Biological Effect of Single or Combined Pharmacological Therapy Using Alendronate and Simvastatin on Implant Osseointegration: An In Vivo Study in Healthy and Osteoporotic Rat Models

Amani M Basudan,Jeroen J.J.P Van Den Beucken,Hamdan S Alghamdi,John A Jansen,Marwa Y Shaheen,Abdurahman A Niazy

doi:10.3390/app10124298

Amani M Basudan, Jeroen J.J.P Van Den Beucken + Show 4 more

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https://doi.org/10.3390/app10124298

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Abstract

To evaluate peri-implant bone formation following single or combined systemic administration of alendronate and simvastatin in healthy and osteoporotic rats, eighty female Wistar rats were ovariectomized (n = 40) or sham-operated (n = 40). At six weeks, implants were placed in femoral condyles. Then, ovariectomized (OVX) and sham-operated (SHAM) animals received daily subcutaneous alendronate (50 µg/kg), simvastatin (5 mg/kg), or both, for three weeks. Control animals received subcutaneous saline. Thereafter, specimens were retrieved for biomechanical testing, histological evaluation, and bone area (BA%) and bone-to-implant contact (BIC%). In healthy and osteoporotic rats, similar (p > 0.05) push-out values were observed for all groups. For BA% analysis, control rats showed similar results for OVX (9.2% ± 2.4%) and SHAM (11.1% ± 3.5%) animals. In contrast, single or combined drug therapy significantly increased BA% compared to controls in both healthy and osteoporotic conditions (p < 0.05). In osteoporotic conditions, alendronate alone showed a superior effect on BA% compared to simvastatin alone, or their combination. Systemic alendronate, simvastatin, or both showed a similar BIC% compared to controls (p > 0.05). The present study demonstrates that single or combined systemic alendronate and simvastatin increases bone formation around implants (i.e., distance osteogenesis) in healthy and osteoporotic bone conditions. However, these drugs showed no beneficial effect on direct bone-to-implant contact or implant fixation.

Highlights

Loss of teeth is regarded as a major health problem in dentistry [1,2]
40 rats were ovariectomized (OVX) to induce osteoporotic bone conditions and the remaining 40 rats were subjected to sham surgery (SHAM) to serve as controls with healthy bone conditions
The total number of implants placed and retrieved in each study group and the numbers of specimens used for push-out testing and histomorphometric analysis (BA% and bone-to-implant contact (BIC)%) are shown in

Summary

Introduction

Loss of teeth (i.e., edentulism) is regarded as a major health problem in dentistry [1,2]. Contemporary titanium implant therapy in healthy patients has resulted in significant long-term success following treatment [4]. Complications related to the healing process of titanium implants may occur in patients with systemic impaired bone metabolism and turnover, e.g., osteoporosis [5]. This is a major systemic condition affecting bone physiology and might lead to increased risk of implant failure [6,7,8]. Several approaches have been used to enhance titanium implant success in patients with impaired bone condition [9].

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