Departament of Dental Clinic - Federal University of Ceara, Fortaleza, Ceará, Brazil.
Departament of Dental Clinic - Federal University of Ceara, Fortaleza, Ceará, Brazil.
Arch Oral Biol. 2020 Apr;112:104680. doi: 10.1016/j.archoralbio.2020.104680. Epub 2020 Feb 7.
TNF-α, which acts directly on osteoclastogenesis, may modify bone turnover. Thus, the objective of this study was to evaluate the influence of infliximab on extraction socket healing.
Eighty-four Wistar rats were randomized into two groups (infliximab EV 5 mg / kg or saline EV 1 ml / kg) and submitted to lower first molar extraction protocol. The animals were sacrificed 1, 3, 7, 14, 21 and 28 days after surgery. The jaws were subjected to radiographic, histomorphometric, histochemical (picrosirius red) and immunohistochemical (TNF-α, RANKL and OPG) analysis.
No differences were observed between the groups in surgical difficulty parameters: mass of teeth, number of root fractures and surgical time. Lower area filling with bone as well as increased amounts of remaining cicatricial tissue were observed in the infliximab group at 14 days (p < 0.001). Lower scores for polymorphonuclear neutrophils were seen at 3 (p < 0.01) and 7 days (p < 0.001), lower mononuclear counts at 7 days (p < 0.01) and lower osteoclast counts at 7 and 14 days (p < 0.01 and p < 0.001, respectively). Additionally, reduced TNF-α, RANKL and OPG immunoreactivity were observed, especially at 7 days (p < 0.05).
TNF-α inhibitor may alter the bone repair capacity after tooth extraction, especially in the initial repair periods, by lower expression of TNF α, RANKL and OPG. Thus, additional caution may be needed in patients who use this class of medication after dental extraction.
TNF-α 可直接作用于破骨细胞生成，从而改变骨转换。因此，本研究旨在评估英夫利昔单抗对拔牙窝愈合的影响。
84 只 Wistar 大鼠随机分为两组（英夫利昔单抗 EV 5mg/kg 或生理盐水 EV 1ml/kg），并接受下颌第一磨牙拔除术。术后 1、3、7、14、21 和 28 天处死动物。对颌骨进行放射学、组织形态计量学、组织化学（苦味酸天狼星红）和免疫组织化学（TNF-α、RANKL 和 OPG）分析。
两组在手术难度参数（牙齿质量、根折数量和手术时间）方面无差异。在第 14 天，英夫利昔单抗组牙槽骨下面积填充较多，剩余瘢痕组织较多（p<0.001）。第 3 天（p<0.01）和第 7 天（p<0.001）中性粒细胞评分较低，第 7 天单核细胞计数较低（p<0.01），第 7 天和第 14 天破骨细胞计数较低（p<0.01 和 p<0.001）。此外，观察到 TNF-α、RANKL 和 OPG 免疫反应降低，尤其是在第 7 天（p<0.05）。
TNF-α 抑制剂可能通过降低 TNF-α、RANKL 和 OPG 的表达来改变拔牙后骨修复能力，尤其是在初始修复期。因此，在拔牙后使用此类药物的患者中可能需要更加小心。
