An in vitro study on the role of calcium in bisphosphonate-related osteonecrosis of jaw.

Bisphosphonate (BP) is known to possess cytotoxicity in mucosal tissues. In this study, we demonstrated that calcium enhances the cytotoxic effects of BP on cultured epithelial cells, using one of the popular intravenous BPs, zoledronate (ZA). It is of note that low concentrations of ZA, which alone had little effects, could be toxic to the epithelial cells depending on the conditions of extracellular calcium. We think that the present results will be an important knowledge to elucidate the cytotoxic mechanism of BP to mucosal tissues.