Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, South Korea.
Department of Oral and Maxillofacial Surgery, Sahmyook Dental Hospital, Seoul, South Korea.
Sci Rep. 2021 Jan 8;11(1):54. doi: 10.1038/s41598-020-79787-w.
The purpose of this study was to investigate the effect of administering intermittent parathyroid hormone (iPTH) before tooth extraction versus after tooth extraction on the risk of developing MRONJ in experimental animal model. Twenty-five ovariectomized rats received 6 weeks of bisphosphonate therapy. They were classified into 3 groups, based on the timing of the medication, as Control, Pre-PTH and Post-PTH groups. For Control group, normal saline was administered before and after tooth extraction. iPTH was administered during 4 weeks before tooth extraction for Pre-PTH group and after tooth extraction for Post-PTH group. The animals were euthanized 8 weeks after tooth extraction. Macroscopic, histological, micro-computed tomography (micro-CT), and histomorphometric examinations were conducted. The incidences of impaired healing were 11.11% both in Pre-PTH and Post-PTH groups, which was lower than the Control group (42.86%). Bone healing in the extraction socket, based on micro-CT and histomorphometry evaluations, was best in Post-PTH and worst in Control group. The Pre-PTH group showed moderate healing pattern. Despite of limitations in this study, the authors identified Pre-PTH group seems to have positive effect on extraction socket healing. With regard to timing, administering iPTH after tooth extraction was superior to applying it before tooth extraction.
本研究旨在探讨拔牙前与拔牙后给予间歇甲状旁腺素（iPTH）对实验动物模型中 MRONJ 发生风险的影响。25 只去卵巢大鼠接受 6 周双膦酸盐治疗。根据用药时间，将它们分为 3 组：对照组、Pre-PTH 组和 Post-PTH 组。对于对照组，在拔牙前后给予生理盐水。Pre-PTH 组在拔牙前 4 周内给予 iPTH，Post-PTH 组在拔牙后给予 iPTH。拔牙后 8 周处死动物。进行大体观察、组织学、微计算机断层扫描（micro-CT）和组织形态计量学检查。Pre-PTH 组和 Post-PTH 组的愈合不良发生率均为 11.11%，低于对照组（42.86%）。基于 micro-CT 和组织形态计量学评估，拔牙窝中的骨愈合在 Post-PTH 组最好，在对照组最差。Pre-PTH 组显示出中度愈合模式。尽管本研究存在局限性，但作者认为 Pre-PTH 组似乎对拔牙窝愈合有积极影响。就时间而言，拔牙后给予 iPTH 优于拔牙前给予。
