Mulinari-Santos Gabriel, de Souza Batista Fábio Roberto, Kirchweger Franziska, Tangl Stefan, Gruber Reinhard, Okamoto Roberta
Department of Oral Surgery and Integrated Clinic, Araçatuba Dental School, Universidade Estadual Paulista "Júlio de Mesquita Filho", Araçatuba, Brazil.
Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Department of Oral Surgery, School of Dentistry, Medical University of Vienna, Vienna, Austria.
Clin Oral Implants Res. 2018 Nov;29(11):1126-1134. doi: 10.1111/clr.13376. Epub 2018 Oct 31.
Hypertension is not only associated with cardiovascular diseases but also with alterations in bone quality. Hypertension therefore might be a risk factor for osseointegration. Preclinical studies suggest that losartan, an angiotensin II receptor blocker widely used to treat hypertension, has a beneficial effect in graft consolidation. Here, we determine the effect of hypertension and losartan on osseointegration.
We used spontaneously hypertensive rats (SHR) and normotensive Wistar albinus rats receiving losartan (30 mg/kg, p.o.) or left untreated. After 1 week, titanium miniscrews were inserted into the tibia. Sixty days after implantation, implant stability was evaluated by removal torque measurement considered the primary endpoint. Microcomputed tomography and histomorphometric analysis were secondary endpoints.
Losartan increased the removal torque in the hypertensive SHR group to levels of the Wistar controls. While the cortical parameters of osseointegration remained unchanged, losartan increased medullary bone formation. Microcomputed tomography revealed a higher bone volume per tissue volume and trabecular thickness in the SHR rats treated with losartan. Histomorphometric analysis further showed that losartan significantly increased the thickness of newly formed bone in medullary area in hypertensive SHR rats. Losartan did not significantly alter the parameters of osseointegration in normotensive rats.
The data presented suggest that the angiotensin II receptor antagonist losartan increases the medullary parameters of osseointegration in a tibia model of spontaneously hypertensive rats. Considering the study limitations, understanding the impact of hypertension and the respective drugs on osseointegration requires further research.
高血压不仅与心血管疾病相关,还与骨质量改变有关。因此,高血压可能是骨整合的一个危险因素。临床前研究表明,氯沙坦是一种广泛用于治疗高血压的血管紧张素II受体阻滞剂,对移植物巩固有有益作用。在此,我们确定高血压和氯沙坦对骨整合的影响。
我们使用自发性高血压大鼠(SHR)和接受氯沙坦(30mg/kg,口服)或未治疗的正常血压Wistar白化大鼠。1周后,将微型钛螺钉植入胫骨。植入60天后,通过移除扭矩测量评估植入物稳定性,将其视为主要终点。微计算机断层扫描和组织形态计量分析为次要终点。
氯沙坦使高血压SHR组的移除扭矩增加到Wistar对照组的水平。虽然骨整合的皮质参数保持不变,但氯沙坦增加了髓质骨形成。微计算机断层扫描显示,用氯沙坦治疗的SHR大鼠的每组织体积骨体积和小梁厚度更高。组织形态计量分析进一步表明,氯沙坦显著增加了高血压SHR大鼠髓质区域新形成骨的厚度。氯沙坦对正常血压大鼠的骨整合参数没有显著影响。
所呈现的数据表明,血管紧张素II受体拮抗剂氯沙坦在自发性高血压大鼠胫骨模型中增加了骨整合的髓质参数。考虑到研究局限性,了解高血压和相应药物对骨整合的影响需要进一步研究。