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阿仑膦酸钠局部给药对减少大鼠牙周手术后牙槽骨丧失的有效性。

Effectiveness of local delivery of alendronate in reducing alveolar bone loss following periodontal surgery in rats.

作者信息

Binderman I, Adut M, Yaffe A

机构信息

Department of Oral Biology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Israel.

出版信息

J Periodontol. 2000 Aug;71(8):1236-40. doi: 10.1902/jop.2000.71.8.1236.

Abstract

BACKGROUND

Mucoperiosteal flaps are used to access bone and root surfaces for debridement, pocket elimination, management of periodontal defects, and in regenerative procedures, as well as in implant surgery. Many reports show that periodontal surgery stimulates osteoclast activity with varying amounts of alveolar bone loss. Alendronate given intravenously significantly reduced alveolar bone loss in mucoperiosteal flap procedures. In the present study, we explored the effectiveness of different concentrations of alendronate, delivered at the surgical site at the time of surgery, in distant delivery in reducing alveolar bone loss.

METHODS

Following elevation of a mucoperiosteal flap next to molars of the rat mandible, a gelatin sponge soaked with different concentrations of alendronate (0, 1, 5, 20, or 40 mg/ml; experiment A) was applied to exposed bone on the experimental side. In the second group (experiment B), alendronate (0, 50, 200, or 400 microg) was topically delivered in the cheek submucosa on the left side (distant to the surgical site) in a small cut into which the gelatin sponge soaked with the drug was placed.

RESULTS

Topical application of 200 microg and 400 microg doses of alendronate at the time of surgery was significantly effective (P <0.001) in reducing bone loss. Generally, the percentage of sections with mild bone loss (V1, V2) increased with an increase in the dose of alendronate, while the percentage of sections with severe bone loss (H1, H2) decreased with an increase in alendronate dose. Topical application of 400 microg of alendronate had a systemic effect.

CONCLUSIONS

This study implies that topical delivery of alendronate at the time of surgery reduces bone loss in periodontal procedures involving mucoperiosteal flap surgery. The most effective dose is 200 microg for topical delivery at the surgical site and 400 microg for distant sites.

摘要

背景

黏骨膜瓣用于暴露骨面和牙根表面以进行清创、消除牙周袋、治疗牙周缺损、再生手术以及种植手术。许多报告表明,牙周手术会刺激破骨细胞活性,导致不同程度的牙槽骨丧失。静脉注射阿仑膦酸钠可显著减少黏骨膜瓣手术中的牙槽骨丧失。在本研究中,我们探讨了手术时在手术部位给予不同浓度阿仑膦酸钠进行远距离给药以减少牙槽骨丧失的有效性。

方法

在大鼠下颌磨牙旁掀起黏骨膜瓣后,将浸泡有不同浓度阿仑膦酸钠(0、1、5、20或40mg/ml;实验A)的明胶海绵应用于实验侧暴露的骨面。在第二组(实验B)中,将阿仑膦酸钠(0、50、200或400μg)局部注射到左侧颊黏膜下层(远离手术部位)的一个小切口中,切口内放置浸泡有药物的明胶海绵。

结果

手术时局部应用200μg和400μg剂量的阿仑膦酸钠在减少骨丧失方面具有显著效果(P<0.001)。一般来说,轻度骨丧失(V1、V2)切片的百分比随阿仑膦酸钠剂量的增加而增加,而重度骨丧失(H1、H2)切片的百分比随阿仑膦酸钠剂量的增加而降低。局部应用400μg阿仑膦酸钠具有全身效应。

结论

本研究表明,在涉及黏骨膜瓣手术的牙周手术中,手术时局部应用阿仑膦酸钠可减少骨丧失。手术部位局部给药的最有效剂量为200μg,远距离给药的最有效剂量为400μg。

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