Clinical Oral Investigations

, Volume 22, Issue 7, pp 2527–2534 | Cite as

Effects of an oral bisphosphonate and three intravenous bisphosphonates on several cell types in vitro

  • Junho Jung
  • Jung Soo Park
  • Leonardo Righesso
  • Andreas Max Pabst
  • Bilal Al-Nawas
  • Yong-Dae KwonEmail author
  • Christian WalterEmail author
Original Article



To analyze the influence of an oral bisphosphonate and compare the potency to intravenous bisphosphonates on various cell types as regards the rarity of bisphosphonate-associated osteonecrosis of the jaw (BP-ONJ) caused by oral bisphosphonate.

Materials and methods

A viability assay (MTT), a migration assay (Boyden chamber), and an apoptosis assay (Caspase-Glo® 3/7) were performed to analyze the effect of bisphosphonates on human fibroblasts, umbilical vein endothelial cells (HUVEC), and osteoblasts.


Alendronate and intravenous bisphosphonates suppressed cell viability and migration, and induced apoptosis in all tested cell types. Alendronate had a greater impact than ibandronate on the characteristics in fibroblasts and osteoblasts but not as strong as zoledronate.


The incidence of BP-ONJ in oral bisphosphonate treatment is reported to be much lower than that in intravenous bisphosphonates. However, the influences of alendronate on human cells were at least as strong as ibandronate, although it was lower than zoledronate.

Clinical relevance

Alendronate showed strong enough effects to suppress human somatic cells and was comparable to certain intravenous bisphosphonates in potency. This study suggests that the lower incidence of BP-ONJ in alendronate treatment is not originated by its potency, but might be due to the low bioavailability of alendronate, lower dosing on a daily basis, and having no additional therapies.


Bisphosphonate Alendronate Bisphosphonate-associated osteonecrosis of the jaw BP-ONJ HUVEC Fibroblasts Osteoblasts 



The part of this work was presented in thesis form for the doctoral dissertation for Junho Jung from Johannes-Gutenberg University Mainz.


This study was funded by the International Team for Implantology (ITI) scholarship program (to the first author).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Informed consent is not required for this study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Junho Jung
    • 1
    • 3
  • Jung Soo Park
    • 2
  • Leonardo Righesso
    • 1
  • Andreas Max Pabst
    • 1
    • 4
  • Bilal Al-Nawas
    • 1
  • Yong-Dae Kwon
    • 3
    Email author
  • Christian Walter
    • 1
    • 5
    Email author
  1. 1.Department of Oral and Maxillofacial Surgery, Plastic SurgeryUniversity Medical Center of the Johannes Gutenberg-University MainzMainzGermany
  2. 2.Department of PeriodontologyKorea University Anam HospitalSeoulRepublic of Korea
  3. 3.Department of Oral and Maxillofacial Surgery, School of DentistryKyung Hee UniversitySeoulRepublic of Korea
  4. 4.Department of Oral and Maxillofacial SurgeryFederal Armed Forces HospitalKoblenzGermany
  5. 5.Oral and Maxillofacial Surgery – Facial Plastic SurgeryMediplus ClinicMainzGermany

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