Post-Graduate Program, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.
Serviço de Estomatologia-Hospital São Lucas, PUCRS, Av. Ipiranga, 6690 Sala 231, Porto Alegre, RS, 90610-000, Brazil.
Clin Oral Investig. 2021 May;25(5):2705-2716. doi: 10.1007/s00784-020-03585-x. Epub 2020 Sep 23.
The aim of this study was to evaluate morphological and immunohistochemical features of tooth extraction sites in rats subjected to different antiresorptive drugs.
Wistar rats were allocated into 4 groups according to the treatment: (1) alendronate, (2) raloxifene, (3) strontium ranelate, and (4) control. The animals underwent tooth extraction (60th day of treatment) and afterwards were euthanized (90th day of treatment). Tooth extraction sites were analyzed by means of scanning electron microscopy (SEM), hematoxylin-eosin staining (H&E), and immunohistochemical staining (RANKL and OPG).
On H&E analysis, the alendronate group showed greater amounts of non-vital bone, biofilm, inflammatory infiltrate and root fragment, and smaller amount of vital bone. The strontium ranelate group showed great amount of non-vital bone. This group also had lower levels of OPG, while the alendronate group showed lower OPG and RANKL than the other groups. On SEM analysis, the alendronate group showed a considerable number of microcracks on the alveolar bone surface and few Howship lacunae and lack of bone cells as well. The raloxifene, strontium ranelate, and control groups showed a large number of bone cells and Howship lacunae on the bone surface and few microcracks.
Alendronate therapy is associated with macro- and microscopic features of medication-related osteonecrosis of the jaw at tooth extraction sites, whereas raloxifene therapy is not, and strontium ranelate therapy is associated with non-vital bone.
Osteonecrosis of the jaws is a serious side effect of alendronate therapy, where tooth extraction is a major risk factor. Considering the significant number of patients undergoing antiresorptive therapies worldwide, the present study investigated whether raloxifene and strontium ranelate interfere with bone repair after tooth extraction in a similar way to bisphosphonates.
本研究旨在评估接受不同抗吸收药物治疗的大鼠拔牙部位的形态学和免疫组织化学特征。
将 Wistar 大鼠根据治疗方法分为 4 组：（1）阿伦膦酸盐，（2）雷洛昔芬，（3）雷奈酸锶，和（4）对照组。动物接受拔牙（治疗第 60 天），然后处死（治疗第 90 天）。通过扫描电子显微镜（SEM）、苏木精-伊红染色（H&E）和免疫组织化学染色（RANKL 和 OPG）分析拔牙部位。
在 H&E 分析中，阿伦膦酸盐组显示出更多的无活力骨、生物膜、炎症浸润和牙根碎片，以及更少的活力骨。雷奈酸锶组显示出大量的无活力骨。该组的 OPG 水平也较低，而阿伦膦酸盐组的 OPG 和 RANKL 水平均低于其他组。在 SEM 分析中，阿伦膦酸盐组显示牙槽骨表面有相当数量的微裂纹，Howship 陷窝和骨细胞较少。雷洛昔芬、雷奈酸锶和对照组在骨表面显示出大量的骨细胞和 Howship 陷窝，以及较少的微裂纹。
阿伦膦酸盐治疗与拔牙部位药物相关性颌骨坏死的宏观和微观特征相关，而雷洛昔芬治疗则不相关，雷奈酸锶治疗与无活力骨相关。
颌骨坏死是阿伦膦酸盐治疗的严重副作用，拔牙是一个主要的危险因素。考虑到全世界有大量接受抗吸收治疗的患者，本研究调查了雷洛昔芬和雷奈酸锶是否以类似于双膦酸盐的方式干扰拔牙后骨修复。
