Abstract
The present study aimed to investigate the use of platelet-rich plasma (PRP) on tooth extraction sites in rats treated with bisphosphonates. Thirty Albinus Wistar male rats were administered 0.035 mg/kg zoledronic acid intravenously for 8 weeks, divided into four administrations with a 2-week interval between each application, after which their upper right central incisors were extracted to induce the development of bisphosphonate-related osteonecrosis of the jaw (BRONJ). The samples were divided into the following two groups: Group 1 (G1) underwent marginal resection of BRONJ followed by the use of PRP, while Group 2 (G2) underwent resection of BRONJ but without the use of PRP. The treatment groups were evaluated after 14, 28, and 42 days. Clinical, microtomographic, microscopic, and immunohistochemical (IHC) evaluations were performed. Microtomography results revealed no significant difference between the groups (p <0.05) in any time period. Histomorphometric analysis showed increased bone formation over time for both groups (p < 0.001). G1 demonstrated a greater amount of new bone formation than G2 at 28 and 42 days (p < 0.001), with G1 presenting greater vascularization and a slightly higher VEGF expression. For both groups, RANKL/OPG expression levels were sufficient as a parameter for indicating the rate of bone remodeling in a previously treated area of osteonecrosis groups. Taken together, our findings indicated that the use of PRP improves the resolution process of BRONJ.
Highlights
In the literature, strategies on how to manage the treatment of bisphosphonate-related osteonecrosis of the jaw (BRONJ) are still widely debated, and an established protocol with predictable results remains to be established
Platelet-rich plasma (PRP) is an autologous source of growth factors that is obtained via centrifugation to yield very high concentrations of human platelets containing various growth factors, which promote the rapid healing of wounds.[5]
When the new bone formation within the socket is considered, qualitative analysis revealed an increase in new bone formation over time which is expected in the process of alveolar repair of a healthy socket
Summary
Strategies on how to manage the treatment of bisphosphonate-related osteonecrosis of the jaw (BRONJ) are still widely debated, and an established protocol with predictable results remains to be established. Treatment of bisphosphonate-related osteonecrosis using platelet-rich plasma: microtomographic, microscopic, and immunohistochemical analyses and 3) caused by the risk of bacteremia and sepsis in immunocompromised patients, as well as the reduced quality of life.[1,2] Given this scenario, a variety of surgical treatment options have been used to improve resolution rates of BRONJ cases. A variety of surgical treatment options have been used to improve resolution rates of BRONJ cases Of these therapies, treatment via bone resection combined with the use of growth factors has yielded promising results in the search for a satisfactory cure for this complication.[3,4] Platelet-rich plasma (PRP) is an autologous source of growth factors that is obtained via centrifugation to yield very high concentrations of human platelets containing various growth factors (derived growth factor, transforming growth factor β, epidermal growth factor, and vascular endothelial growth factor), which promote the rapid healing of wounds.[5]. Given the absence of well-defined protocols for BRONJ treatment and the scarcity of detailed experimental studies using surgical therapy in combination with PRP, the present study aimed to analyze the surgical therapeutic method proposed by using imaging, microscopic, and immunohistochemical analyses
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