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透明质酸、可吸收胶原海绵及其组合在减少拔牙后双膦酸盐相关颌骨坏死（BRONJ）中的疗效：一项初步动物组织形态计量学研究。

Efficacy of hyaluronic acid, absorbable collagen sponge, and their combination in minimizing bisphosphonate-related osteonecrosis of the jaws (BRONJ) after dental extraction: a preliminary animal histomorphometric study.

作者信息

Sarkarat Farzin, Modarresi Alireza, Riyahi Arefeh, Mortazavi Pejman, Tabandeh Fatemeh, Rakhshan Vahid

机构信息

Oral and Maxillofacial Surgery Department; Head, Craniomaxillofacial Research Center, Dental Faculty, Tehran Medical Sciences University, Islamic Azad University, Tehran, Iran.

Department of Oral and Maxillofacial Surgery, Gulf Medical University, Ajman, United Arab Emirates.

出版信息

Maxillofac Plast Reconstr Surg. 2022 Mar 1;44(1):8. doi: 10.1186/s40902-022-00337-7.

DOI:10.1186/s40902-022-00337-7
PMID:35230522
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8888787/
Abstract

INTRODUCTION

There is no study on the effectiveness of hyaluronic acid (HA) placement either with or without absorbable collagen sponge (ACS) in reducing or preventing bisphosphonate-related osteonecrosis of the jaws (BRONJ). This preliminary animal study examined the efficacy of this clinically important treatment.

METHODS

For simulating BRONJ, zoledronic acid was administered to 40 rats for 5 weeks. Two weeks later, a right first molar was extracted from each rat. The rats were randomized into four groups of socket treatments: control (empty extraction socket) or with sockets filled with ACS, HA, or HA+ACS (n=4×10). After 2 weeks, 5 rats in each group were sacrificed and subjected to histopathologic and histomorphometric evaluation. Eight weeks post-surgically, the rest of rats were euthanized and histologically examined. The Kruskal-Wallis test was used to compare the four treatments at each time point (α=0.05).

RESULTS

Six rats were lost overall. In the second week, vascularization was higher in ACS group (P<0.05); osteoclast activity was not different between groups (P>0.05); empty lacunae were the most and fewest in control and HA+ACS groups, respectively (P<0.05); eosinophil infiltration was maximum in HA group (P<0.05); lymphocyte counts were maximum and minimum in the HA+ACS and ACS groups, respectively (P<0.05); the highest and lowest neutrophil counts were seen in ACS and control groups, respectively (P<0.05); and the extent of live bone did not differ between groups (P>0.05). In the eighth week, vascularization was not different in groups (P>0.05); the highest and lowest osteoclast activities were seen in the control and HA+ACS groups, respectively (P<0.05); empty lacunae were the most and fewest in control and HA+ACS, respectively (P<0.05); maximum and minimum numbers of eosinophils were in control and HA+ACS groups, respectively (P<0.05); HA and control groups exhibited the highest and lowest lymphocyte counts, respectively (P<0.05); the lowest and highest neutrophil counts were observed in HA+ACs and control groups, respectively (P<0.05); and the highest and lowest extents of the live bone were observed in HA+ACS and control groups, respectively (P<0.05).

CONCLUSIONS

Within the limitations of this preliminary animal study, HA and especially HA+ACS seem a proper method for preventing or treating BRONJ.

摘要

引言

目前尚无关于透明质酸（HA）联合或不联合可吸收胶原海绵（ACS）植入在减少或预防双膦酸盐相关颌骨骨坏死（BRONJ）方面有效性的研究。这项初步的动物研究检验了这种具有临床重要性的治疗方法的疗效。

方法

为模拟BRONJ，给40只大鼠注射唑来膦酸，持续5周。两周后，从每只大鼠拔除右侧第一磨牙。将大鼠随机分为四组牙槽窝处理组：对照组（拔牙后牙槽窝为空）或牙槽窝分别填充ACS、HA或HA + ACS（n = 4×10）。2周后，每组处死5只大鼠并进行组织病理学和组织形态计量学评估。术后8周，其余大鼠实施安乐死并进行组织学检查。采用Kruskal - Wallis检验在每个时间点比较四种处理方法（α = 0.05）。

结果

总共6只大鼠丢失。在第2周，ACS组的血管化程度更高（P < 0.05）；各组间破骨细胞活性无差异（P > 0.05）；对照组空陷窝最多，HA + ACS组最少（P < 0.05）；HA组嗜酸性粒细胞浸润最多（P < 0.05）；HA + ACS组淋巴细胞计数最多，ACS组最少（P < 0.05）；ACS组中性粒细胞计数最高，对照组最低（P < 0.05）；各组活骨范围无差异（P > 0.05）。在第8周，各组间血管化程度无差异（P > 0.05）；对照组破骨细胞活性最高，HA + ACS组最低（P < 0.05）；对照组空陷窝最多，HA + ACS组最少（P < 0.05）；对照组嗜酸性粒细胞数量最多，HA + ACS组最少（P < 0.05）；HA组淋巴细胞计数最高，对照组最低（P < 0.05）；HA + ACs组中性粒细胞计数最低，对照组最高（P < 0.05）；HA + ACS组活骨范围最大，对照组最小（P < 0.05）。

结论

在这项初步动物研究的局限性范围内，HA尤其是HA + ACS似乎是预防或治疗BRONJ的一种合适方法。

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