Histopathological Effects of Teriparatide in Medication-Related Osteonecrosis of the Jaw: An Animal Study
Histopathological Effects of Teriparatide in Medication-Related Osteonecrosis of the Jaw: An Animal Study
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DOI：
10.1016/j.joms.2015.07.005
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发表时间：
2016-01-01
影响因子：
1.9
通讯作者：
Cetiner, Sedat
中科院分区：
文献类型：
--
作者：
Keskinruzgar, Aydin;Bozdag, Zehra;Cetiner, Sedat
目的：拔牙后颌骨骨坏死是使用双膦酸盐（bp）治疗骨病变（如骨质疏松症）的主要并发症。本研究的目的是探讨特立帕肽（一种合成甲状旁腺激素）对使用BP的大鼠骨坏死的组织病理学影响。材料与方法：选用经腹腔注射唑来膦酸7周的大鼠80只。第8周上颌第一磨牙拔除和骨缺损在同一区域建立。皮下注射特立帕肽预防骨坏死。处死动物，观察组织病理变化。评估成骨细胞、破骨细胞、骨愈合炎症期和骨坏死区域。结果：实验组（拔牙前和拔牙后立即给予特立帕肽）的破骨细胞数量明显大于对照组（唑来膦酸）。实验组（拔牙前使用特立帕肽）骨愈合的炎症期比对照组更明显。实验组与对照组破骨细胞数量及骨愈合炎症期差异有统计学意义（P < 0.05）。实验组与对照组成骨细胞数量及坏死面积大小相近。两组间差异无统计学意义（P < 0.05）。结论：bp对破骨细胞和骨愈合的炎症期有负面影响，而特立帕肽可有效消除bp的负面影响。特立帕肽有预防骨坏死的积极作用；因此，特立帕肽可能是治疗MRONJ的有效药物。(C) 2016年美国口腔颌面外科医师协会
Purpose: Osteonecrosis of the jaw after tooth extraction is a major complication in patients using bisphosphonates (BPs) for bone lesions, such as for the treatment of osteoporosis. The purpose of this study was to investigate the histopathologic effects of teriparatide (a synthetic parathyroid hormone) on rats developing osteonecrosis with BP use.Materials and Methods: Rats (n = 80) that had been injected intraperitoneally with zoledronic acid for 7 weeks were used. Maxillary first molar extractions and bone defects were established in the same region in the eighth week. Teriparatidewas administered subcutaneously to prevent osteonecrosis. Animals were sacrificed and histopathologic changes were examined. Osteoblasts, osteoclasts, inflammatory phase of bone healing, and osteonecrotic areas were evaluated.Results: The osteoclast numbers were larger in the experimental groups (teriparatide administered before and immediately after tooth extraction) than in the control group (administered zoledronic acid). The inflammatory phase of bone healing was more pronounced in the experimental group (teriparatide administered before tooth extraction) than in the control group. There were significant differences in osteoclast numbers and in the inflammatory phase of bone healing between the experimental and control groups (P < .05). The osteoblast numbers and osteonecrotic areas were similar in size between the experimental and control groups. There were no significant differences (P > .05).Conclusions: BPs have negative effects on osteoclasts and the inflammatory phase of bone healing, whereas teriparatide was found to be effective in eliminating the negative effects of BPs. Teriparatide had positive effects in preventing osteonecrosis; therefore, teriparatide could be an effective agent for MRONJ. (C) 2016 American Association of Oral and Maxillofacial Surgeons