Evaluation of the effect of teriparatide therapy on mandibular fracture healing in rats with medication-related osteonecrosis of the jaw.

Abstract

OBJECTIVE:

The aim of this study was to evaluate the effect of teriparatide therapy on mandibular fracture healing in rats with medication-related osteonecrosis of the jaw (MRONJ).

MATERIALS AND METHODS:

To induce MRONJ, a total of 120 rats received intravenous zoledronate 0.06 mg/kg once a week for 6 weeks and their right mandibular first molar was extracted. Eighty of 94 rats with MRONJ were randomly selected and underwent unilateral mandibular osteotomy to replicate a fracture. After surgery, the rats were randomly assigned to T (teriparatide-treated) and C (control) groups. Group T (n = 40) received subcutaneous injection of 2 μg/kg/day teriparatide and group C (n = 40) received the same volume of normal saline until sacrifice. Four and 8 weeks after surgery, 20 rats in each group were sacrificed. Fracture healing was scored using a histological grading system (1 to 10).

RESULTS:

In group C, at 4 weeks and 8 weeks post-fracture, fibrous and cartilaginous tissues and scant bone formation at the fracture site and lacunae without osteocyte in adjacent mandibular bone were seen. In group T, substantial amounts of new trabecular bone rimmed by osteoblasts and some areas of remodeled mature bone were seen. After 8 weeks, extensive replacement of trabecular bone with mature bone occurred. Except between C4 and C8 groups, the healing score was significantly different between all subgroups.

CONCLUSION:

Teriparatide therapy successfully improved mandibular fracture healing in rats with MRONJ. However, this study was limited by the use of an animal model whose anatomy, physiology, and drug metabolism might be different from humans.

CLINICAL RELEVANCE:

The present study showed that teriparatide therapy may be used adjunctive to surgery in the treatment of mandibular fractures in MRONJ patients.

• Authors: Mohammad Zandi, Arash Dehghan, Payam Amini, Shideh Doulati, Leila Rezaeian
• Journal: Clinical oral investigations (Clin Oral Investig) Vol. 23 Issue 11 Pg. 3987-3993 (Nov 2019) ISSN: 1436-3771 [Electronic] Germany
• PMID: 30715621 (Publication Type: Journal Article)

Chemical References

• Bone Density Conservation Agents
• Teriparatide

Topics

• Animals
• Bisphosphonate-Associated Osteonecrosis of the Jaw (complications)
• Bone Density Conservation Agents (therapeutic use)
• Fracture Healing (drug effects)
• Mandibular Fractures (drug therapy)
• Rats
• Teriparatide (therapeutic use)