Histologisch-histomorphometrische Verlaufsbeobachtungen bei der Fluortherapie der Osteoporose
In addition to the dosage, the total amount of fluoride applied and the duration of treatment, also the initial histodynamic situation is of crucial importance for the mode and extent of the traction of a spongy bone to a fluorid therapy of osteoporosis. In low turnover osteoporosis, even after 2 years an unsufficient therapeutic effect can, both clinically and roentgenologically, be conspicuous by the relatively late reaching the phase of osteoidosis. On the other hand, high turnover osteoporosis show a tendency to a depression of the activity of cellular bone remodelling, if the monotherapy with fluoride lasts too long. In both cases, the chematic administration of 60–80 mg of sodium fluoride per day should be revised. Pauses of fluoride therapy with administration of vitamin D and calcium or as general triple therapy with fluoride pauses should be taken into consideration. Moreover, the overall amount of fluoride designed for therapy as well the overall treatment period should be variable for high and low turnover osteoporosis. Uncontrolled too long fluoride therapy or too high doses of it will result in histologic pictures of the spongy bone that remind more of a mixed osteopathy than of an osteoporosis and, hence, require quite different therapy consequences. The initial histomorphometric analysis and an appropriate control the course or termination should be considered in every proper therapy of osteoporosis.
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