Department of Pediatric Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café s/n, Ribeirão Preto, SP, 14040-904, Brazil.
University of Rio Verde, Rio Verde, Goiás, Brazil.
Clin Oral Investig. 2021 Mar;25(3):1255-1264. doi: 10.1007/s00784-020-03430-1. Epub 2020 Jul 29.
To evaluate denosumab, a human monoclonal antibody that mimics the effects of osteoprotegerin in bone metabolism, as a topical treatment of root surface to be used prior to delayed tooth replantation.
Thirty-six rats' right incisors were used. Teeth were extracted and divided into: delayed replantation without root surface treatment (control); delayed replantation with root surface treatment with denosumab 60 mg/mL and 30 mg/mL, respectively, for 10 min both experimentals groups. After that, the root canals were filled with calcium hydroxide and replanted. After 15 and 60 days, the animals were euthanized, and the samples were collected and processed for microscopic analysis. Histological sections were performed, and stained with HE to describe the dental characteristics, measure ankylosis, replacement resorption, and dental resorption by conventional microscopy. Also, was performed Brown & Brenn staining and immunohistochemistry for RANKL, OPG, and periostin.
Denosumab 60 mg/mL reducted ankylosis (p < 0.0001), replacement resorption (p < 0.0001), and tooth resorption, 60 days after replantation, compared to untreated replanted teeth (p < 0.005). Lower bacterial contamination in root surface in the denosumab treatment groups was found, regardless of the concentration used (p < 0.001). Also, denosumab treatment inhibited the expression of RANKL without modulating OPG. Periostin was observed in periodontal ligament of replanted tooth, although this labelling was absent in the ankylosis areas, in both experimental periods.
Treatment of the root surface with denosumab at 60 mg/mL of rat teeth before delayed replantation reduced dental root resorption compared with the untreated teeth after 60 days.
Survival of a replanted tooth has been a challenge in clinical practice. The use of a medication, such as denosumab, to limit dental root resorption represents an important therapeutical approach.
评估地舒单抗，一种模拟骨保护素在骨代谢中作用的人源单克隆抗体，作为延迟牙再植前根面的局部治疗。
使用 36 只大鼠的右切牙。牙齿被拔出并分为三组：无根面处理的延迟再植（对照组）；分别用 60mg/ml 和 30mg/ml 的地舒单抗进行根面处理，实验组各处理 10 分钟。之后，根管用氢氧化钙填充并再植。15 和 60 天后，处死动物，收集样本并进行显微镜分析。进行组织学切片，用 HE 染色描述牙特征，通过常规显微镜测量骨性粘连、替代吸收和牙吸收。还进行了 Brown&Brenn 染色和 RANKL、OPG 和骨膜蛋白的免疫组织化学染色。
60mg/ml 的地舒单抗减少了再植后 60 天的骨性粘连（p<0.0001）、替代吸收（p<0.0001）和牙吸收，与未处理的再植牙相比（p<0.005）。无论使用的浓度如何，根面的细菌污染都减少了（p<0.001）。此外，地舒单抗治疗抑制了 RANKL 的表达，而没有调节 OPG。在牙周韧带中观察到骨膜蛋白，但在两个实验期间，在骨性粘连区域都没有观察到这种标记。
在延迟再植前，用 60mg/ml 的地舒单抗处理大鼠牙齿的根面，与 60 天后未处理的牙齿相比，减少了牙根部的吸收。
再植牙的存活一直是临床实践中的一个挑战。使用地舒单抗等药物来限制牙根部吸收代表了一种重要的治疗方法。
