Three-dimensional Microarchitecture and Local Mineralization of Human Jaws affected by Bisphosphonate-related Osteonecrosis

Recently, we showed that osteocyte lacunar volume and distribution, as well as mineralized bone mass density, are dependent on the specific region of the jaw in patients suffering from bisphosphonate-related osteonecrosis of the jaw (BRONJ) [1]. Indeed, a significant heterogeneity was found in terms of osteocyte lacunar morphology, most likely due to the variety of mechanical loading in the different regions. As lately shown, bone can be described through a model of mineral and collagen assembly in which the mineral organization is hierarchical, following a fractal-like organization that is self-affine [2]. This assembly explains the interesting combination of stiffness and toughness of bone, suggesting that the full understanding of bone pathophysiology passes through the combined study of the tissue at different hierarchical levels. Therefore, in the present study, we quantitatively investigated the trabecular structure and the mineralization balance in jaw biopsies of patients with BRONJ, previously studied in terms of osteocyte lacunar volume and distribution [1], with the objective of verifying the effect of the pathology at micro-level, thus on the biomechanical performances...