Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Daneshjou Boulevard, Evin, P.O. 19839, Tehran, Iran.
Department of Surgery and Radiology, Center of Excellence for Cell Therapy and Tissue Engineering, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran.
Clin Oral Investig. 2019 Apr;23(4):1803-1809. doi: 10.1007/s00784-018-2579-7. Epub 2018 Sep 5.
Bisphosphonates (BPs) are anti-resorptive medications with inhibitory effects on osteoclasts which decrease bone turnover. The present study aimed to assess the early effects of BPs on peri-implant bone.
Twelve female mongrel dogs were assigned to one control and two experimental groups as follows: 12 months of oral alendronate (ALN, 3.5 mg/kg/week) or intravenous (IV) pamidronate (PAM, 1 mg/kg/week) for experimental groups. Following 8 weeks after implant insertion, the specimens were sacrificed, histological evaluation was performed, and C-terminal telopeptide of collagen I (CTx) analysis was performed on serums.
PAM demonstrated the greatest marginal bone level (MBL), 2.64 ± 0.48, followed by ALN and control, 2.5 ± 0.4 and 0.66 ± 0.5 respectively. The least bone-implant contact was observed in PAM group (%39 ± 0.03) while it was significantly greater in the control group (p < 0.05). PAM and ALN demonstrated < 10 CTx levels versus > 300 in controls.
It is assumed that long-term oral or IV BP therapy decreases marginal bone resorption and osseointegration. These changes were more accentuated in IV BP administration. CTx does not seem to be a precise predictor for bisphosphonate-related osteonecrosis of the jaw.
BPs impair peri-implant bone remodeling and this phenomena may be effective for reducing resorption at esthetic zone implants; however, decrease in osseointegration may be a concern for implant treatment in patients receiving BPs.
双膦酸盐（BPs）是具有抑制破骨细胞作用的抗吸收药物，可减少骨转换。本研究旨在评估 BPs 对种植体周围骨的早期影响。
将 12 只雌性杂种犬分为对照组和两个实验组，如下所示：实验组给予口服阿仑膦酸钠（ALN，3.5mg/kg/周）或静脉注射帕米膦酸二钠（PAM，1mg/kg/周）治疗 12 个月。植入物插入 8 周后，处死标本，进行组织学评估，并对血清中的 I 型胶原 C 末端肽（CTX）进行分析。
PAM 显示最大的边缘骨水平（MBL），为 2.64±0.48，其次是 ALN 和对照组，分别为 2.5±0.4 和 0.66±0.5。PAM 组的骨-种植体接触率最低（%39±0.03），而对照组显著更高（p<0.05）。PAM 和 ALN 的 CTx 水平<10，而对照组>300。
长期口服或静脉 BP 治疗可减少边缘骨吸收和骨整合。这些变化在静脉 BP 给药中更为明显。CTX 似乎不是预测双膦酸盐相关颌骨坏死的准确指标。
BPs 会损害种植体周围骨重塑，这种现象可能有助于减少美学区域种植体的吸收；然而，对于接受 BPs 治疗的患者，骨整合减少可能是一个令人担忧的问题。
