Huja Sarandeep S, Mason Amin, Fenell Celia E, Mo X, Hueni Sarah, D'Atri Andrew M, Fernandez Soledad A
Division of Orthodontics, The Ohio State University, Columbus, OH, USA.
J Oral Maxillofac Surg. 2011 Feb;69(2):418-27. doi: 10.1016/j.joms.2010.05.062. Epub 2010 Dec 3.
It is unknown whether zoledronic acid (ZA) interferes with initial bone healing at extraction and implant sites. The goal of this study was to examine the effect of short-duration ZA on bone remodeling and healing after surgical insult in an aged dog model.
Four 2- to 3-year-old male dogs were administered ZA (0.1 mg/kg per month for 4 months), and 3 age-matched untreated dogs received no drug. In both groups, after the ZA-treated group had completed receiving the drug, the third premolar was extracted unilaterally and 2 orthodontic mini-implants per jaw per dog were placed on the ipsilateral side. After a 6-week healing period, a pair of calcein bone labels were administered. Bone sections from the mandible, maxilla, rib, and femur were obtained. The percent necrosis in the alveolar and basal regions of tooth-supporting bone was assayed by lactate dehydrogenase, and dynamic histomorphometric parameters were quantified and analyzed by use of mixed models.
All extraction sites healed uneventfully, and no lesions resembling osteonecrosis were detected. The total percent necrosis was limited to less than 1% for all the bone sites examined. The ZA reduced bone remodeling at both surgical sites (extraction sites and mini-implant site) and nonsurgical sites. Although there was a significant (P < .05) increase in bone formation rate at the surgical sites in the untreated group, this increase was not significant (P = .3) in the ZA-treated group.
Bone remodeling occurs in ZA-treated animals at surgical sites. ZA dramatically reduced bone turnover, but no exposed lesions resembling osteonecrosis developed at extraction and mini-implant sites after the 4-month drug duration.
唑来膦酸（ZA）是否会干扰拔牙和种植部位的初期骨愈合尚不清楚。本研究的目的是在老年犬模型中研究短期使用ZA对手术创伤后骨重塑和愈合的影响。
4只2至3岁的雄性犬给予ZA（每月0.1mg/kg，共4个月），3只年龄匹配的未治疗犬未用药。两组中，在ZA治疗组完成用药后，单侧拔除第三前磨牙，每只犬每侧颌骨植入2枚正畸微型种植体。经过6周的愈合期后，给予一对钙黄绿素骨标记物。获取下颌骨、上颌骨、肋骨和股骨的骨切片。通过乳酸脱氢酶检测支持牙齿的牙槽骨和基底部区域的坏死百分比，并使用混合模型对动态组织形态计量学参数进行量化和分析。
所有拔牙部位均顺利愈合，未检测到类似骨坏死的病变。所有检查的骨部位的总坏死百分比均限制在1%以下。ZA降低了手术部位（拔牙部位和微型种植体部位）和非手术部位的骨重塑。虽然未治疗组手术部位的骨形成率显著（P <.05）增加，但在ZA治疗组中这种增加并不显著（P =.3）。
在接受ZA治疗的动物中，手术部位会发生骨重塑。ZA显著降低了骨转换，但在4个月的用药期后，拔牙和微型种植体部位未出现类似骨坏死的暴露病变。
