Botafbraak

Botafbraak is a medical term used in Dutch to describe the process by which bone tissue is degraded or resorbed, resulting in reduced bone mass and weakened strength. In English, the terms bone resorption or osteolysis are commonly used. The concept appears in fields such as orthopedics, dentistry, and pathology.

Mechanism involves the normal bone remodeling cycle, in which osteoclasts break down old bone and osteoblasts form new bone. When resorption outpaces formation, or when inflammatory, infectious, or neoplastic processes provoke accelerated destruction, net bone loss occurs. Localized botafbraak can occur around implants or tumors, while systemic bone loss is seen in conditions like osteoporosis.

Causes and conditions associated with botafbraak include osteoporosis, osteolysis around prosthetic joints or metastases, periodontal disease with alveolar bone loss, osteomyelitis, hyperparathyroidism, chronic inflammatory diseases, and long-term glucocorticoid use. Trauma or radiation can also contribute to bone degradation. Symptoms may include bone pain, increased fracture risk, or dental changes, though some cases are asymptomatic and detected via imaging or routine testing.

Diagnosis combines imaging and laboratory evaluation. X-rays, CT, and MRI identify areas of bone loss; bone scintigraphy can show active resorption; DXA assesses bone density. Laboratory tests may measure calcium, phosphate, parathyroid hormone, vitamin D, and bone turnover markers. In uncertain cases, biopsy or histology can be informative.

Treatment targets the underlying cause and may include calcium and vitamin D supplementation, lifestyle measures (weight-bearing exercise, smoking cessation), and pharmacologic therapy such as bisphosphonates or denosumab; anabolic agents like teriparatide may be used in select situations. Dental care is important for periodontal bone loss.

See also: osteoporosis, osteolysis, bone remodeling, osteomyelitis.