Medication-related osteonecrosis of the jaw using periodontitis-induced rat before tooth extraction

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Authors: Kyeong-Mee Park ; Jieun Cheong ; Nan-Sim Pang ; Kee-Deog Kim ; Jung-Seok Lee ; Wonse Park

MeSH: Animals ; Bisphosphonate-Associated Osteonecrosis of the Jaw* / diagnostic imaging ; Bone Density Conservation Agents* / adverse effects ; Diphosphonates / adverse effects ; Periodontitis* / diagnostic imaging ; Rats ; Tooth Extraction / adverse effects ; X-Ray Microtomography ; Zoledronic Acid / adverse effects

Keywords: Bisphosphonate ; MRONJ ; Ovariectomy ; Periodontitis ; Rat ; Tooth extraction ; Zoledronic acid

Abstract: Objective: This study aimed to investigate the occurrence of medication-related osteonecrosis of the jaw (MRONJ) after tooth extraction due to periodontitis in ovariectomized rats.

Methods: Twenty-four osteoporosis-induced rats were administered with zoledronic acid (ZA; ZA group) or saline (CONT group). In both groups, tooth extraction was performed after inducing periodontitis, and all animals were sacrificed 10-week after tooth extraction.

Results: Micro-CT of the tibia showed that the bone volume fraction, bone surface density, trabecular number, and bone mineral density were significantly higher in the ZA group than in the CONT group. Histologically, the proliferative zone on the growth plate was thicker in the ZA group than in the CONT group. Micro-CT of the extraction sites revealed that the bone volume fraction was significantly higher in the ZA group than in the CONT group. Radiologically, the ZA group showed partial healing and delayed healing. Histological analysis revealed normal bone healing status with completely healed epithelium in the extraction sites of the CONT group, whereas abnormal empty osteocytes in the necrotic bone and inflammatory infiltration were observed in the ZA group.

Conclusion: The incidence of MRONJ increased in the rats administered with ZA.