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Wang J, Lin J, Song X, Wang M, Chen Y, Luo N, Wu X. Differential effects of clopidogrel and/or aspirin on the healing of tooth extraction wound bone tissue. Front Physiol 2024; 15:1387633. [PMID: 39086935 PMCID: PMC11289322 DOI: 10.3389/fphys.2024.1387633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 06/24/2024] [Indexed: 08/02/2024] Open
Abstract
Introduction A multitude of variables influence the healing of tooth extraction wounds, and delayed or non-healing extraction wounds might complicate later prosthodontic therapy. In this research, we analyzed the effects of systemic clopidogrel and aspirin alone or in combination on the healing of tooth extraction wounds in mice in order to provide experimental evidence for the healing of extraction wounds in patients who are clinically treated with the two medicines. Methods 7-week-old ICR mice were randomly divided into four groups: control group (CON), clopidogrel group (CLOP), aspirin group (ASP), and clopidogrel combined with aspirin group (CLOP + ASP); left upper first molar was extracted, after which mice in 1 week of adaptive feeding, CLOP/ASP/CLOP + ASP groups were respectively administered with clopidogrel (10 mg/kg/d), aspirin (15 mg/kg/d), clopidogrel (10 mg/kg/d)+aspirin (15 mg/kg/d), and the control group was given an equal amount of 0.9% saline by gavage. Mice in each group were euthanized at 14 and 28 days postoperatively, and the maxilla was extracted. The tissues in the extraction sockets were examined using MicroCT and sectioned for HE staining, Masson staining, and TRAP staining, and immunohistochemistry staining (for TRAP, RANKL and osteoprotegerin). Results MicroCT analysis showed that at day 14, BS/BV was significantly lower in CLOP and CLOP + ASP groups compared to control and ASP groups, while BV/TV, Tb.Th was significantly higher. At day 28, BV/TV was significantly higher in the CLOP + ASP group compared to the CLOP group, with p < 0.05 for all results. HE staining and Masson trichrome staining findings revealed that at day 28, the mesenchyme in the bone was further decreased compared to that at day 14, accompanied with tightly arranged and interconnected bone trabeculae. In the quantitative analysis of Masson, the fraction of newly formed collagen was significantly higher in the CLOP group in comparison with that in the CON group (p < 0.05). At day 14, the ASP group had substantially more TRAP-positive cells than the CLOP and CLOP + ASP groups (p < 0.05). In immunohistochemical staining, RANKL expression was found to be significantly higher in the ASP group than those in the other three groups at day 28 (p < 0.05); OPG expression was significantly higher in the CLOP group and the CLOP + ASP group compared with that at day 14, and was higher than that in the ASP group at day 14 and day 28. OPG/RANKL was significantly higher in the CLOP and the CLOP + ASP groups than in the ASP group (p < 0.05). Conclusion Clopidogrel alone promotes osteogenesis in the extraction wound, whereas aspirin alone inhibits alveolar bone healing. When the two drugs were combined, the healing effect of the extraction wound was more similar to that of the clopidogrel alone group. These results indicated that clopidogrel could promote the healing of the tooth extraction wound, and neutralize the adverse effect of ASP on osteogenesis when the two drugs were used in combination.
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Affiliation(s)
- Jiaping Wang
- Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Juan Lin
- Nanjing First Hospital, Department of Stomatology, Nanjing, China
| | - Xin Song
- Nanjing First Hospital, Department of Stomatology, Nanjing, China
| | - Mengting Wang
- Nanjing First Hospital, Department of Stomatology, Nanjing, China
| | - Yan Chen
- Nanjing First Hospital, Department of Stomatology, Nanjing, China
| | - Ning Luo
- Nanjing First Hospital, Department of Stomatology, Nanjing, China
| | - Xin Wu
- Nanjing First Hospital, Department of Stomatology, Nanjing, China
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Mardas N, Macbeth N, Donos N, Jung RE, Zuercher AN. Is alveolar ridge preservation an overtreatment? Periodontol 2000 2023; 93:289-308. [PMID: 37622682 DOI: 10.1111/prd.12508] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/24/2023] [Accepted: 05/19/2023] [Indexed: 08/26/2023]
Abstract
The morphology and dimensions of the postextraction alveolar ridge are important for the surgical and restorative phases of implant treatment. Adequate new bone formation and preservation of alveolar ridge dimensions following extraction will facilitate installation of the implant in a restorative position, while preservation of soft tissue contour and volume is essential for an aesthetic and implant-supported restoration with healthy peri-implant tissues. Alveolar ridge preservation (ARP) refers to any procedure that aims to: (i) limit dimensional changes in the alveolar ridge after extraction facilitating implant placement without additional extensive bone and soft tissue augmentation procedures (ii) promote new bone formation in the healing alveolus, and (iii) promote soft tissue healing at the entrance of the alveolus and preserve the alveolar ridge contour. Although ARP is a clinically validated and safe approach, in certain clinical scenarios, the additional clinical benefit of ARP over unassisted socket healing has been debated and it appears that for some clinicians may represent an overtreatment. The aim of this critical review was to discuss the evidence pertaining to the four key objectives of ARP and to determine where ARP can lead to favorable outcomes when compared to unassisted socket healing.
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Affiliation(s)
- Nikos Mardas
- Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University of London (QMUL), Barts & The London School of Medicine & Dentistry, London, UK
| | - Neil Macbeth
- Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University of London (QMUL), Barts & The London School of Medicine & Dentistry, London, UK
- Defence Centre for Rehabilitative Dentistry, Defence Primary Health Care (DPHC), Dental Centre Aldershot, Guildford, UK
| | - Nikolaos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University of London (QMUL), Barts & The London School of Medicine & Dentistry, London, UK
| | - Ronald Ernst Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Anina Nives Zuercher
- Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University of London (QMUL), Barts & The London School of Medicine & Dentistry, London, UK
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Isaias PHC, Silva PGDB, do Nascimento IV, Verde MEQL, Moreira MDS, Alves APNN, Sousa FB, Pereira KMA, Mota MRL. Effect of continuous and intermittent sodium alendronate oral dosing on post-extraction alveoli healing in rats. Arch Oral Biol 2021; 132:105291. [PMID: 34700193 DOI: 10.1016/j.archoralbio.2021.105291] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 09/06/2021] [Accepted: 10/13/2021] [Indexed: 01/24/2023]
Abstract
OBJECTIVE This study aimed to compare alveolar healing after tooth extraction in two experimental rat models using continuous or discontinuous dosing of sodium alendronate (ALN). DESIGN Forty-eight male Wistar rats were divided into eight experimental groups (n = 6/group) and administered ALN (2.5, 5.0, or 7.5 mg/kg) by gavage, weekly, either intermittently or following a continuous regimen (2.5, 5.0, or 7.5 mg/kg) before tooth extraction. The positive control rats were administered zoledronic acid (ZA; 0.2 mg/kg, intravenous), whereas negative control rats received sterile saline (0.9% NaCl, gavage). RESULTS Only the ZA-treated animals showed a larger radiolucent extraction site area compared to the saline group (p = 0.007). Small areas of bone tissue filling the alveoli were visualized in the 7.5 mg/kg continuous ALN group and compared with the saline group (p < 0.001). Increased amounts of empty osteocyte lacunae (p < 0.001) and osteoclasts with signs of apoptosis (p = 0.004) were observed in the continuous ALN groups (2.5, 5.0, and 7.5 mg/kg) compared with the saline group. Increased immunolabeling for TNF-α was observed in the 7.5 mg/kg discontinuous ALN group and all continuous ALN groups compared with the saline group (p < 0.001). The number of tartrate-resistant acid phosphatase (TRAP)-positive osteoclasts was higher in the two continuous ALN groups (5.0 and 7.5 mg/kg) than in the saline group (p < 0.001). CONCLUSIONS Continuous administration of ALN impaired post-extraction alveolar bone healing in rats; however, discontinuation of ALN administration before tooth extraction allowed for adequate post-dental extraction alveolar healing.
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Affiliation(s)
- Pedro Henrique Chaves Isaias
- Department of Dental Clinic, Division of Oral Pathology, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Ceará, Brazil.
| | - Paulo Goberlânio de Barros Silva
- Department of Dental Clinic, Division of Oral Pathology, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Ceará, Brazil; Department of Dentistry, Unichristus, Fortaleza, Ceará, Brazil; Ceará Oncology School, Ceará Cancer Institute, Hospital Haroldo Juaçaba, Fortaleza, Ceará, Brazil.
| | - Isabelly Vidal do Nascimento
- Department of Dental Clinic, Division of Oral Pathology, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Ceará, Brazil; Department of Dentistry, Unichristus, Fortaleza, Ceará, Brazil.
| | - Maria Elisa Quezado Lima Verde
- Department of Dental Clinic, Division of Oral Pathology, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Ceará, Brazil; Department of Dentistry, Unichristus, Fortaleza, Ceará, Brazil.
| | - Manuela da Silva Moreira
- Department of Dental Clinic, Division of Oral Pathology, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Ceará, Brazil.
| | - Ana Paula Negreiros Nunes Alves
- Department of Dental Clinic, Division of Oral Pathology, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Ceará, Brazil.
| | - Fabrício Bitu Sousa
- Department of Dental Clinic, Division of Oral Pathology, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Ceará, Brazil; Department of Dentistry, Unichristus, Fortaleza, Ceará, Brazil.
| | - Karuza Maria Alves Pereira
- Department of Dental Clinic, Division of Oral Pathology, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Ceará, Brazil; Department of Morphology, School Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil.
| | - Mário Rogério Lima Mota
- Department of Dental Clinic, Division of Oral Pathology, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Ceará, Brazil.
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Ozonated oil effect for prevention of medication-related osteonecrosis of the jaw (MRONJ) in rats undergoing zoledronic acid therapy. Clin Oral Investig 2021; 25:6653-6659. [PMID: 33895916 DOI: 10.1007/s00784-021-03951-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 04/16/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate the preventive effect of ozonated oil on the development of MRONJ-like lesions at tooth extraction sites in rats submitted to zoledronic acid treatment. MATERIALS AND METHODS Twelve rats were divided into two groups. Each rat received an injection of zoledronic acid solution once a week for 5 weeks before having its upper first molar extracted. In group 1, the clotted socket was maintained, while in the group 2, the socket was treated with ozonated oil for 10 min/day during 3 days. After euthanasia, block resection was performed for histological analysis. Necrotic bone was defined as the area of the bone with empty osteocyte lacunae and vital bone as the area with osteocyte-occupied lacunae. RESULTS There was no statistically significant difference between the groups in the average area of vital bone (p = 0.2248) and the average area of necrotic bone (p = 0.1208). However, the average area of vital bone in group 1 was smaller (24.1 ± 2.9 cells/cm2) than in group 2 (26.8 ± 4.2 cells/cm2), and the average area of necrotic bone in group 1 was higher (7.0 ± 2.5 cells/cm2) than in group 2 (4.0 ± 1.1 cells/cm2), indicating that ozonated oil may reduce the development of osteonecrosis. CONCLUSIONS Our findings suggest that ozonated oil might prevent MRONJ-like lesions at tooth extraction sites in rats submitted to a disease induction protocol. Further research should be conducted to confirm this hypothesis. CLINICAL RELEVANCE MRONJ has been reported as a complication of surgical dental procedures, and there are currently no predictable preventive therapies.
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Só BB, Silveira FM, Llantada GS, Jardim LC, Calcagnotto T, Martins MAT, Martins MD. Effects of osteoporosis on alveolar bone repair after tooth extraction: A systematic review of preclinical studies. Arch Oral Biol 2021; 125:105054. [PMID: 33667958 DOI: 10.1016/j.archoralbio.2021.105054] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 01/15/2021] [Accepted: 01/16/2021] [Indexed: 12/09/2022]
Abstract
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.
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Affiliation(s)
- Bruna Barcelos Só
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, R. Ramiro Barcelos, 2492, CEP: 90035-003, Porto Alegre, RS, Brazil
| | - Felipe Martins Silveira
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, CEP: 13414-903, Piracicaba, SP, Brazil
| | - Gabriela Sauer Llantada
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, R. Ramiro Barcelos, 2492, CEP: 90035-003, Porto Alegre, RS, Brazil
| | - Luisa Comerlato Jardim
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, R. Ramiro Barcelos, 2492, CEP: 90035-003, Porto Alegre, RS, Brazil
| | - Thiago Calcagnotto
- Oral and Maxillofacial Surgery Department, FATEC Dental CEEO, Igrejinha, R. Independência, 290, CEP: 95650-000, RS, Brazil
| | - Marco Antonio Trevizani Martins
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, R. Ramiro Barcelos, 2492, CEP: 90035-003, Porto Alegre, RS, Brazil
| | - Manoela Domingues Martins
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, R. Ramiro Barcelos, 2492, CEP: 90035-003, Porto Alegre, RS, Brazil; Oral Diagnosis Department, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, CEP: 13414-903, Piracicaba, SP, Brazil.
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Oliveira CCD, Barros Silva PGD, Ferreira AEC, Gonçalves RP, Sousa FBD, Mota MRL, Alves APNN. Effects of dexamethasone and nimesulide on bisphosphonate-related osteonecrosis of the jaw: An experimental study. Arch Oral Biol 2017; 83:317-326. [DOI: 10.1016/j.archoralbio.2017.08.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Revised: 08/24/2017] [Accepted: 08/27/2017] [Indexed: 11/27/2022]
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Willett ES, Liu J, Berke M, Giannini PJ, Schmid M, Jia Z, Wang X, Wang X, Samson K, Yu F, Wang D, Nawshad A, Reinhardt RA. Standardized Rat Model Testing Effects of Inflammation and Grafting on Extraction Healing. J Periodontol 2017; 88:799-807. [PMID: 28440741 DOI: 10.1902/jop.2017.160771] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Loss of alveolar ridge width and height after tooth extraction is well documented, but models to evaluate ridge preservation are neither standardized nor cost-effective. This rat model characterizes the pattern of bone turnover and inflammation after extraction and bone grafting with or without local simvastatin (SIM). METHODS Fifty retired-breeder rats underwent extraction of the maxillary right first molar and standard surgical defect creation under inhalation/local anesthesia. The left side of each animal served as unmanipulated control. Untreated groups (n = 8 to 9 per group) were compared (analysis of variance, t test) at days 0, 7, 14, and 28 for alveolar ridge height and width and for markers of inflammation and bone turnover by microcomputed tomography, histology, and enzyme-linked immunosorbent assay. Seventeen additional specimens had defects grafted with either bone mineralized matrix (BMM) or a BMM+SIM conjugate. RESULTS Extraction-induced bone loss (BL) was noted on buccal, palatal, and interproximal height (P <0.05) and ridge width (P <0.01). Week 1 inflammation positively correlated with ridge height; thereafter, a more intense inflammatory reaction corresponded to reduction in alveolar bone height and density (r = 0.74; P <0.05; Spearman). BMM+SIM preserved the most interproximal bone height (P <0.01), increased ridge width and bone density (P <0.01), enhanced 7-day prostaglandin E2 (P <0.01), and reduced 28-day inflammation density (P <0.05). CONCLUSIONS The standard defect used in the current study paralleled human postextraction alveolar BL. Defect grafting, especially BMM+SIM, reduced inflammation and preserved bone.
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Affiliation(s)
- Emily S Willett
- Department of Oral Biology, College of Dentistry, University of Nebraska Medical Center, Lincoln, NE
| | - Jingpeng Liu
- Department of Oral Biology, College of Dentistry, University of Nebraska Medical Center, Lincoln, NE
| | - Molly Berke
- Department of Oral Biology, College of Dentistry, University of Nebraska Medical Center, Lincoln, NE
| | - Peter J Giannini
- Department of Oral Biology, College of Dentistry, University of Nebraska Medical Center, Lincoln, NE
| | - Marian Schmid
- Department of Oral Biology, College of Dentistry, University of Nebraska Medical Center, Lincoln, NE
| | - Zhenshan Jia
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE
| | - Xiaobei Wang
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE
| | - Xiaoyan Wang
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE
| | - Kaeli Samson
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE
| | - Fang Yu
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE
| | - Dong Wang
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE
| | - Ali Nawshad
- Department of Oral Biology, College of Dentistry, University of Nebraska Medical Center, Lincoln, NE
| | - Richard A Reinhardt
- Department of Surgical Specialties, College of Dentistry, University of Nebraska Medical Center
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Ru N, Liu SSY, Bai Y, Li S, Liu Y, Wei X. BoneCeramic graft regenerates alveolar defects but slows orthodontic tooth movement with less root resorption. Am J Orthod Dentofacial Orthop 2016; 149:523-32. [PMID: 27021457 DOI: 10.1016/j.ajodo.2015.09.027] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 09/01/2015] [Accepted: 09/01/2015] [Indexed: 10/22/2022]
Abstract
INTRODUCTION BoneCeramic (Straumann, Basel, Switzerland) can regenerate bone in alveolar defects after tooth extraction, but it is unknown whether it is feasible to move a tooth through BoneCeramic grafting sites. The objective of this study was to investigate 3-dimensional real-time root resorption and bone responses in grafted sites during orthodontic tooth movement. METHODS Sixty 5-week-old rats were randomly assigned to 3 groups to receive BoneCeramic, natural bovine cancellous bone particles (Bio-Oss; Geistlich Pharma, Wolhusen, Switzerland), or no graft, after the extraction of the maxillary left first molar. After 4 weeks, the maxillary left second molar was moved into the extraction site for 28 days. Dynamic bone microstructures and root resorption were evaluated using in-vivo microcomputed tomography. Stress distribution and corresponding tissue responses were examined by the finite element method and histology. Mixed model analysis of variance was performed to compare the differences among time points with Bonferroni post-hoc tests at the significance level of P <0.05. RESULTS The BoneCeramic group had the least amount of tooth movement and root resorption volumes and craters, and the highest bone volume fraction, trabecular number, and mean trabecular thickness, followed by the Bio-Oss and the control groups. The highest stress accumulated in the cervical region of the mesial roots. CONCLUSIONS BoneCeramic has better osteoconductive potential and induces less root resorption compared with Bio-Oss grafting and naturally recovered extraction sites.
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Affiliation(s)
- Nan Ru
- Lecturer, Department of Orthodontics, School of Stomatology, Capital Medical University, Beijing, China
| | - Sean Shih-Yao Liu
- Associate professor; director, Mineralized Tissues and Histology Research Laboratory; and director, Orthodontic Fellowship Program, Department of Orthodontics and Oral Facial Genetics, Indiana University School of Dentistry, Indianapolis, Ind
| | - Yuxing Bai
- Professor, Department of Orthodontics, School of Stomatology, Capital Medical University, Beijing, China.
| | - Song Li
- Professor, Department of Orthodontics, School of Stomatology, Capital Medical University, Beijing, China
| | - Yunfeng Liu
- Associate professor, Key Laboratory of Equipment & Manufacturing, Zhejiang University of Technology, Hangzhou, China
| | - Xiaoxia Wei
- Associate professor, Department of Orthodontics, School of Stomatology, Zhengzhou University, Zhengzhou, China
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CONTE NETO N, SPOLIDORIO LC, ANDRADE CRD, ESTEVES JC, MARCANTONIO JR E. Experimental osteonecrosis: development of a model in rodents administered alendronate. Braz Oral Res 2016; 30:e99. [DOI: 10.1590/1807-3107bor-2016.vol30.0099] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 06/09/2016] [Indexed: 11/22/2022] Open
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Silva PGDB, Ferreira Junior AEC, Teófilo CR, Barbosa MC, Lima Júnior RCP, Sousa FB, Mota MRL, Ribeiro RDA, Alves APNN. Effect of different doses of zoledronic acid in establishing of bisphosphonate-related osteonecrosis. Arch Oral Biol 2015; 60:1237-45. [PMID: 26093347 DOI: 10.1016/j.archoralbio.2015.05.015] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 05/13/2015] [Accepted: 05/24/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To establish osteonecrosis of the jaws in rats treated with different doses of zoledronic acid (ZA). METHODS Male Wistar rats (n=6-7) received three consecutive weekly intravenous ZA infusions at doses of 0.04, 0.20 or 1.00mg/kg ZA or saline (control). Four weeks after the last administration, the animals were submitted to simple extraction of the lower left first molar. An additional dose of ZA was administered seven days later, and the animals were sacrificed 28 days after exodontia. Weight was measured and blood was collected weekly for analysis. The jaw was radiographically and microscopically examined along with the liver, spleen, kidney and stomach. RESULTS All ZA doses showed a higher radiolucent area than the control (p<0.0001), but the dose of 0.04mg/kg did not show BRONJ. Doses of 0.20 and 1.00mg/kg ZA showed histological evidence of bone necrosis (p=0.0004). Anaemia (p<0.0001, r(2)=0.8073) and leucocytosis (p<0.0001, r(2)=0.9699) are seen with an increase of lymphocytes (p<0.0001, r(2)=0.6431) and neutrophils and monocytes (p=0.0218, r(2)=0.8724) in all the animals treated with an increasing dose of ZA. Haemorrhage and ectasia were observed in the spleen (p=0.0004) and stomach (p=0.0168) in a dose-dependent manner, and the animals treated with ZA showed a lower rate of weight gain (p<0.0001). CONCLUSIONS We designed a bisphosphonate-related osteonecrosis of the jaw model that reproduces radiographic and histological parameters and mimics clinical alterations such as leucocytosis, anaemia and idiosyncratic inflammatory post infusion reactions.
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Affiliation(s)
- Paulo Goberlânio de Barros Silva
- Department of Dental Clinic, Division of Oral Pathology, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceara, Fortaleza, Ceara, Brazil.
| | - Antonio Ernando Carlos Ferreira Junior
- Department of Dental Clinic, Division of Oral Pathology, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceara, Fortaleza, Ceara, Brazil
| | - Carolina Rodrigues Teófilo
- Department of Dental Clinic, Division of Oral Pathology, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceara, Fortaleza, Ceara, Brazil
| | - Maritza Cavalcante Barbosa
- Department of Clinical Analysis, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceara, Fortaleza, Ceara, Brazil
| | | | - Fabrício Bitú Sousa
- Department of Dental Clinic, Division of Oral Pathology, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceara, Fortaleza, Ceara, Brazil
| | - Mário Rogério Lima Mota
- Department of Dental Clinic, Division of Oral Pathology, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceara, Fortaleza, Ceara, Brazil
| | | | - Ana Paula Negreiros Nunes Alves
- Department of Dental Clinic, Division of Oral Pathology, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceara, Fortaleza, Ceara, Brazil
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Melo RB, Guimarães SB, Silva PGDB, Oriá RB, Melo JUDS, Vasconcelos PRL. Antiperoxidative properties of oil mixes of high ratio Omega-9:Omega-6 and low ratio Omega-6:Omega-3 after molar extraction in rats. Acta Cir Bras 2014; 29:371-5. [DOI: 10.1590/s0102-86502014000600004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Accepted: 04/22/2014] [Indexed: 11/22/2022] Open
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Sartorato FAS, Mura CAM, Lucas SRR. Histometric evaluation of dental alveolar repair in malnourished rats in the intrauterine or postnatal phase. Arch Oral Biol 2014; 59:241-50. [PMID: 24581845 DOI: 10.1016/j.archoralbio.2013.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Revised: 11/19/2013] [Accepted: 11/25/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Nutritional aggravations during pregnancy or during the early stages of postnatal development can impair bone development; thus, we aimed to assess the effects of food restriction on the dental alveolar bone repair process using histometric analysis. DESIGN Thirty-six Wistar rats were divided into three groups: (C) 12 pups were obtained from control mothers with food intake at ease; (GR) 12 pups from mothers subjected to 70% food restriction during pregnancy; (PNR) 50% of maternal food restriction during lactation and 50% of restriction for the 12 pups after weaning. At three months of age, the upper right incisor was extracted from the pups. After 14 or 28 days, the pups were sacrificed for evaluation of newly formed bone area (NB) and total bone area (TA) in the medial and apical thirds of the alveolus. RESULTS In the apical third of the alveolus, the ratio of NB/TA was greater at 28 days for all groups and there was no damage to any of the groups. In the medial third, the ratio was higher at 28 days for the C and GR groups. The PNR group did not show an evolution of alveolar dental repair. Compared between the thirds, all groups exhibited a higher percentage of newly formed bone in the medial third area, at any time point after surgery. CONCLUSIONS The percentage of the total alveolar area covered by newly formed bone (NB/TA) revealed a late preference in the process of alveolar repair in the medial third, although only in the PNR group.
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Affiliation(s)
- Fábio A S Sartorato
- Laboratory of Developmental Biology, Department of Morphology and Genetics, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil.
| | - Cláudia A M Mura
- Laboratory of Developmental Biology, Department of Morphology and Genetics, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Sandra R R Lucas
- Laboratory of Developmental Biology, Department of Morphology and Genetics, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
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Conte Neto N, Spolidorio LC, Andrade CR, S Bastos A, Guimarães M, Marcantonio E. Experimental development of bisphosphonate-related osteonecrosis of the jaws in rodents. Int J Exp Pathol 2013; 94:65-73. [PMID: 23317355 DOI: 10.1111/iep.12007] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Accepted: 10/05/2012] [Indexed: 11/28/2022] Open
Abstract
Osteonecrosis of the jaw (ONJ) following the use of bisphosphonates has become of increased interest in the scientific community, due in particular to its as-yet-unsolved pathogenesis. An experimental model of ONJ was induced in normal male rats [alendronate (ALN); 1 mg/Kg/day; n = 10] and matched controls (saline solution; n = 10). After 60 days of drug treatment, all animals were subjected to extractions of the left first lower molars and were euthanized at 3 and 28 days postsurgery. The following analyses were performed: (i) descriptive and quantitative (scores) histological evaluation, (ii) stereometry of distal sockets and (iii) biochemical measurement of C-telopeptide cross-linked collagen type I (CTX) and bone-specific alkaline phosphatase (BALP). The results showed that 28 days postsurgery the animals treated with ALN had areas of exposed and necrotic bone, associated with significant infection, especially in the interalveolar septum area and crestal regions, compared with controls. The levels of CTX, BALP and bone volume, as well as the degrees of inflammation and vascularization, were significantly reduced in these animals. Therefore, analysis of the data presented suggests that ALN therapy is associated with the development of osteonecrosis in the jaws of rodents after tooth extraction.
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Affiliation(s)
- Nicolau Conte Neto
- Division of Periodontology, Department of Diagnosis and Surgery, School of Dentistry, UNESP- Univ. Estadual Paulista, Araraquara, SP, Brazil
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Boonyagul S, Banlunara W, Sangvanich P, Thunyakitpisal P. Effect of acemannan, an extracted polysaccharide from Aloe vera, on BMSCs proliferation, differentiation, extracellular matrix synthesis, mineralization, and bone formation in a tooth extraction model. Odontology 2013; 102:310-7. [PMID: 23315202 DOI: 10.1007/s10266-012-0101-2] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2012] [Accepted: 12/05/2012] [Indexed: 12/28/2022]
Abstract
Aloe vera is a traditional wound healing medicine. We hypothesized acemannan, a polysaccharide extracted from Aloe vera gel, could affect bone formation. Primary rat bone marrow stromal cells (BMSCs) were treated with various concentrations of acemannan. New DNA synthesis, VEGF, BMP-2, alkaline phosphatase activity, bone sialoprotein, osteopontin expression, and mineralization were determined by [(3)H] thymidine incorporation assay, ELISA, biochemical assay, western blotting, and Alizarin Red staining, respectively. In an animal study, mandibular right incisors of male Sprague-Dawley rats were extracted and an acemannan treated sponge was placed in the socket. After 1, 2, and 4 weeks, the mandibles were dissected. Bone formation was evaluated by dual-energy X-ray absorptiometry and histopathological examination. The in vitro results revealed acemannan significantly increased BMSC proliferation, VEGF, BMP-2, alkaline phosphatase activity, bone sialoprotein and osteopontin expression, and mineralization. In-vivo results showed acemannan-treated groups had higher bone mineral density and faster bone healing compared with untreated controls. A substantial ingrowth of bone trabeculae was observed in acemannan-treated groups. These data suggest acemannan could function as a bioactive molecule inducing bone formation by stimulating BMSCs proliferation, differentiation into osteoblasts, and extracellular matrix synthesis. Acemannan could be a candidate natural biomaterial for bone regeneration.
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Affiliation(s)
- Sani Boonyagul
- Dental Biomaterials Science Program, Graduate School, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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Manrique N, Pereira CCS, Garcia LMG, Micaroni S, Carvalho AAFD, Perri SHV, Okamoto R, Sumida DH, Antoniali C. Alveolar bone healing process in spontaneously hypertensive rats (SHR). A radiographic densitometry study. J Appl Oral Sci 2012; 20:222-7. [PMID: 22666841 PMCID: PMC3894767 DOI: 10.1590/s1678-77572012000200017] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2010] [Accepted: 01/18/2011] [Indexed: 11/22/2022] Open
Abstract
UNLABELLED Hypertension is one of the most important public health problems worldwide. If undiagnosed or untreated, this pathology represents a systemic risk factor and offers unfavorable conditions for dental treatments, especially those requiring bone healing. OBJECTIVES The purpose of this study was to demonstrate, by analysis of bone mineral density (BMD), that the alveolar bone healing process is altered in spontaneously hypertensive rats (SHRs). MATERIAL AND METHODS Wistar rats and SHRs were submitted to extraction of the upper right incisor and were euthanized 7, 14, 21, 28 and 42 days after surgery. Right maxillae were collected, radiographed and analyzed using Digora software. BMD was expressed as minimum (min), middle (med) and maximum (max) in the medium (MT) and apical (AT) thirds of the dental alveolus. RESULTS The results were compared across days and groups. Wistar showed difference in med and max BMD in the MT between 7 and 28 and also between 14 and 28 days. The AT exhibited significant difference in med and min BMD between 7 and 28 days, as well as difference in min BMD between 28 and 42 days. SHRs showed lower med BMD in the MT at 28 days when compared to 21 and 42 days. Differences were observed across groups in med and min BMD at day 28 in the MT and AT; and in max BMD at 14, 21 and 42 days in the MT. CONCLUSIONS These results suggest that the alveolar bone healing process is delayed in SHRs comparing with Wistar rats.
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Affiliation(s)
- Natalia Manrique
- Department of Pediatric and Community Dentistry, School of Dentistry of Araçatuba, Univ. Estadual Paulista, Araçatuba, SP, Brazil
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Vasconcelos ACU, Berti-Couto SA, Azambuja AA, Salum FG, Figueiredo MA, da Silva VD, Cherubini K. Comparison of effects of clodronate and zoledronic acid on the repair of maxilla surgical wounds - histomorphometric, receptor activator of nuclear factor-kB ligand, osteoprotegerin, von Willebrand factor, and caspase-3 evaluation. J Oral Pathol Med 2012; 41:702-12. [PMID: 22417074 DOI: 10.1111/j.1600-0714.2012.01140.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The aim of this study was to compare clodronate and zoledronic acid regarding their influence on the repair of surgical wounds in maxillae (soft tissue wound and tooth extraction) and their relation to osteonecrosis. MATERIAL AND METHODS Thirty-four Wistar rats were allocated into three groups according to the treatment received: (i) 12 animals treated with zoledronic acid, (ii) 12 animals treated with clodronate and (iii) 10 animals that were given saline solution. All animals were subjected to tooth extractions and surgically induced soft tissue injury. Histological analysis of the wound sites was performed by means of hematoxylin-eosin (H&E) staining and immunohistochemical staining for receptor activator of nuclear factor-kB ligand (RANKL), osteoprotegerin (OPG), von Willebrand factor, and caspase-3. RESULTS The zoledronic acid group showed higher incidence of non-vital bone than did the clodronate group at the tooth extraction site. At the soft tissue wound site, there were no significant differences in non-vital bone between the test groups. RANKL, OPG, von Willebrand factor, and caspase-3 did not show significant differences between the groups for both sites of surgical procedures. CONCLUSION Both of the bisphosphonates zoledronic acid and clodronate are capable of inducing maxillary osteonecrosis. Immunohistochemical analysis suggests that the involvement of soft tissues as the initiator of osteonecrosis development is less probable than has been pointed out.
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Affiliation(s)
- Ana C U Vasconcelos
- Dental College, Pontifical Catholic University of Rio Grande do Sul - PUCRS, Porto Alegre, Rio Grande do Sul, Brazil
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Korpi JT, Åström P, Lehtonen N, Tjäderhane L, Kallio-Pulkkinen S, Siponen M, Sorsa T, Pirilä E, Salo T. Healing of extraction sockets in collagenase-2 (matrix metalloproteinase-8)-deficient mice. Eur J Oral Sci 2009; 117:248-54. [DOI: 10.1111/j.1600-0722.2009.00620.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Mahl CRW, Fontanella V. Optimal parameters for lateral oblique radiographs of rat mandibles. Dentomaxillofac Radiol 2008; 37:224-7. [DOI: 10.1259/dmfr/32763038] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Watanabe K, Imamura H, Uchikanbori S, Fujita Y, Maki K. Effects of Restricted Calcium Intake on Bone and Maxillofacial Growth. Angle Orthod 2008; 78:445-52. [DOI: 10.2319/101106-417.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2006] [Accepted: 02/01/2007] [Indexed: 11/23/2022] Open
Abstract
Abstract
Objective: To investigate the effects of a low calcium diet on maxillofacial development by evaluating Bone Mineral Content (BMC) in the lower alveolar bones, femurs, and tibias and by performing cephalometry on growing rats.
Materials and Methods: Thirty 5-week-old male Wistar rats were randomly divided into 3 groups; the control group (n = 10) was given standard diet for 6 weeks, the low calcium/standard diet group (n = 10) was given a calcium-restricted diet for the first 4 weeks, and then a standard diet for the following 2 weeks, and the low calcium diet group (n = 10) was given the calcium-restricted diet for 6 weeks. After the rats were euthanized, heads and legs were fixed and cephalometry was performed. Next, mandibles, femurs and tibias were digitally photographed and the BMC was evaluated using our newly developed software.
Results: The BMC was decreased in all of the bone samples from the two groups that received restricted calcium. In the low calcium/standard diet group, the BMC recovered the most in the tibias and least in the lower alveolar bones. Development of the mandibles in the anterior-posterior direction was accelerated, while that in the superior-inferior direction was inhibited in those rats.
Conclusion: The BMC reduction following calcium deficiency in the lower alveolar bone hardly recovers, so prevention is important. Development of the mandible in a superior-inferior direction is inhibited while that in an anterior-posterior direction is accelerated due to a calcium-restricted diet.
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Affiliation(s)
- Koji Watanabe
- a Graduate PhD student, Department of Developmental Stomatognathic Function Science, Kyushu Dental College, Fukuoka, Japan
| | - Hitoshi Imamura
- b Research Fellow, Department of Developmental Stomatognathic Function Science, Kyushu Dental College, Fukuoka, Japan
| | - Shinsaku Uchikanbori
- a Graduate PhD student, Department of Developmental Stomatognathic Function Science, Kyushu Dental College, Fukuoka, Japan
| | - Yuko Fujita
- a Graduate PhD student, Department of Developmental Stomatognathic Function Science, Kyushu Dental College, Fukuoka, Japan
| | - Kenshi Maki
- c Chief Professor, Department of Developmental Stomatognathic Function Science, Kyushu Dental College, Fukuoka, Japan
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Pereira MC, Zecchin KG, Campagnoli EB, Jorge J. Ovariectomy delays alveolar wound healing after molar extractions in rats. J Oral Maxillofac Surg 2007; 65:2248-53. [PMID: 17954321 DOI: 10.1016/j.joms.2006.11.040] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2006] [Revised: 11/03/2006] [Accepted: 11/17/2006] [Indexed: 10/22/2022]
Abstract
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.
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Affiliation(s)
- Michele Conceição Pereira
- Department of Oral Diagnosis, Dental School, State University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
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Arisawa EAL, Brandão AAH, Almeida JD, da Rocha RF. Calcitonin in bone-guided regeneration of mandibles in ovariectomized rats: densitometric, histologic and histomorphometric analysis. Int J Oral Maxillofac Surg 2007; 37:47-53. [PMID: 17826959 DOI: 10.1016/j.ijom.2007.07.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2006] [Revised: 05/10/2007] [Accepted: 07/06/2007] [Indexed: 12/01/2022]
Abstract
The aim of the present study was to investigate bone promotion in surgical defects created in the mandible of normal and ovariectomized female rats using calcitonin associated with a polytetrafluoroethylene barrier. The 100 female rats were divided into four groups: control (C), control treated with calcitonin (CM), ovariectomized control (OV) and ovariectomized treated with calcitonin (OVM). A circumscribed bone defect 4mm in diameter was created in the region of the mandibular angle, and covered with the barrier. Groups CM and OVM received 2 IU/kg of synthetic salmon calcitonin intramuscularly three times a week. The animals were killed 3, 7, 14, 21 and 28 days after surgery. The bone defects were submitted to densitometric, histologic and histomorphometric analysis. Groups C and CM showed higher levels of bone formation after 7 days compared to the OV and OVM groups. A significant difference was observed between groups C and OV at 3-14 days. The OV group presented slower bone regeneration of the surgical bone defect created in the mandibular angle than group C. Synthetic salmon calcitonin accelerated regeneration of the bone defect in the mandibles of OVM animals similarly to group C, and also increased the formation of new bone during the regeneration process in CM.
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Affiliation(s)
- E A L Arisawa
- Department of Pathology, Faculty of Health Sciences, Vale do Paraíba University - UNIVAP, São José dos Campos, São Paulo, Brazil.
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Jorge RS, Jorge J, Luz JGC. Reconstruction of a mandibular critical-sized defect using iliac graft in rats. IMPLANT DENT 2007; 15:282-9. [PMID: 16966902 DOI: 10.1097/01.id.0000230317.45997.32] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate, histologically and by optical densitometry of radiographs, the healing of a critical-sized defect in the rat mandible filled with iliac graft. MATERIALS The study was conducted on 25 adult Wistar rats. With the rats under general anesthesia, a bicortical critical-sized osseous defect was created in the right mandibular ramus and filled with autogenous iliac crest graft. The animals were divided into 5 groups, with 5 rats in each. They were sacrificed after 1, 7, and 14 days, and 1 and 3 months. The mandibles were removed, fixed in formalin, and radiographed. The right hemi-mandibles were decalcified, and sections were cut and stained with hematoxylin and eosin. RESULTS Initially, an acute inflammatory process was noted along the graft that was tightly fitted to the defect. Subsequently, intense bone neoformation from external corticals and in the inner spaces of the graft was observed, while medullar spaces were occupied by granulation tissue and osteoblasts. There was remodelation of the receptor site, with a decrease in the graft volume and medullary space, as well as cancellous bone replaced by compact bone. Later, the receptor site was similar to the normal mandible, and only devitalized remnants of corticals of the graft were found. Optical densitometry of radiographs revealed statistically significant differences between experimental and control sites. CONCLUSIONS This experimental model is valuable in the study of bone healing. The study showed that autogenous iliac graft promoted healing of the critical-sized defect of the mandible with complete bony remodeling.
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Affiliation(s)
- Rogerio S Jorge
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of São Paulo, Brazil
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Furukawa M, Izumi M, Hishikawa T, Noguchi T, Ariji E. Influence of overlying soft tissues on radiographic absorptiometry in intraoral radiography. Oral Radiol 2005. [DOI: 10.1007/s11282-005-0034-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Nemcovsky CE, Beny L, Shanberger S, Feldman-Herman S, Vardimon A. Bone Apposition in Surgical Bony Defects Following Orthodontic Movement: A Comparative Histomorphometric Study Between Root- and Periodontal Ligament-Damaged and Periodontally Intact Rat Molars. J Periodontol 2004; 75:1013-9. [PMID: 15341361 DOI: 10.1902/jop.2004.75.7.1013] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
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.
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Affiliation(s)
- Carlos E Nemcovsky
- Department of Periodontology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
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Elsubeihi ES, Heersche JNM. Quantitative assessment of post-extraction healing and alveolar ridge remodelling of the mandible in female rats. Arch Oral Biol 2004; 49:401-12. [PMID: 15041488 DOI: 10.1016/j.archoralbio.2003.12.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2003] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To quantitatively evaluate the healing and bone changes in the mandible of adult female rats following unilateral extraction of the mandibular molars and the incisor. METHODS Six-month old female rats had their mandibular molars and the incisor on one side of the mandible extracted. Nine rats were sacrificed at 0, 14, 28, 56 and 112 days post-extraction. Bone mineral density (BMD) as observed by dual energy X-ray absorptiometry (DEXA) and histomorphometric measurements of total bone volume (TBV/TV%) as well as changes in size; height and width on backscattered electron microscopy images of cross-sections of the mandible were evaluated. RESULTS There was a total increase of 28% in BMD of the body of the mandible and 35.1% increase in TBV/TV% at 112 days post-extraction. A maximal increase of 25% in BMD was observed at 14 days post-extraction. TBV/TV% increased by 9.5% at 14 days post-extraction and further increased by 15.9% (P < 0.001) from 14 to 28 days and by 9.2% (P < 0.001) from 28 to 56 days. A further slight but non-significant increase of 6% (P = 0.108) occurred from 56 to 112 days post-extraction. Regression equations demonstrated that the maximal increase in TBV/TV% and BMD occurred between 0 and 28 days, which subsequently slowed down between 28 and 56 days and further declined between 56 and 112 days post-extraction. Healing was associated with a reduction in cross-sectional area (32.89%), height (21%) and width of the mandible (12.84%). CONCLUSIONS BMD of the edentulous mandible following extraction of mandibular molars and the incisor on one side of the mandible increases up to 56 days, but that total bone volume increases up to 112 days post-extraction. This indicates that bone volume measurement is more sensitive than BMD measurements in detecting small increase in bone formation at later stages of healing, possibly because of changes in geometry of the edentulous mandible following teeth extraction. The edentulous mandible undergoes a significant reduction in size as a result of reduction in both height and width up to 112 days post-extraction.
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Affiliation(s)
- Emad S Elsubeihi
- Department of Prosthodontics, Faculty of Dentistry, University of Toronto, 124 Edward Street, Toronto, Ontario, Canada M5G 1G6.
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Yang J, Chiou R, Ruprecht A, Vicario J, MacPhail LA, Rams TE. A new device for measuring density of jaw bones. Dentomaxillofac Radiol 2002; 31:313-6. [PMID: 12203130 DOI: 10.1038/sj.dmfr.4600715] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2002] [Revised: 05/23/2002] [Accepted: 05/29/2002] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES The purpose of this project was to develop a lightweight, simple device to evaluate alveolar process bone density using normal intraoral and extraoral imaging procedures. METHODS A simple lightweight device was constructed using barium sulfate as the major radiopaque component. The 5 x 32 x 12 mm(3) resin block has eight segments with known densities ranging from 1.304 (g/cm(3)) to 1.982 (g/cm(3)). The device was integrated into an XCP unit for standard intraoral radiographs and placed between the jaws for computer aided tomographic imaging. The relationship between the device segment densities and the optical densities of the exposed film was plotted. RESULTS A linear inverse relationship was found between the device segment densities and optical densities when segment densities were between 1.304 (g/cm(3)) to 1.882 (g/cm(3)). However, the relationship was non-linear for segment densities above 1.882 (g/cm(3)). CONCLUSIONS Normal human bone density is 1.85 (g/cm(3)), and this densitometer is useful for determination of material densities from 1.304 (g/cm(3)) to 1.882 (g/cm(3)). The device may be useful for precise bone density assessment.
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Affiliation(s)
- J Yang
- Division of Oral and Maxillofacial Radiology, Department of Oral & Maxillofacial Pathology, Medicine, and Surgery, Temple University School of Dentistry, Philadelphia, Pennsylvania 19140, USA.
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Güngörmüş M, Kaya O. Evaluation of the effect of heterologous type I collagen on healing of bone defects. J Oral Maxillofac Surg 2002; 60:541-5. [PMID: 11988933 DOI: 10.1053/joms.2002.31852] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE The purpose of this investigation was to evaluate the effect of type I collagen on the healing of bone defects both experimentally and clinically. MATERIALS AND METHODS In the experimental study, 16 adult male rabbits were divided into 2 groups: a collagen group and a control group. After the induction of general anesthesia with intraperitoneal ketamine, the anterior surfaces of tibias of the rabbits were surgically exposed, and a hole 4 mm in diameter was made in each tibia. In the collagen group, the defects were filled with type I collagen. The unfilled defects of the other animals were used as controls. During the study, the serum alkaline phosphatase activity of the rabbits, and radiopacity changes in the radiographs of the tibias of the rabbits were evaluated. The rabbits were killed on the 35th day, and histologic sections of the tibias were prepared. The clinical study was carried out on periapical defects in a total of 15 patients who underwent apicoectomy. After the surgical procedure, the osseous defects in periapical regions of 7 patients were filled with type I collagen. The unfilled cavities of the other patients were used for control purposes. The patients were evaluated clinically and radiographically in the postoperative period. The data were analyzed by Student's t-test and Mann-Whitney U test. RESULTS In the experimental study, there was an increase in radiopacity corresponding with the serum alkaline phosphatase activity, and there were statistically significant differences between the control and collagen groups both radiologically and biochemically on the 14th and 28th days of the study. In the clinical study, the control cavities filled with a tissue of normal bone density in about 5 months, but the collagen cavities filled in 3 months. CONCLUSIONS It was determined that heterologous type I collagen provides a more rapid regeneration of bone defects.
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Affiliation(s)
- Metin Güngörmüş
- Department of Oral and Maxillofacial Surgery, Atatürk University, Erzurum, Turkey.
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Silva HC, Coletta RD, Jorge J, Bolzani G, de Almeida OP, Graner E. The effect of cyclosporin A on the activity of matrix metalloproteinases during the healing of rat molar extraction wounds. Arch Oral Biol 2001; 46:875-9. [PMID: 11420061 DOI: 10.1016/s0003-9969(01)00045-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
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.
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Affiliation(s)
- H C Silva
- Department of Oral Pathology and Genetics, School of Dentistry of Piracicaba, UNICAMP, Avenida Limeira 901, 13414-018, CP 52, SP, Piracicaba, Brazil
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Bodner L, Gabor D, Kaffe I. Characteristics of the aging rat mandible. Arch Gerontol Geriatr 1998; 27:147-57. [DOI: 10.1016/s0167-4943(98)00108-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/1997] [Revised: 04/27/1998] [Accepted: 04/30/1998] [Indexed: 11/16/2022]
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Bodner L. Osseous regeneration in the jaws using demineralized allogenic bone implants. J Craniomaxillofac Surg 1998; 26:116-20. [PMID: 9617677 DOI: 10.1016/s1010-5182(98)80051-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Osseous defects of the jaws following trauma, congenital deformity or pathology may show poor osteogenesis and the affected area may never be completely replaced by bone or will show alveolar height loss. The purpose of the present study was to evaluate the effect of allogenic bone implants (ABI) on the osteogenesis of jaw defects. Fifty-two patients (27 males, 25 females) with cystic lesions of the jaws were randomly divided into two groups: Group A underwent enucleation and packing with adsorbable gelatine sponge. Group B underwent enucleation and grafting with ABI. Both groups were evaluated radiographically. The height of the alveolar process was measured directly on the radiography. The density was measured with a digital densitometer. In Group A, the mandibular height at 6, 12 and 24 months postoperatively was 88%, 80% and 78% of the preoperative heights, respectively. In Group B, the heights were 95%, 93% and 90%, respectively. These differences were significant (P < 0.05-0.01). The density in Group B was significantly greater (P < 0.05-0.01) than in Group A at 6 and 12 months postoperatively. The difference at 24 months was not significant. On the basis of these findings, it can be concluded that ABI grafting of jaw defects enhances osteogenesis and prevents alveolar height loss in the mandible. ABI represent an encouraging alternative to autogenous bone grafting.
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Affiliation(s)
- L Bodner
- Department of Oral and Maxillofacial Surgery, Soroka Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Bodner L. Effect of decalcified freeze-dried bone allograft on the healing of jaw defects after cyst enucleation. J Oral Maxillofac Surg 1996; 54:1282-6. [PMID: 8941177 DOI: 10.1016/s0278-2391(96)90482-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE This study radiographically evaluated the changes that occur in jaw defects after enucleation of cysts and either grafting with demineralized freeze-dried bone allograft (DFDBA) or packing with absorbable gelatine sponge (Gelfoam). PATIENTS AND METHODS Thirty-two patients (14 males, 18 females) with cystic lesions of the jaws were divided into two groups. Group A underwent enucleation and bone grafting with DFDBA. Group B underwent enucleation and packing with Gelfoam. Both groups were evaluated radiographically before surgery, immediately postoperatively, and 6, 12, 24, and 36 months postoperatively. The density of the area was measured with a digital densitometer. RESULTS The density in group A was significantly (P < .05 to .01) greater than in group B at 6 and 12 months postoperatively. The difference at 24 months was not significant. Group A reached density levels at 6 months that were reached by group B at 12 months. CONCLUSION The findings demonstrate that decalcified freeze-dried bone allograft enhances bone healing in jaw defects after cyst removal.
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Affiliation(s)
- L Bodner
- Department of Oral and Maxillofacial Surgery, Soroka Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Kawai T, Murakami S, Hiranuma H, Sakuda M. Healing after removal of benign cysts and tumors of the jaws. A radiologic appraisal. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1995; 79:517-25. [PMID: 7614216 DOI: 10.1016/s1079-2104(05)80139-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
A retrospective review of the radiographic findings after removal of benign jaw cysts (n = 31) and ameloblastomas (n = 24) was carried out. The radiographic features of the site margins and interior contents were classified into four categories. In most patients radiographic changes were detected between 1 and 4 months after removal of the lesion, and complete bone healing was found 4 months or more after surgery. Radiographic changes included "spiculed" or "trabecular" contents within the interior of the surgical site. The fourth month was found to be the optimum time for follow-up radiographic examination for the early detection of residual lesions. In nine (53%) of the patients who had ameloblastoma, recurrent lesions were noted within or at the periphery of the original surgical sites 6 to 10 years after the initial tumor removal.
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Affiliation(s)
- T Kawai
- Department of Oral and Maxillofacial Radiology, Osaka University, Faculty of Dentistry, Japan
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Kawai T, Murakami S, Hiranuma H. Radiologic appraisal of healing after iliac crest bone grafts. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1994; 77:678-83. [PMID: 8065738 DOI: 10.1016/0030-4220(94)90334-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Radiographic changes were observed in 45 patients who had undergone iliac bone grafting with either metal or wire fixation after resection of the mandible. Changes were generally not observed during the first month after surgery. Bony resorption was seen during the second or third month. Osteogenesis commenced at any stage, but was usually radiographically evident by 3 to 6 months. Union was not radiographically evident in most cases until more than 6 months had elapsed after surgery. For follow up, plain film radiographs 4 to 6 months after surgery are recommended in patients who receive bone grafts.
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Affiliation(s)
- T Kawai
- Department of Oral and Maxillofacial Radiology, Osaka University, Japan
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Bodner L, Kaffe I, Cohen Z, Dayan D. Long-term effect of desalivation on extraction wound healing: a densitometric study in rats. Dentomaxillofac Radiol 1993; 22:195-8. [PMID: 8181646 DOI: 10.1259/dmfr.22.4.8181646] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
The study evaluates radiographically the long-term changes that occur during the healing of tooth sockets in a desalivated rat model. Experimental rats underwent sialadenectomy of the submandibular and sublingual glands and ligation of the parotid ducts. Mandibular left first molars were extracted and the rats killed at 0, 14, 21, 28, 45 and 60 days post-extraction. The mandibles were removed, cleaned of soft tissue, placed on a size 2 dental X-ray film and exposed together with an aluminium stepwedge 0.5-3.0 mm. Socket density was measured using a digital densitometer and related to the equivalent density of aluminium. The density of the image of the apical area of the socket was similar in control and desalivated groups (P > 0.05) throughout the study. However, the density of the image of the crestal area of the socket was lower (P < 0.01-0.001) between days 21 and 60 in desalivated rats. This suggests that desalivation causes a long-term delay in socket healing.
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Affiliation(s)
- L Bodner
- Department of Oral and Maxillofacial Surgery, Tel Aviv University, Israel
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