Bone regeneration biomarkers in maxillofacial surgery: a critical review of literature

Abstract

Relevance. Drug-associated osteonecrosis is known to cause some pathological changes. The titers of biomarkers responsible for bone metabolism are also subject to such changes. They are essential in the diagnosis and treatment planning, especially during surgical interventions, because of the risk of osteonecrosis. Purpose – based on the data of modern scientific literature and articles, identifying markers of bone remodeling and endothelial disorders is of primary importance for optimizing the early diagnosis of microcirculati on disorders in patients with maxillofacial pathologies.Materials and methods. A review of available data in the literature on normal bone anatomy, bone biomarkers, and regulatory factors. The study of diagnostic modes and identification of the most valuable and fastest in bone and vascular endothelium impairment.Results. According to the studies, osteocalcin, C-terminal telopeptide, tartrate-resistant acid phosphatase and VEGF are clinically the most informative for predicting jawbone osteonecrosis. With a serum C-terminal telopeptide concentration of less than 100 pg/mL, the risk of osteonecrosis increases. Serum osteocalcin is a specific biomarker of osteoblast function for assessing the rate of bone formation in osteoporosis. The average osteocalcin level revealed a significant difference between postmenopausal osteoporotic (16.16 ± 4.5 ng/ml) and non-osteoporotic (11.26 ± 3.07 ng/ml) women. Tartrate-resistant acid phosphatase (TRAP 5b) is used to reference the activity and number of osteoclasts. TRAP 5b can be specifically detected in serum by immunoassays.Conclusion. The study of bone degeneration markers and vascular markers allows us to understand the principles of the occurrence of osteonecrosis more clearly, and, therefore, more clearly predict, diagnose osteonecrosis, and also correctly select the tactics of treatment for these patients, the type of surgical intervention, conservative, operative (partial resection, total jaw resection), – palliative, pre- and post-drug preparation of the body for intervention.