Oral Surgery Department, School of Medical Sciences, Division of Dentistry, The University of Manchester, Coupland 3 Building, Oxford Rd, Manchester M13 9PL, UK.
Oral Surgery Department, Dental School, Fluminense Federal University, Rio de Janeiro 24020-140, Brazil.
Medicina (Kaunas). 2022 Dec 27;59(1):46. doi: 10.3390/medicina59010046.
Medication-related osteonecrosis of the jaw (MRONJ) is considered as a severe adverse side effect of specific drugs such as anti-resorptive and anti-angiogenic medications. Evidence suggests that MRONJ is linked to invasive dental procedures, mainly dentoalveolar surgery. Several preventive strategies to minimize the risk of developing MRONJ have been investigated. However, no investigation has been attempted to evaluate the therapeutic effect of local drug-delivery technology as a preventive strategy protocol. The aim of this study is to evaluate the efficacy of hydroxyapatite-containing doxycycline (HADOX) in rats with high-risk MRONJ development. All the rats used in this study were divided into seven groups. Six groups of rats out of seven were exposed to two different doses of antiresorptive drug therapy for four weeks before undergoing an upper incisor extraction. After 28 days, all the animals were euthanized, and the bone blocks were processed for histological and histomorphometrical evaluation. The histomorphometric analysis confirmed that newly formed bone (NFB) was present in all groups, with significant differences. NFB in the HADOX group treated with zoledronic acid at 4% showed (28.38; C.I. 22.29-34.48), which represents a significant increase compared to HA (15.69; C.I. 4.89-26.48) ( = 0.02). A similar pattern was observed in the HADOX group treated with zoledronic acid 8% ZA treatment ( = 0.001). : HADOX did not inhibit any bone repair and reduced early inflammatory response. Hence, HADOX could promote bone healing in patients undergoing antiresorptive drug therapy.
药物相关性下颌骨坏死（MRONJ）被认为是某些药物（如抗吸收和抗血管生成药物）的严重不良反应。有证据表明，MRONJ 与侵袭性牙科手术有关，主要是牙槽外科手术。已经研究了几种预防策略来最大程度地降低发生 MRONJ 的风险。然而，尚未尝试调查局部药物输送技术作为预防策略方案的治疗效果。本研究旨在评估载羟磷灰石多西环素（HADOX）在高危 MRONJ 发展大鼠中的疗效。本研究中使用的所有大鼠均分为七组。七组大鼠中的六组在接受两种不同剂量的抗吸收药物治疗四周后，在上颌切牙拔牙前进行了治疗。28 天后，所有动物被安乐死，骨块进行组织学和组织形态计量学评估。组织形态计量学分析证实，所有组均存在新形成的骨（NFB），且差异具有统计学意义。用唑来膦酸治疗的 HADOX 组的 NFB 为 4%（28.38；置信区间 22.29-34.48），与 HA（15.69；置信区间 4.89-26.48）相比，有显著增加（ = 0.02）。用唑来膦酸 8% ZA 治疗的 HADOX 组也观察到类似的模式（ = 0.001）。结论：HADOX 并未抑制任何骨修复，反而减轻了早期炎症反应。因此，HADOX 可促进接受抗吸收药物治疗的患者的骨愈合。
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