Demircan Sabit, İşler S Cemil
Oral Health Program, Vocational School Dental Services, Beykent University, Istanbul, Turkey.
Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, Istanbul, Turkey.
J Maxillofac Oral Surg. 2021 Mar;20(1):144-148. doi: 10.1007/s12663-020-01335-w. Epub 2020 Jan 27.
The effect of bisphosphonates on the resorption process of normal bone tissue has been clearly mentioned in the literature, while their effect on the grafting material is a new research area. Limited former study is not sufficient to determine the strength, reliability and dosage of bisphosphonates. In this study, our aim is to examine the effects of local and systemic use of bisphosphonates in bone graft applications on bone healing, histopathologically.
Therefore, 32 Sprague-Dawley rats are separated into four groups. In the first group, only an empty bone defect is made on tibia and the tissue is sutured primarily without any other application. In the second group, bone defect is filled with allograft material and closed without any other application. In the third group (LA), alendronate solution is locally added to the graft material before its application to the site of bone defect. In the fourth group, alendronate is applied systemically after the site of bone defect is grafted and primarily closed. After 6 weeks, all rats are killed and the obtained samples are examined histopathologically.
Local and systemic application of alendronate increases new bone formation in a statistically significant degree. In LA group, newly formed bone was observed more mature and well developed. Alendronate application does not cause an increase in inflammation, fibrosis and necrosis. There is no increased necrosis with alendronate application.
Local and systemic application of alendronate in bone grafting increases bone formation without any other complication. But we believe that further research should be made on dosage, usage and possible side effects.
双膦酸盐对正常骨组织吸收过程的影响在文献中已有明确提及,而其对移植材料的影响是一个新的研究领域。以往有限的研究不足以确定双膦酸盐的强度、可靠性和剂量。在本研究中,我们的目的是从组织病理学角度研究双膦酸盐局部和全身应用于骨移植时对骨愈合的影响。
因此,将32只Sprague-Dawley大鼠分为四组。第一组,仅在胫骨上制造一个空的骨缺损,然后直接缝合组织,不进行任何其他处理。第二组,用同种异体移植材料填充骨缺损并缝合,不进行任何其他处理。第三组(LA组),在将移植材料应用于骨缺损部位之前,将阿仑膦酸钠溶液局部添加到移植材料中。第四组,在骨缺损部位进行移植并初步缝合后,全身应用阿仑膦酸钠。6周后,处死所有大鼠,对获得的样本进行组织病理学检查。
阿仑膦酸钠的局部和全身应用均能在统计学上显著增加新骨形成。在LA组中,观察到新形成的骨更成熟且发育良好。应用阿仑膦酸钠不会导致炎症、纤维化和坏死增加。应用阿仑膦酸钠也不会增加坏死。
阿仑膦酸钠在骨移植中的局部和全身应用均可增加骨形成,且无任何其他并发症。但我们认为,应进一步研究其剂量、用法及可能的副作用。