The Effect of Systemically Administered Bisphosphonates on Bony Healing After Tooth Extraction and Osseointegration of Dental Implants in the Rabbit Maxilla

Abstract

To evaluate the effects of bisphosphonates on bone healing after tooth extraction and osseointegration of dental implants in a rabbit model. Twenty-four rabbits were divided into four groups; one control and three experimental. The experimental were treated with intravenous zoledronic acid (ZA, 0.1 mg/kg) twice per week starting 4 (Z4 group) and 8 (Z8 group) weeks before surgery until the end of the experiments. The experimental ZD4 group was treated with intravenous ZA (0.01 mg/kg) and intramuscular dexamethasone (1 mg/kg) twice per week starting 4 weeks before surgery until the end of the experiments. The maxillary first premolar was extracted, and an implant with a diameter of 1.5 mm was placed between the incisor and the premolar of each maxilla. Healing of the extraction socket was evaluated and histomorphometric analysis around the implant was performed, using the bone-to-implant contact ratio (BIC) and bone area ratio (BA) 4 and 8 weeks after the surgery. The control group underwent a normal healing process, but all experimental groups showed necrotic bone with hollow lacunae. BIC and BA in the control group increased from the 4- to 8-week evaluations, but decreased in the experimental groups from 4 to 8 weeks. BIC and BA of the Z8 and ZD4 groups were higher than those of the control group at the 4-week evaluation, but were lower than the control at the the 8-week evaluation. This study showed that administration of bisphosphonates interferes with normal bone remodeling after tooth extraction. The experimental groups showed good initial stability, but long-term healing around the implants was impaired. Within the limits of this study, it may be suggested that patients taking bisphosphonates should be treated with caution when performing tooth extraction or placing dental implants.