Bone wound healing after maxillary molar extraction in ovariectomized aged rats: quantitative backscattered electron image analysis

A comparative study of the effects of platelet-rich fibrin, concentrated growth factor and platelet-poor plasma on the healing of tooth extraction sockets in rabbits

BACKGROUND

Autologous platelet concentrate has been widely used to encourage the regeneration of hard and soft tissues. Up to now, there are three generations of autologous platelet concentrates. Many studies have shown that the three autologous concentrates have different effects, but the specific diversities have not been studied. The purpose of this study was to explore and compare the effects of platelet-rich fibrin, concentrated growth factor and platelet-poor plasma on the healing of tooth extraction sockets in New Zealand rabbits.

METHODS

A total of 24 healthy male New Zealand white rabbits aged 8-12 weeks were selected. The experimental animals were randomly divided into four groups: three experimental groups were respectively implanted with PPP, CGF and PRF gel after bilateral mandibular anterior teeth were extracted, and the control group did not implant any material. The alveolar bone of the mandibular anterior region was taken at 2, 4 and 8 weeks after operation. The height and width of the extraction wound were detected by CBCT, the growth of the new bone was observed by HE and Masson staining, and the expression of osteogenic genes was detected by real-time PCR. Data were analyzed using IBM SPSS statistical package 22.0.

RESULTS

The radiological results showed that alveolar bone resorption in all groups gradually increased over time. However, the experimental groups showed lower amounts of bone resorption. The histological results showed that new bone formation was observed in all groups. Over time, the new bone trabeculae of the CGF group became closely aligned while those in the PPP and PRF groups remained scattered. PCR results showed that the expression of BMP-2 and ALP was higher in the experimental groups than the control group.

CONCLUSION

In conclusion, the application of PRF, CGF and PPP in tooth extraction sockets effectively promoted bone regeneration. CGF showed more effective bone induction and tissue regeneration ability in the long term.

Effects of a single intravaneous dose of zoledronic acid on bone healing following tooth extraction in ovariectomized rabbits

Objective

The present study is aimed to investigate the effects of administering a single intravenous dose of zoledronic acid (ZA) on bone healing following tooth extraction in ovariectomized rabbits.

Materials and methods

Female, New Zealand rabbits were randomly divided into three groups including Control, ovariectomy + saline (OVX) and ovariectomy + zoledronic acid group (ZOL). Bilateral ovariectomy was performed to the rabbits in OVX and ZOL groups under general anesthesia. Control group underwent sham surgery. Eight weeks later, mandibular right incisors of all animals were extracted under general anesthesia. Before the procedure, Control and OVX groups were given saline and 0.1 mg/kg ZA was administered to ZOL group intravenously. All animals were sacrificed after 12 weeks.

Results

The findings of histopathological and biochemical evaluations reflected insignificant differences among study groups in vascular endothelial growth factor (VEGF), increases in osteoclasts, ossification, vascularization and mononuclear cell infiltration measures (p > 0.05). In contrast, bone morphogenic protein 2 (BMP-2), tumor necrosis factor alpha (TNF-α) and organization of the extraction wound differed significantly between groups (p < 0.05)

Conclusion

The potential beneficial effects of ZA administration on the wound healing process following tooth extraction were demonstrated via serum TNF-α, BMP-2 and VEGF levels in an osteoporotic model in ovariectomized rabbits.

Osteogenesis Differences Around Titanium Implant and in Bone Defect Between Jaw Bones and Long Bones

The aim of this study is to evaluate the osteogenesis around titanium implant and in bone defect or fracture in jaw bones and long bones in ovariectomized (OVX) animal models. The literature on the osteogenesis around titanium implant and in bone defect or fracture in jaw bones and long bones was reviewed with charts. Fourty-eight rats were randomly divided into OVX group with ovariectomy and SHAM (sham-surgery) group with sham surgery. Titanium implants were inserted in the right mandibles and tibiae; bone defects were created in the left mandibles and tibiae. Two-week postoperatively, mandibles and tibiae of 8 rats were harvested and examined by hematoxylin and eosin staining and histological analysis; 4-week postoperatively, all mandibles and tibiae were harvested and examined by Micro-CT and histological analysis. A total of 52 articles were included in this literature review. Tibial osteogenesis around titanium implant and in bone defect in OVX group were significantly decreased compared with SHAM group. However, osteogenesis differences in the mandible both around titanium implant and in bone defect between groups were not statistically significant. OVX-induced osteoporosis suppresses osteogenesis around titanium implant and in the bone defect or fracture in long bones significantly while has less effect on that in the jaw bones.

Effects of osteoporosis on alveolar bone repair after tooth extraction: A systematic review of preclinical studies

OBJECTIVE

This systematic review aimed to address whether the alveolar socket repair after a tooth extraction is impacted by an osteoporotic phenotype and propose methodological observations.

DESIGN

A search strategy in MEDLINE/PubMed, EMBASE, Web of Science, and Scopus databases was performed. Quality assessment was carried out through the SYRCLE Risk of Bias tool.

RESULTS

Out of the 1147 potentially relevant records, 25 met the inclusion criteria. Most of the studies were performed in rats, and ovariectomy (OVX) was the most frequent osteoporosis induction method. Histomorphometry, micro-computed tomography (microCT), and immunohistochemistry were the main bone repair evaluation methods. Most of the included studies (88 %) presented negative impacts of osteoporosis on the alveolar socket repair. Only three studies (12 %) showed no statistical differences among groups. Overall, most of the quality assessment categories presented a high percentage of unclear risk of bias due to insufficient information in the studies.

CONCLUSIONS

The results indicated that an osteoporotic phenotype seems to impair alveolar socket repair after tooth extraction. However, there is still a lack of information and standardization. Therefore, further studies should consider the proposed methodological aspects regarding animal characteristics, OVX associated with a low calcium diet, waiting 8 weeks to osteoporosis induction, maxillary molars as the best option for tooth extraction, confirming and reporting OVX and osteoporosis success, and an appropriate method of repair analysis.

Hydrophilic titanium surface modulates early stages of osseointegration in osteoporosis

OBJECTIVE

Using a mouse osteoporotic model, this study aimed to determine the influence of hydrophilic titanium surfaces on gene expression and bone formation during the osseointegration process.

BACKGROUND

Based on the previous evidence, it is plausible to assume that osteoporotic bone has a different potential of bone healing. Therefore, implant surface modification study that aims at enhancing bone formation to further improve short- and long-term clinical outcomes in osteoporosis is necessary.

MATERIAL AND METHODS

Fifty female, 3-month-old mice were included in this study. Osteoporosis was induced by ovariectomy (OVX, test group) in 25 mice. The further 25 mice had ovaries exposed but not removed (SHAM, control group). Seven weeks following the ovariectomy procedures, one customized implant (0.7 × 8 mm) of each surface was placed in each femur for both groups. Implants had either a hydrophobic surface (SAE) or a hydrophilic treatment surface (SAE-HD). Calcium (Ca) and phosphorus (P) content was measured by energy-dispersive X-ray spectroscopy (EDS) after 7 days. The femurs were analyzed for bone-to-implant contact (BIC) and bone volume fraction (BV) by nano-computed tomography (nano-CT) after 14 and 28 days. Same specimens were further submitted to histological analysis. Additionally, after 3 and 7 days, implants were removed and cells were collected around the implant to access gene expression profile of key osteogenic (Runx2, Alp, Sp7, Bsp, Sost, Ocn) and inflammatory genes (IL-1β, IL-10, Tnf-α, and Nos2) by qRT-PCR assay. Statistical analysis was performed by ANOVA and paired t test with significance at P < .05.

RESULTS

The amount of Ca and P deposited on the surface due to the mineralization process was higher for SAE-HD compared to SAE on the intra-group analysis. Nano-CT and histology revealed more BV and BIC for SAE-HD in SHAM and OVX groups compared to SAE. Analysis in OVX group showed that most genes (ie, ALP, Runx2) involved in the bone morphogenetic protein (BMP) signaling were significantly activated in the hydrophilic treatment.

CONCLUSION

Both surfaces were able to modulate bone responses toward osteoblast differentiation. SAE-HD presented a faster response in terms of bone formation and osteogenic gene expression compared to SAE. Hydrophilic surface in situations of osteoporosis seems to provide additional benefits in the early stages of osseointegration.

The role of strontium ranelate and guided bone regeneration in osteoporotic and healthy conditions

BACKGROUND/ OBJECTIVES

SR is a chemical agent developed for the treatment of osteoporosis. In vitro, SR enhanced replication of osteoprogenitor cells and bone formation. In vivo, in ovariectomized rats SR prevented the biomechanical deterioration of bone while in non-ovariectomized rats, enhanced bone architecture and increased trabecular and cortical bone mass. The aim of this study was to evaluate the effect of SR on bone healing of calvarial critical size defects treated with a deproteinized bovine bone mineral (DBBM) and a collagen barrier (CM), in healthy and osteoporotic rats.

MATERIAL AND METHODS

Sixty-four, 4-month-old Wistar female rats were used. Osteoporosis was induced by ovariectomy and calcium-deficient diet in half of them. Sixteen ovariectomized (OSR) and 16 healthy (HSR) rats were treated with SR while no medication was administered in the remaining 16 healthy (H) and 16 ovariectomized (O) rats. At 6 weeks after ovariectomy, a 5mm defect was created in each parietal bone of every animal. One defect was treated with DBBM and CM, while the contralateral was left untreated. Qualitative and quantitative histological analysis was performed at 30 and 60 days of healing. A generalized estimating equations test was performed to evaluate the effect of SR and osteoporosis, on new bone formation (NB).

RESULTS

After 30 days of healing, NB in the untreated defects was 3.4%±1.7%, 4.3%±6.2%, 3.2±4.5%, 15.9±23.5% in O, OSR, H and HSR groups, respectively; after 60 days, NB was 4.7%±4.3%, 11.3%±7%, 7.1%±13.2, 12.1%±13.5%, respectively. In the GBR-treated defects, after 30 days, NB was 2.6%±1.4%, 2.4%±1.6%, 4.5%±4.1%, 10.3%±14.4% in O, OSR, H and HSR groups, respectively; after 60 days, NB was 2.2%±1.6%, 4.3%±4.2%, 7%±5.1%, 10.8%±17.4%, respectively. Osteoporosis (p=0.008) and the absence of strontium ranelate treatment (p=0.01) had a negative impact on NB.

CONCLUSION

SR may promote bone formation in calvarial defects in healthy and osteoporotic rats, albeit in a moderate extent.

The preventive effect of medicinal herbal extract and gelatin sponge on alveolar osteitis: An in vivo micro-computed tomography and immunohistochemical analysis in rats

OBJECTIVE

The purpose of this study was to evaluate the preventive effect of medicinal herbal extract (MHE) and gelatin sponge on alveolar osteitis (AO) in an experimental rat model.

DESIGN

Twenty-one Sprague-Dawley male rats with a mean age of 12 weeks were used. After extraction of the maxillary right first molar, an AO model was created for each animal. The animals were randomly separated to three equal groups. Group I served as a control, Group II was subjected to an intra-alveolar MHE application, and gelatin sponge was left in the sockets of Group III. On the 7th post-extraction day, the animals were sacrificed. The specimens were analyzed by micro-computed tomography (micro-CT), histopathologically and immunohistochemically.

RESULTS

Macroscopic evaluation revealed mild to intense signs of AO in all groups, but the difference was not significant (p < 0.05). Micro-CT analysis showed that bone formation was the highest in Group III (bone volume/total volume; 10.63 ± 4.9 %), whereas bone mineral density was the highest in Group I (2.05 ± 0.2 g/cm³). The difference was not significant (p > 0.05). In Group III, only 16.7 % of specimens showed no signal of inflammatory response (p < 0.01). The difference was not significant between the positive labeling for receptor activator of nuclear kappa-β (RANK), receptor activator of nuclear kappa-β ligand (RANKL), osteoprotegerin and osteopontin, but the intensity of Groups II and III was higher than the Group I for osteopontin (p < 0.01).

CONCLUSIONS

MHE and gelatin sponge were not effective enough to prevent alveolar osteitis, but positive results were obtained in bone healing.

Systemic Lithium Chloride Administration Improves Tooth Extraction Wound Healing in Estrogen-Deficient Rats

The purpose of this investigation was to evaluate the effects of lithium chloride (LiCl) on the socket healing of estrogen-deficient rats. Seventy-two rats were allocated into one of the following groups: Control, Ovariectomy and LiCl (150 mg/kg/2 every other day orally) + Ovariectomy. Animals received LiCl or water from the 14th day post-ovariectomy, until the completion of the experiment. On the 21st day after ovariectomy, the first molars were extracted. Rats were euthanized on the 10th, 20th and 30th days following extractions. Bone healing (BH), TRAP positive cells and immunohistochemical staining for OPG, RANKL, BSP, OPN and OCN were evaluated. The Ovariectomy group presented decreased BH compared to the LiCl group at 10 days, and the lowest BH at 20 days (p<0.05). At 30 days, the Ovariectomy and LiCl-groups presented lower BH than that of the Control (p<0.05). The number of TRAP-stained cells was the lowest in the LiCl group at 20 days and the highest in the Ovariectomy group at 30 days (p<0.05). At 10 days of healing, the LiCl group demonstrated stronger staining for all bone markers when compared to the other groups, while the Ovariectomy group presented higher RANKL expression than that of the Control (p<0.05). LiCl enhanced bone healing in rats with estrogen deficiency, particularly in the initial healing phases. However, as data on the effects of lithium chloride on bone tissue are still preliminary, more studies related to its toxicity and protocol of administration are necessary before its application in clinical practice.

Bone Regeneration of Hydroxyapatite with Granular Form or Porous Scaffold in Canine Alveolar Sockets

This study was undertaken to assess bone regeneration using hydroxyapatite (HA). The primary focus was comparison of bone regeneration between granular HA (gHA) forms and porous HA (pHA) scaffold. The extracted canine alveolar sockets were divided with three groups: control, gHA and pHA. Osteogenic effect in the gHA and pHA groups showed bone-specific surface and bone mineral density to be significantly higher than that of the control group (p<0.01). Bone volume fraction, bone mineral density, and amount of connective tissue related to disturbing osseointegration of the gHA group was higher than in the pHA group. Quantity of new bone formation of the pHA group was higher than that of the gHA group. This study demonstrated that gHA and pHA are potentially good bone substitutes for alveolar socket healing. For new bone formation during 8 weeks' post-implantation, HA with porous scaffold was superior to the granular form of HA.

Guided bone regeneration in osteoporotic conditions following treatment with zoledronic acid

OBJECTIVES

To evaluate new bone formation in calvarial critical size defects (CSD) under dense polytetrafluoroethylene (d-PTFE), microporous membranes for guided bone regeneration (GBR) in healthy, osteoporotic and osteoporotic treated with zoledronic acid (ZA) rats.

METHODS

Forty-eight, female, 6-month old Wistar rats were included in the study. Osteoporosis was induced by ovariectomy (OVX) and calcium-deficient diet in 32 rats. Sixteen OVX rats were treated with a single dose of Zolendronic Acid (ZA) (OZ), while 16 OVX rats received no treatment (O). The remaining 16 rats were sham-operated and used as healthy controls (C). At 6 weeks following osteoporosis induction, two 5 mm CSD were created in the parietal bones and one of them was treated with a double d-PTFE membrane. The healing periods were 30 and 60 days. New bone formation (NB) was assessed by qualitative and quantitative histological analysis.

RESULTS

After 30 days of healing, NB (mean% (95% CI)) was 78.9% (21), 93.1% (9.3) and 84.2% (26.9) in the membrane treated defects and 18.8% (24.1), 27.1% (7.9) and 31% (38.8) in the untreated defects of group O, OZ and C, respectively. After 60 days of healing, NB was 78.3% (14.4), 95.8% (9) and 90.1% (26.1) in the membrane treated defects and 10.8% (17.4), 51.6% (39.4) and 15.7% (12.1) in the untreated defects of group O, OZ and C, respectively. Hierarchical analysis of variance showed that treatment with ZA (P = 0.001) and the use of membrane (P = 0.000) significantly increased new bone formation while presence of osteoporosis may have reduced new bone formation (P = 0.028).

CONCLUSION

d-PTFE membranes for GBR promote bone healing in osteoporotic and healthy rats. Treatment with ZA may improve new bone formation in osteoporotic rats.

Evaluation of the effects of two different bone resorption inhibitors on osteoclast numbers and activity: An animal study

Background:

The aim of this study was to evaluate the effects of bone resorption inhibitors, doxycycline (DOX) and erythromycin (EM), on osseous wound healing in rat alveolar socket.

Materials and Methods:

In this randomized controlled trial, 45 8–10-week-old male Wistar rats had their maxillary right molar extracted. They were divided into three groups of 15. In Group 1 normal saline, Group 2 DOX, and Group 3 EM were administered at the doses of 5 ml/kg/day, 5 mg/kg/day, and 2 mg/kg/day, respectively, for 7 consecutive days. The rats were sacrificed 7, 14, and 21 days after surgery. Real-time polymerase chain reaction was employed to evaluate the mRNA expression of receptor activator of nuclear factor κB ligand (RANKL) and osteoprotegerin (OPG) and immunohistochemical staining for tartrate-resistant acid phosphatase (TRAP) to determine osteoclasts. The data were analyzed by one-way analysis of variance followed by Tukey's post hoc test using SPSS version 20. Significant level was set at 0.05.

Results:

The results showed that when drug-treated groups compared to control groups, RANKL gene expression significantly decreased, TRAP⁺ cells decreased on day 7. The RANKL/OPG ratios in the first two weeks in the test groups were significantly lower than the control group. There was no significant difference in the studied indices between DOX and EM groups.

Conclusion:

Following administration of DOX and EM, the number of osteoclasts and RANKL/OPG ratio decreased suggesting their anti-osteoclastogenesis activity. These two drugs have no advantage over each other in increasing the bone formation.

Hypertension modifies OPG, RANK, and RANKL expression during the dental socket bone healing process in spontaneously hypertensive rats

OBJECTIVE

The aim of this study was to evaluate the dental socket bone healing process by histomorphometric and immunohistochemical analysis of osteoprotegerin (OPG), receptor activator of nuclear factor-κβ (RANK), and receptor activator of nuclear factor-κβ ligand (RANKL) proteins in spontaneously hypertensive rats (SHR).

MATERIALS AND METHODS

Under general anesthesia, 25 Wistar rats and 25 SHRs underwent upper right incisor extraction. Rats were euthanized after 7, 14, 21, 28, or 42 days of dental extractions. Histomorphometric and immunohistochemical analyses of OPG, RANK, and RANKL proteins were performed.

RESULTS

Histomorphometric results showed decreased bone healing and reduced bone trabecular thickness in SHRs. Immunohistochemical reactions showed intense RANKL and RANK immunolabeling at 14 and 28 postoperative days and mild OPG immunolabeling at 7, 14, and 21 days after surgery in SHRs.

CONCLUSION

The results of this study show that RANK, RANKL, and OPG immunolabeling was altered in SHRs, and these results are associated with bone healing delay and decreased trabecular thickness in SHRs.

CLINICAL RELEVANCE

Hypertension alters the expression of RANK, RANKL, and OPG and delays the socket bone healing process. These alterations could influence some dental procedures such as orthodontic treatment and implant placement.

The effect of Astragalus extractive on alveolar bone rebuilding progress of tooth extracted socket of ovariectomied rats

BACKGROUND

Postmenopausal osteoporosis (PMO) is an estrogen deficiency condition that causes severe loss of bone mass in the vertebrae and long bones. We explored the effect and the possible underlying mechanism of the extracts of Astragalus (AE) on the tooth alveolar bone rebuilding progress of postmenopausal osteoporosis of PMO animal models.

MATERIAL AND METHODS

The PMO models were acquired by ovariectomy. After 8 weeks the first left maxillary molars of the rats were extracted and AE was administered orally for 8 weeks. Then the histological morphology and the transcription and expression of TGF-β1 and TNF-α in the tooth extracted socket were detected by HE dying, QRT-PCR and ELISA.

RESULTS

The results showed that the new bone volume and TGF-β1 was significantly lower in PMO group than the control group and AE group at the observing period. At the same time TNF-α in PMO group was significantly higher than the other two groups. Moreover AE group had no significant differences with the control group in all data at the observing period.

CONCLUSION

AE has positive effect on alveolar bone rebuilding progress of tooth extracted socket of PMO rats. AE also has the potential to enhance the expression of TGF-β1 and decrease the expression of TNF-α of the rebuilding tooth extracted socket.

Effects of experimental osteoporosis and low calcium intake on postextraction sockets of rats

This study analysed the initial effects of the combination of oestrogen deficiency with a calcium-deficient diet on alveolar bone repair. Sixty-three 3-month-old female rats were either ovariectomized (OVX, n = 42) or sham-operated (SHAM, n = 21). Among the 42 ovariectomized rats, 21 received standard commercial food (OVX) and 21 received food with low calcium content (ESP). The mandibular first molars were extracted bilaterally 15 days after ovariectomy or sham surgery. The rats were weighed and killed at 7, 21 and 45 days after tooth extraction. The results were evaluated by descriptive microscopic analysis, histomorphometry of the trabecular and osteoid volume and mast cell counts. Analysis of the results indicated that trabecular volume and mast cell counts increased significantly over time, while osteoid volume decreased over time. Comparisons between the SHAM and OVX groups demonstrated no statistical differences, while comparison between the OVX and ESP groups indicated differences in trabecular volume and the number of mast cells. The data suggest that hormonal deficiency does not delay alveolar bone repair in OVX rats; however, oestrogen deficiency associated with calcium deficiency can lead to bone resorption through the activation of mast cells.

Histomorphometric analysis of new bone obtained by osteogenic periosteal distraction in ovariectomized rabbits

OBJECTIVE

The aim of this study was to evaluate the effects of estrogen deficiency on newly formed bone obtained by osteogenic periosteal distraction histomorphometrically.

STUDY DESIGN

Thirty-six female rabbits were divided into 2 groups. The experimental group underwent a bilateral ovariectomy and a sham operation was applied to the control group to equalize the stress of ovariectomy surgery. Four weeks postoperatively, a gradual distraction of the mandibular corpus was performed.

RESULTS

In the experimental group, callus formation was delayed and the new bone was less mineralized; conversely, when histomorphometric measurements were compared statistically, there were no significant differences between the ovariectomized and sham-operated subgroups in the mean extent of newly formed bone tissue.

CONCLUSIONS

Although osteoporosis caused by the lack of estrogen has negative effects on osteogenic periosteal distraction (OPD), these negative effects do not appear to present a contraindication to OPD.

The effect of SLActive surface in guided bone formation in osteoporotic-like conditions

OBJECTIVES

The aim of the study was to evaluate new bone formation under etched titanium (SLA) and modified-etched hydrophilic titanium (modSLA) domes placed on the calvarium of healthy, osteoporotic and osteoporotic treated with bisphosphonates rabbits.

METHODS

Experimental osteoporosis was induced by ovariectomy (OV) and calcium-deficient diet in 24 New Zealand female rabbits. Twelve OV rabbits were treated with weekly dozes of alendronate (Fosamax(®)) (B) while 12 OV rabbits received no treatment (O). Another 12 rabbits were sham operated and used as healthy controls (C). At 6 weeks following OV, one modSLA and one SLA titanium dome were placed in the parietal bones of each rabbit. The animals were sacrificed at 30 and 120 days following the dome placement. Various histomorphometric measurements were performed in the most central of the undecalcified sections produced.

RESULTS

After 30 days of healing, in the C group, the total bone (TB) area was 37.6% and 37.0% under the modSLA and SLA domes, respectively. In the O group, the TB was 35.7% and 24.8%. In the B group, TB was 37.0% and 32.1%, respectively. After 120 days of healing, in the C group TB was 40.1% and 36.4%, respectively. In the O group, TB was 29.6% and 27.9%, respectively. In the B group, TB was 49.7% and 42.5%, respectively. Hierarchical analysis of variance showed that the type of titanium dome significantly influenced new bone and the amount of new bone being in contact with inner surface of the dome (BIC) independently of the observation period and group (P<0.05). The administration of bisphosphonates influenced the BIC (P<0.05).

CONCLUSION

The use of modSLA surface may promote bone healing and osseointegration in osteoporotic rabbits, whereas administration of bisphosphonates may compromise the osseointegration of the newly formed bone at the early healing period.

Osteocalcin immunolabeling during the alveolar healing process in ovariectomized rats treated with estrogen or raloxifene

The influence of an estrogen-deficient state was evaluated in this study and also its treatments with estrogen (E(2)) or with raloxifene (RLX) on the expression of osteocalcin during the periods of the chronology of the alveolar bone healing process (7, 14, 21, 28 and 42 post-extraction days) by means of immunohistochemistry reactions and histomorphometric analysis. Rats (200-220 g) with oestrus cycles normal were either OVX or sham-operated and divided into four groups: sham, OVX control (OVX/O), estrogen (OVX/E(2); 17 beta-estradiol, 400 microg/mo) and raloxifene (OVX/RLX; 1 mg/kg bw/d) groups. Histomorphometric analysis showed the sham group presented the highest mean value of bone formation post-extraction. The reaction of immunohistochemistry for osteocalcin presented stronger expression of osteocalcin with predominance at 14 and 21 days on sham group. The OVX/RLX group presented better results than OVX/E(2), considering the expression of osteocalcin in osteoblastic lineage cells, but still inferior than the sham group. It was concluded that ovariectomy decreases the mineralization process and the osteocalcin expression during the chronology of the alveolar healing process that is not totally recovered with estrogen replacement or raloxifene treatment.

Short-term effect of ovariectomy on osteoprogenitors in the healing rat mandibular incisor extraction socket

OVX increased the percentage of AP-positive CFU-F in healing rat mandible. The increase of the number of osteoprogenitors was not significant in rat mandible-derived cultures but was in femur-derived ones. This suggests that the effect of OVX on osteoprogenitors is either smaller or develops later in mandible relative to femur.

INTRODUCTION

Osteoprogenitors play an essential role in the regeneration process that leads to the successful integration of dental implants. However, it is unclear how systemic osteoporosis affects osteoprogenitors in oral bone. The present study was designed to determine the short-term effects of ovariectomy (OVX) on osteoprogenitors from the healing extraction socket in rat mandible.

METHODS

Six-month-old rats were ovariectomized (n=8) and control rats were left intact (n=8). Two weeks post-OVX, the right mandibular incisor was extracted. Four weeks post-extraction, the basal mandibular bone between the 1st and 3rd molar in the healing extraction socket was used to determine the number of fibroblastic progenitors (CFU-F), alkaline phosphatase-positive fibroblastic progenitors (AP-positive CFU-F), Dex-dependent osteoprogenitors (CFU-O Dex) and Prog-dependent osteoprogenitors (CFU-O Prog) using colony assays (n=5). Osteocalcin mRNA expression was evaluated using in situ hybridization (n=3). Data were analyzed using two-way ANOVA or Student's t-test.

RESULTS

OVX increased the percentage of AP-positive CFU-F in both mandible and femur. The number of CFU-O was increased only in femur. Osteocalcin mRNA expression in regenerating mandible was not statistically different between control and OVX animals.

CONCLUSION

Our results suggest that the effect of OVX on osteoprogenitors is either smaller or develops later in mandible relative to femur.

Ovariectomy delays alveolar wound healing after molar extractions in rats

PURPOSE

This study was conducted to investigate the morphological effects of the absence of estrogen on alveolar wound healing of young female rats after tooth extraction.

MATERIALS AND METHODS

A total of 60 4- to 6-week-old female rats underwent bilateral ovariectomy (OVX) or sham operations. Three weeks later, the first mandibular molars were extracted. Subsequently, the animals were killed by cervical dislocation 3, 5, 7, 14, 21, or 28 days after tooth extraction. The mandibles were removed, and serial transversal sections of mesial alveolus of the first mandibular molars were obtained for histometric analysis.

RESULTS

OVX sockets showed significant increases in fibroblasts and collagen content 3 and 5 days after the extractions, followed by significant decreases in these parameters in the subsequent periods. In accordance with the decreased collagen content in the latest period of healing, new bone formation was significantly reduced in the OVX animals.

CONCLUSION

These findings suggest that the initial molecular changes observed in the absence of estrogen lead to delayed alveolar wound healing.

Bone healing in osteoporotic female rats following intra-alveolar grafting of bioactive glass

We have investigated the effect of ovariectomy combined with a low Ca diet on bone healing following the implantation of bioactive glass into extraction sockets, in rats. Ovariectomized rats received a low Ca diet from the day of surgery until sacrifice while sham-operated animals were fed a standard laboratory chow. Two weeks after surgery the upper incisors were extracted and the alveolar sockets in both groups were partially filled with a particulate bioglass (PerioGlas). The animals were killed 1, 2, 3 and 9 weeks after tooth extraction and the relative volume fraction of the healing components (bone trabeculae, connective tissue and coagulum remnants) was estimated in histological paraffin sections by a histometric differential point-counting method. The bioglass particles persisted inside the socket for all the experimental periods and, as bone repair proceeded, they were progressively enclosed in newly formed bone trabeculae which in some cases established a close contact with their surface. The volume fraction of neoformed bone trabeculae relative to the volume fraction of connective tissue and coagulum remnants was greater in the sockets of ovariectomized animals implanted with bioglass than in those of the overiectomized non-implanted groups.

Bone Apposition in Surgical Bony Defects Following Orthodontic Movement: A Comparative Histomorphometric Study Between Root- and Periodontal Ligament-Damaged and Periodontally Intact Rat Molars

BACKGROUND

The influence of orthodontic tooth movement with diminished periodontal support is unclear. The aim of the present study was to evaluate bone healing in surgical defects following orthodontic tooth movement with and without periodontal ligament (PDL) and root surface damage.

METHODS

The study comprised 33 adult male Wistar rats, divided into two groups: group 1 (n = 14) with bony defect and no root damage and group 2 (n = 19) with periodontal bony defect including root/PDL damage on the mesial root of the maxillary first molar. One week after a surgical defect was created, orthodontic protraction of the right maxillary first molar was initiated in both groups. After 2 weeks of protraction, retention of 1 week was established; at the end of this period block sections were made. Histomorphometric analysis through light microscopy of decalcified tissue was performed. Results were statistically analyzed using independent samples t test and analysis of variance (ANOVA) with repeated measures.

RESULTS

Differences between groups in total area of bone defect and bone apposition were not statistically significant. Bone apposition calculated as percentage of the bone defect was significantly (t-test) greater (P = 0.002) in group 2 (46.21%) than in group 1 (24.95%). Within each group, area of bone apposition was significantly (ANOVA) greater in the distal than in the mesial quadrants of the bony defect (P = 0.006) and in the apical than the occlusal ones (P = 0.021).

CONCLUSION

Following orthodontic tooth movement, periodontal bony defects showed enhanced bony healing compared with alveolar bone defects with no direct association with the periodontal attachment apparatus.

Comparison between two experimental protocols to promote osteoporosis in the maxilla and proximal tibia of female rats

The effects of two experimental protocols (ovariectomy associated or not with a low calcium diet) used to promote osteoporosis in the rat maxilla and proximal tibia were compared 5 and 11 weeks after surgery. Female Wistar rats were ovariectomized or sham-operated. Half of the ovariectomized rats were fed a low Ca++ diet (ovx*) and the remaining ovariectomized (ovx) and sham animals received a standard chow. At sacrifice, the proximal metaphysis was excised from the tibia and the molars were extracted from the hemi-maxilla. Dry (60 degrees C overnight) and ash (700 degrees C/14 h) weights were measured and the ashes were used for Ca++ measurement by means of a colorimetric method. After 5 weeks, ovx caused no alteration while ovx* decreased proximal metaphysis (17%) and maxilla (35%) bone mass. After 11 weeks, ovx caused a 14% bone mass reduction in the proximal metaphysis but not in the maxilla, while ovx* caused a comparable bone mass reduction (30%) in both bone segments. Calcium concentration was not altered in any experimental condition. The results show that estrogen deficiency is insufficient to cause maxillary osteoporosis in rats over an 11-week period and a long-term ovariectomy is needed to exert deleterious effect on proximal metaphysis bone mass. When a low Ca++ diet is associated with estrogen deficiency, however, a relatively precocious harmful effect is observed, twice as pronounced in the maxilla than in the proximal metaphysis. On a long-term basis, ovariectomy associated with a low Ca++ diet seems to be equally injurious to both proximal metaphysis and maxilla.

Effects of oestrogen deficiency on rat mandibular and tibial microarchitecture

OBJECTIVES

To investigate the effects of oestrogen deficiency on the microarchitecture of trabecular bone in the mandible and the tibia and to test whether they are correlated.

METHODS

Twenty-four age-matched Lewis-Brown-Norway female rats underwent surgical intervention either to remove ovaries (ovariectomy, n=12) or to create a complementary control group (sham-operated, n=12). Sixteen weeks later, the animals were sacrificed and the left side of the mandibles and the tibias were scanned with high resolution micro-CT (15 micro m). Multiple morphological measures including the ratio of bone volume/tissue volume, trabecular thickness, trabecular separation and structure model index were obtained from the experimental and control groups.

RESULTS

Ovariectomy significantly decreased the ratio of bone volume/soft tissue volume and trabecular thickness, whilst significantly increasing trabecular separation and structure model index in the mandible (P<0.005) and the tibia (P<0.005). There were significant positive correlations between the mandible and the tibia for trabecular separation (r=0.68, P<0.01) and structure model index (r=0.60, P<0.01).

CONCLUSIONS

Oestrogen deficiency results in microarchitectural alterations of trabecular bone in both the mandible and the tibia within 16 weeks. The size of marrow spaces and the shape of trabeculae in the mandible correlate with osteoporotic changes in the long bone.

Long-term changes in trabecular structure of aged rat alveolar bone after ovariectomy

OBJECTIVE

Trabecular structural changes in the jaw after long-term estrogen deficiency are not well understood. Therefore, we sought to observe the changes in rat alveolar bone for 1 year.

METHODS

Six-month-old female rats were ovariectomized (OVX) or underwent a sham operation. After 1 year, bone histomorphometry and a node-strut analysis were performed on the interradicular septum of the mandibular first molar by using micro computed tomography and confocal laser scanning microscopy. Statistical analysis was carried out by using analysis of variance.

RESULTS

The alveolar trabeculae of rats in the sham group had network structures, whereas the trabeculae of rats in the OVX group became fragmented. The trabecular bone volume, number, and thickness in the OVX group were significantly lower than those found in the sham group, and the trabecular separation was 4-fold higher in the OVX group than in the sham group. Bone resorptive and formative activity appeared to be moderately higher in the OVX group than in the sham group, but only the difference in bone formation was of statistical significance.

CONCLUSION

By 1 year after ovariectomy, bone loss and trabecular fragmentation had occurred in the rat mandibular alveolar bone.

Effects of ovariectomy on trabecular structures of rat alveolar bone

An association between postmenopausal osteoporosis and tooth loss has been proposed. However, histomorphometrical changes in alveolar bone following estrogen deficiency are rarely reported with data on microtrabecular structural changes. To clarify the relationship between estrogen deficiency and tooth loss, we histomorphometrically analyzed the trabecular structural changes of mandibular alveolar bone in ovariectomized rats. Twenty-four adult female Fischer rats were used. Eight rats were sacrificed on day 0 (baseline). The remaining 16 rats were divided into two groups. One group was ovariectomized bilaterally (OVX) and the other group was subjected to sham surgery (Sham). After administration of tetracycline and calcein, the animals were sacrificed 60 days after surgery. Bone histomorphometry, node-strut analysis and measurement of thickness of alveolar bone proper were performed on the interradicular septum of the first molar on the sagittal surface. The trabecular bone volume and trabecular number of the OVX group were significantly lower than those of the baseline and Sham groups. All of the bone resorptive and formative parameters of the OVX group were significantly higher (about one-and-a-half times) than those of the Sham group. Several osteoclasts were seen lining the irregular, eroded surface facing the bone marrow in the OVX group. Furthermore, the OVX group tended to have low microtrabecular stiffness and showed significantly thinner distal alveolar bone proper than in the baseline and Sham groups. In summary, estrogen deficiency caused osteoporotic changes and thin alveolar bone proper in the interradicular septum of rat first molar. This phenomenon might accelerate destruction of alveolar bone and tooth loss, especially in elderly women affected by periodontal disease.

The effect of cyclosporin A on the activity of matrix metalloproteinases during the healing of rat molar extraction wounds

Cyclosporin A (CyA) is a cyclic peptide used as an immunosuppressive agent because it can block the synthesis of interleukin-2 and other cytokines produced by CD4+ lymphocytes. It is widely used for the prevention of allograft rejection and treatment of autoimmune diseases. Several side-effects of CyA treatment have been reported, among which are chronic nephrotoxicity, hepatotoxicity and neurotoxicity, lymphoproliferative neoplasms, hypertension, thromboembolic complications and gingival overgrowth. Here, using a rat molar model, it is demonstrated that CyA immunosuppression inhibits the activity of matrix metalloproteinases 2 and 9 in the early phase of granulation tissue in the healing dental socket. These observations suggest that CyA may interfere with the wound healing following dental extractions.

Acute effects of ovariectomy on wound healing of alveolar bone after maxillary molar extraction in aged rats

Acute effects of ovariectomy on the bone wound healing processes after maxillary molar extraction in aged rats were examined by means of quantitative scanning electron microscopy (SEM), backscattered electron image (BSE) analysis and energy-dispersive X-ray (EDX) microanalysis. Six-month-old female rats underwent either sham operation or bilateral ovariectomy, and 7 days postoperatively, the maxillary first molars were extracted. On post-extraction days 7, 30 and 60, the dissected maxillary bone surfaces were examined by SEM to reveal the bone formative and resorptive areas around the extracted alveolar sockets. In addition, the resin-embedded maxillae were micromilled in the transverse direction through the extracted alveolar sockets, and the newly-formed bone mass on the buccal bone surfaces and within the extracted sockets was examined by BSE analysis. Compared with sham-operated controls, the extent of newly-formed bone mass on the buccal bone surfaces in OVX rats was significantly decreased, due to increased bone resorption. On the other hand, new bone formation within the extracted sockets was similar in the experimental groups. In EDX microanalysis of these newly-formed bone matrices, both Ca and P weight % and Ca/P molar ratio were similar in the experimental groups. Our results suggest that 1) acute estrogen deficiency induced by ovariectomy stimulates sustained bone resorption, but has less effect on bone formation, and 2) bone wound healing after maxillary molar extraction within extracted alveolar sockets is not significantly delayed by ovariectomy, but bony support by newly-formed bone mass on the maxillary bone surfaces at the buccal side of the extracted sockets is significantly decreased, due to increased bone resorption.