Abstract
Objectives The study investigated the effect of soft tissue closure after tooth extraction on the prevention of medication-related osteonecrosis of the jaw in a rabbit model. Materials and Methods Twenty female New Zealand white rabbits were randomly assigned into the experimental group administrated with zoledronic acid (ZA) and control groups treated with saline. Bilateral lower premolar extraction was performed 4 weeks after ZA/saline administration. Immediately after extraction, the wound on the right mandible was closed by suture while the other side was left open. Animals were sacrificed 4 weeks and 8 weeks after tooth extraction. Fluorochrome labeling solutions were injected subcutaneously to evaluate the bone growth rates. The mandibles were harvested and subjected for microcomputed tomography, confocal microscope, and histomorphological examinations. Results All extraction sites healed well without any signs of infection. Trabecular thickness (Tb.Th) was significantly higher in the ZA-treated group than in the control group at both week 4 and week 8, while no significant difference was detected in the rest of the assessed parameters. The bone growth rate in mandibles showed gradual reduction in the ZA-treated group. Histological analysis showed that at week 8, the animals in the ZA-treated group had significantly higher incidence of osteonecrosis than that in the control group, while no significance was revealed between the sutured and nonsutured side. Conclusions ZA treatment significantly reduces bone growth rates but does not reveal a significant effect on bone mineral density and bone microarchitecture. Soft tissue closure of the extraction socket does not reduce the incidence of ONJ in the ZA-treated rabbit model.
Highlights
Bisphosphonates (BPs) are known to inhibit the activity of osteoclasts and reduce bone resorption and the subsequent bone remodeling
BPs are widely used against overactive osteoclasts in various bone diseases, such as osteoporosis, Paget’s disease, and bone metastasizing malignant tumours, including multiple myeloma, breast cancer, and prostate cancer [1,2,3]
bone mineral density (BMD), BV/TV, Tb.Th, and Tb.N in the zoledronic acid (ZA)-treated group were higher, and Tb.Sp was lower than the control group at both week 4 and week 8 (Figure 4)
Summary
Bisphosphonates (BPs) are known to inhibit the activity of osteoclasts and reduce bone resorption and the subsequent bone remodeling. BPs are widely used against overactive osteoclasts in various bone diseases, such as osteoporosis, Paget’s disease, and bone metastasizing malignant tumours, including multiple myeloma, breast cancer, and prostate cancer [1,2,3]. One of the many explanations for this site-specific feature of MRONJ is that the oral microbes may cause inflammation or infection under the specific condition of oral wound [14,15,16]. How these oral microbes affect bone healing and whether an open oral wound puts
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