[Microradiographic study of iliac bone biopsies taken after treatment of postmenopausal osteoporosis with sodium fluoride. Histomorphometric correlations].

Thirty seven female patients with osteoporosis underwent iliac bone biopsy after 10 to 23 months of continuous or discontinuous treatment with sodium fluoride, calcium, and vitamin D. Microradiographs of the biopsies from 13 patients showed one or--more often--several of the characteristic appearances of bone fluorosis: defects in periosteocytic mineralization, unmineralized strips inside the trabeculae of spongy bone, construction of fibrous bone, hypercalcified periosteal apposition. The occurrence of these microradiographic signs of fluorosis does not seem to be linked either to the age of the patients, to the interval elapsed since ovarian function ceased, or to the degree of bone remodelling at the time that treatment was started. Moreover, none of these patients showed signs of even moderate renal insufficiency. Should the development of this fluorosis, which is most frequently clinically asymptomatic, be considered as a condition or as a factor in therapeutic efficacy? Or are the effects detrimental and therefore to be avoided by a reduction in dosage or a change in therapeutic methods?