. This study will, therefore, illustrate the importance of keeping the teeth and gums healthy for the development of strong, smooth and well-controlled chewing forces, and potentially create opportunities to improve chewing (and thereby quality of life) in toothless individuals or those experiencing other difficulties in chewing.Read moreRead less
Effect Zoledronic Acid And Risedronate On The Preservation Of The Femoral Head In A Rat Model Of Perthes Disease
Funder
National Health and Medical Research Council
Funding Amount
$199,750.00
Summary
Perthes Disease (Legg-Perthes Disease) is a common childhood disorder, which leads to collapse and deformity of the growing hip joint. This can lead to arthritis in adult life, as well as a short leg on the affected side. The cause is as yet unknown. A class of drugs called bisphosphonates has been shown to help children with osteogenesis imperfecta (brittle bone disease). We believe, based on our extensive studies of the effect of these drugs on bone healing, that they could also help children ....Perthes Disease (Legg-Perthes Disease) is a common childhood disorder, which leads to collapse and deformity of the growing hip joint. This can lead to arthritis in adult life, as well as a short leg on the affected side. The cause is as yet unknown. A class of drugs called bisphosphonates has been shown to help children with osteogenesis imperfecta (brittle bone disease). We believe, based on our extensive studies of the effect of these drugs on bone healing, that they could also help children with Perthes disease. Although proving to be safe and effective in children with osteogenesis imperfecta, before exposing children with Perthes disease to the risk of any side effects, animal studies are needed. A certain type of rat called the spontaneously hypertensive rat gets a condition almost exactly the same as Perthes disease. This study will treat a large number of these rats and perform detailed study into whether it has a positive effect on preserving the shape of the hip joint, as well as looking into how this actually occurs. A successful outcome would pave the way for trials in children with Perthes disease, and could result in the avoidance of surgery and improved health outcomes for the children.Read moreRead less
Temporomandibular Disorders (TMD) are characterised by pain and limited jaw movement and are a significant issue. Current management is influenced by the view of a simple association between pain and limited movement. This study will test a new theory that an individual's motor response to pain is influenced by the complexity of the jaw motor system as well as the individual's pain experience. This project will point towards individualised recommendations for effective management of TMD.