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Nakashima F, Matsuda S, Ninomiya Y, Ueda T, Yasuda K, Hatano S, Shimada S, Furutama D, Memida T, Kajiya M, Shukunami C, Ouhara K, Mizuno N. Role of sclerostin deletion in bisphosphonate-induced osteonecrosis of the jaw. Bone 2024; 187:117200. [PMID: 39019131 DOI: 10.1016/j.bone.2024.117200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 07/04/2024] [Accepted: 07/09/2024] [Indexed: 07/19/2024]
Abstract
PURPOSE Bone resorption inhibitors, such as bisphosphonates (BP) and denosumab, are frequently used for the management of osteoporosis. Although both drugs reduce the risk of osteoporotic fractures, they are associated with a serious side effect known as medication-related osteonecrosis of the jaw (MRONJ). Sclerostin antibodies (romosozumab) increase bone formation and decrease the risk of osteoporotic fractures: however, their anti-resorptive effect increases ONJ. Thus, this study aimed to elucidate the role of sclerostin deletion in the development of MRONJ. METHODS Sclerostin knockout (SostΔ26/Δ26) mice were used to confirm the development of ONJ by performing tooth extractions. To confirm the role of sclerostin deficiency in a more ONJ-prone situation, we used the BP-induced ONJ model in combination with severe periodontitis to evaluate the development of ONJ and bone formation in wild-type (WT) and SostΔ26/Δ26 mice. Wound healing assay using gingival fibroblasts with or without sclerostin stimulation and tooth extraction socket healing were evaluated in the WT and SostΔ26/Δ26 mice. RESULTS ONJ was not detected in the extraction socket of SostΔ26/Δ26 mice. Moreover, the incidence of ONJ was significantly lower in the SostΔ26/Δ26 mice treated with BP compared to that of the WT mice. Osteogenic proteins, osteocalcin, and runt-related transcription factor 2, were expressed in the bone surface in SostΔ26/Δ26 mice. Recombinant sclerostin inhibited gingival fibroblast migration. The wound healing rate of the extraction socket was faster in SostΔ26/Δ26 mice than in WT mice. CONCLUSION Sclerostin deficiency did not cause ONJ and reduced the risk of developing BP-induced ONJ. Enhanced bone formation and wound healing were observed in the tooth extraction socket. The use of romosozumab (anti-sclerostin antibody) has proven to be safe for surgical procedures of the jaw.
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Affiliation(s)
- Fuminori Nakashima
- Department of Periodontal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
| | - Shinji Matsuda
- Department of Periodontal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan.
| | - Yurika Ninomiya
- Department of Periodontal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
| | - Tomoya Ueda
- Department of Periodontal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
| | - Keisuke Yasuda
- Department of Periodontal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
| | - Saki Hatano
- Department of Periodontal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
| | - Shogo Shimada
- Department of Periodontal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
| | - Daisuke Furutama
- Department of Biological Endodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
| | - Takumi Memida
- Department of Oral Science and Translation Research, College of Dental Medicine, Nova Southeastern University, United States of America
| | - Mikihito Kajiya
- Center of Oral Clinical Examination, Hiroshima University Hospital, Japan
| | - Chisa Shukunami
- Department of Molecular Biology and Biochemistry, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kazuhisa Ouhara
- Department of Periodontal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
| | - Noriyoshi Mizuno
- Department of Periodontal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan
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Pereira-Silva M, Hadad H, de Jesus LK, de Freitas Santana Oliveira ME, de Almeida JM, Nímia HH, Magro Filho O, Okamoto R, Macedo SB, Palmieri Junior CF, Souza FÁ. Ozone therapy effect in medication-related osteonecrosis of the jaw as prevention or treatment: microtomographic, confocal laser microscopy and histomorphometric analysis. Clin Oral Investig 2024; 28:151. [PMID: 38360985 DOI: 10.1007/s00784-024-05547-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 02/07/2024] [Indexed: 02/17/2024]
Abstract
OBJECTIVE This study aimed to evaluate the efficacy of ozone therapy in the preoperative (prevention) and/or postoperative (treatment) of MRONJ. MATERIAL AND METHODS Forty male Wistar rats were caudally treated with zoledronic acid (ZOL) and to ozone therapy before extraction (prevention, POG), after extraction (treatment, TOG), or both (prevention and treatment, TPOG), and treated with saline (SAL). The animals received intramuscular fluorochrome (calcein and alizarin), and 28 days postoperatively, they were euthanized, and the tissues were subjected to microtomographic computed tomography (microCT), LASER confocal, and histomorphometric analyses. RESULTS Micro-CT showed a higher bone volume fraction average in all groups than that in the ZOL group (P < 0.001), the ZOL group showed high porosity (P = 0.03), and trabecular separation was greater in the TOG group than in the POG group (P < 0.05). The mineral apposition rate of the POG group was high (20.46 ± 6.31) (P < 0.001), followed by the TOG group (20.32 ± 7.4). The TOG group presented the highest mean newly formed bone area (68.322 ± 25.296) compared with the ZOL group (P < 0.05), followed by the SAL group (66.039 ± 28.379) and ZOL groups (60.856 ± 28.425). CONCLUSIONS Ozone therapy modulated alveolar bone repair in animals treated with ZOL, mainly after surgery trauma, leading to bone formation as healing tissue. CLINICAL RELEVANCE Osteonecrosis has been a challenge in dentistry, and owing to the lack of a consensus regarding therapy, studies presenting new therapies are important, and ozone has been one of the therapies explored empirically.
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Affiliation(s)
- Maísa Pereira-Silva
- Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University (UNESP), José Bonifácio Street, 1193, Vila Mendonça, Araçatuba, São Paulo, 16015050, Brazil.
| | - Henrique Hadad
- Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University (UNESP), José Bonifácio Street, 1193, Vila Mendonça, Araçatuba, São Paulo, 16015050, Brazil
| | - Laís Kawamata de Jesus
- Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University (UNESP), José Bonifácio Street, 1193, Vila Mendonça, Araçatuba, São Paulo, 16015050, Brazil
| | - Maria Eduarda de Freitas Santana Oliveira
- Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University (UNESP), José Bonifácio Street, 1193, Vila Mendonça, Araçatuba, São Paulo, 16015050, Brazil
| | - Juliano Milanezi de Almeida
- Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University (UNESP), José Bonifácio Street, 1193, Vila Mendonça, Araçatuba, São Paulo, 16015050, Brazil
| | - Heloisa Helena Nímia
- Department of Dental Materials and Prothesis, Araçatuba Dental School, São Paulo State University (UNESP), José Bonifácio Street, Araçatuba, São Paulo, 16015050, Brazil
| | - Osvaldo Magro Filho
- Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University (UNESP), José Bonifácio Street, 1193, Vila Mendonça, Araçatuba, São Paulo, 16015050, Brazil
| | - Roberta Okamoto
- Department of Basic Sciences, Araçatuba Dental School, São Paulo State University (UNESP), Marechal Rondon Highway, Araçatuba, São Paulo, 16066840, Brazil
| | - Sérgio Bruzadelli Macedo
- Department of Dentistry, University of Brasília (UnB), Asa Norte, Brasília, Distrito Federal, 70297-400, Brazil
| | - Celso Fernando Palmieri Junior
- Department of Oral & Maxillofacial Surgery, Louisiana State University Health Sciences Center (LSU), Kings Highway, Shreveport, LA, 71103, USA
| | - Francisley Ávila Souza
- Department of Diagnosis and Surgery, Araçatuba Dental School, São Paulo State University (UNESP), José Bonifácio Street, 1193, Vila Mendonça, Araçatuba, São Paulo, 16015050, Brazil.
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