Department of General Dentistry, Peking University School and Hospital of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Central Laboratory, Peking University School and Hospital of Stomatology, Beijing Key Laboratory of Digital Stomatology, NHC Key Laboratory of Digital Stomatology, NMPA Key Laboratory for Dental Materials, Beijing, 100081, China.
Int J Implant Dent. 2024 Apr 16;10(1):18. doi: 10.1186/s40729-024-00536-z.
Osteoporotic individuals who have dental implants usually require a prolonged healing time for osseointegration due to the shortage of bone mass and the lack of initial stability. Although studies have shown that intermittent teriparatide administration can promote osseointegration, there is little data to support the idea that pre-implantation administration is necessary and beneficial.
Sixty-four titanium implants were placed in the bilateral proximal tibial metaphysis in 32 female SD rats. Bilateral ovariectomy (OVX) was used to induce osteoporosis. Four major groups (n = 8) were created: PRE (OVX + pre-implantation teriparatide administration), POST (OVX + post-implantation administration), OP (OVX + normal saline (NS)) and SHAM (sham rats + NS). Half of rats (n = 4) in each group were euthanized respectively at 4 weeks or 8 weeks after implantation surgery, and four major groups were divided into eight subgroups (PRE4 to SHAM8). Tibiae were collected for micro-CT morphometry, biomechanical test and undecalcified sections analysis.
Compared to OP group, rats in PRE and SHAM groups had a higher value of insertion torque (p < 0.05). The micro-CT analysis, biomechanical test, and histological data showed that peri-implant trabecular growth, implants fixation and bone-implant contact (BIC) were increased after 4 or 8 weeks of teriparatide treatment (p < 0.05). There was no statistically difference in those parameters between PRE4 and POST8 subgroups (p > 0.05).
In osteoporotic rats, post-implantation administration of teriparatide enhanced peri-implant bone formation and this effect was stronger as the medicine was taken longer. Pre-implantation teriparatide treatment improved primary implant stability and accelerated the osseointegration process.
骨质疏松症患者由于骨量减少和初始稳定性不足，通常需要更长的时间来实现种植体的骨整合。尽管研究表明间歇性特立帕肽给药可以促进骨整合，但很少有数据支持在植入前给药是必要且有益的观点。
32 只雌性 SD 大鼠双侧胫骨近端干骺端共植入 64 个钛种植体。双侧卵巢切除术（OVX）用于诱导骨质疏松症。建立 4 个主要组（n=8）：PRE（OVX+植入前特立帕肽给药）、POST（OVX+植入后给药）、OP（OVX+生理盐水（NS））和 SHAM（假手术大鼠+NS）。每组中的一半大鼠（n=4）分别在植入手术后 4 周或 8 周时处死，4 个主要组分为 8 个亚组（PRE4 至 SHAM8）。收集胫骨进行 micro-CT 形态计量学、生物力学测试和脱钙切片分析。
与 OP 组相比，PRE 和 SHAM 组的种植体旋入扭矩值更高（p<0.05）。micro-CT 分析、生物力学测试和组织学数据显示，特立帕肽治疗 4 或 8 周后，种植体周围小梁生长、种植体固定和骨-种植体接触（BIC）增加（p<0.05）。PRE4 和 POST8 亚组之间这些参数没有统计学差异（p>0.05）。
在骨质疏松症大鼠中，植入后给予特立帕肽可增强种植体周围骨形成，且药物使用时间越长，效果越强。植入前特立帕肽治疗可改善初始种植体稳定性并加速骨整合过程。
