Copper accumulation in the sequestrum of medication-related osteonecrosis of the jaw.

Bisphosphonates (BPs) have been widely, efficiently, and safely used for the treatment of various bone-related diseases such as osteoporosis. However, concerns about jaw osteonecrosis associated with oral treatment (medication-related osteonecrosis of the jaw [MRONJ]) have been increasing. Although many risk factors for MRONJ have been elucidated, its precise etiology and methods of prevention remain unknown. In this study, we have applied various elemental analysis methods for MRONJ specimens (e.g., X-ray fluorescence with synchrotron radiation [SR-XRF], particle-induced X-ray emission [PIXE], X-ray absorption fine structure [XAFS]) in order to reveal the accumulation and chemical state of trace bone minerals. In four MRONJ sequestra, the characteristic localization of copper (Cu) was observed by SR-XRF. Using micro-PIXE analysis, Cu looked to be localized near the edge of the trabecular bone. The chemical state of the accumulated Cu was estimated using XAFS and the possibility of a Cu-BP complex formation was assumed. Thus, in this study we argue for the feasibility of the trace element analysis to evaluate the potential pathophysiological mechanism of MRONJ.

Mechanism of incorporation of zinc into hydroxyapatite.

The atomic level mechanism of incorporation of Zn(2+) into hydroxyapatite (HAp), which is a potential dopant to promote bone formation, was investigated, based on first principles total energy calculations and experimental X-ray absorption near edge structure (XANES) analyses. It was found that Zn(2+)-doped HAp tends to have a Ca-deficient chemical composition and substitutional Zn(2+) ions are associated with a defect complex with a Ca(2+) vacancy and two charge compensating protons. Moreover, first principles calculations demonstrated that Zn(2+) incorporation into HAp can take place by occupying the Ca(2+) vacancy of the defect complex. The Ca(2+) vacancy complex is not only the origin of the calcium deficiency in HAp, but also plays a key role in the uptake of trace elements during mineralization.

First-principles calculations of Zn-K XANES in Ca-deficient hydroxyapatite.

The local environment of substitutional Zn(2+) in Ca-deficient hydroxyapatite (HAp) was investigated using experimental and theoretical analyses of the x-ray absorption near edge structure (XANES). For Zn-K XANES calculations, two situations of Zn(2+) were considered. One was Zn(2+) substituted for Ca sites in perfect HAp, and the other was a Ca-deficient HAp model of substitutional Zn(2+) associated with a Ca(2+) vacancy charge compensated by two protons. The model of Zn(2+) in perfect HAp did not reproduce the experimental Zn-K XANES spectrum. In contrast, the Ca-deficient HAp model agreed well with the experimental spectrum. This indicates that substitutional Zn(2+) in Ca-deficient HAp is associated with the Ca(2+) vacancy complex in HAp.