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Oliveira FLP, Matheus HR, Ervolino E, Novaes VCN, Piovezan BR, Furquim EMDA, Fiorin LG, de Almeida JM. Sodium alendronate is an effective adjunctive therapy for treating periodontitis in male rats treated with anticancer chemotherapy. Arch Oral Biol 2023; 155:105794. [PMID: 37633028 DOI: 10.1016/j.archoralbio.2023.105794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 08/03/2023] [Accepted: 08/17/2023] [Indexed: 08/28/2023]
Abstract
OBJECTIVES To assess sodium alendronate as a local adjunctive therapy for treating experimental periodontitis in male rats treated with chemotherapy. DESIGN One-hundred-eighty male rats were randomly divided into two groups (n = 90) based on the systemic treatments: PSS, physiological saline solution; and 5-Fluorouracil, and then, subdivided into three subgroups (n = 30): NT, no treatment; scaling and root planing; and sodium alendronate. Treatments were performed 7 days after induction of experimental periodontitis. Specimens were collected at 14, 22, and 37 days after induction. Alveolar bone level, percentage of bone in the furcation, percentage of non-vital bone in the furcation, histopathologic features, and immunolabeling pattern for tartrate-resistant acid phosphatase (TRAP) and osteocalcin (OCN) were evaluated. RESULTS The lowest amount of alveolar bone and highest amount of non-vital bone was found in group 5-Fluorouracil when no treatment was performed. In animals receiving 5-Flurouracil and subjected to periodontal treatment, adjunctive sodium alendronate resulted in higher percentage of bone in the furcation and higher alveolar bone loss, when compared with scaling and root planing alone. Better structural and cellularity patterns were found in the periodontal tissues when sodium alendronate was used, regardless of systemic treatment. Higher TRAP-expression was found when no treatment was performed. Sodium alendronate didn't affect the immunolabeling pattern of osteocalcin in the presence of 5-Fluorouracil. CONCLUSION Adjunctive therapy with local sodium alendronate prevented alveolar bone loss and improved the histopathological features of the periodontal tissues following scaling and root planing in male rats with experimental periodontitis receiving anticancer chemotherapy with 5-Fluorouracil.
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Affiliation(s)
- Fred Lucas Pinto Oliveira
- Department of Diagnosis and Surgery, Division of Periodontics, São Paulo State University "Júlio de Mesquita Filho", UNESP, Araçatuba, Brazil; Nucleus of Study and Research in Periodontics and Implantology (NEPPI), School of Dentistry, Sao Paulo, State University (Unesp), Aracatuba, SP, Brazil
| | - Henrique Rinaldi Matheus
- Department of Diagnosis and Surgery, Division of Periodontics, São Paulo State University "Júlio de Mesquita Filho", UNESP, Araçatuba, Brazil; Nucleus of Study and Research in Periodontics and Implantology (NEPPI), School of Dentistry, Sao Paulo, State University (Unesp), Aracatuba, SP, Brazil
| | - Edilson Ervolino
- Nucleus of Study and Research in Periodontics and Implantology (NEPPI), School of Dentistry, Sao Paulo, State University (Unesp), Aracatuba, SP, Brazil; Department of Basics Sciences, Sao Paulo State University-Unesp Araçatuba School of Dentistry Sao Paulo, UNESP, Araçatuba, Brazil
| | - Vivian Cristina Noronha Novaes
- Nucleus of Study and Research in Periodontics and Implantology (NEPPI), School of Dentistry, Sao Paulo, State University (Unesp), Aracatuba, SP, Brazil
| | - Bianca Rafaeli Piovezan
- Department of Diagnosis and Surgery, Division of Periodontics, São Paulo State University "Júlio de Mesquita Filho", UNESP, Araçatuba, Brazil; Nucleus of Study and Research in Periodontics and Implantology (NEPPI), School of Dentistry, Sao Paulo, State University (Unesp), Aracatuba, SP, Brazil
| | - Elisa Mara de Abreu Furquim
- Department of Diagnosis and Surgery, Division of Periodontics, São Paulo State University "Júlio de Mesquita Filho", UNESP, Araçatuba, Brazil; Nucleus of Study and Research in Periodontics and Implantology (NEPPI), School of Dentistry, Sao Paulo, State University (Unesp), Aracatuba, SP, Brazil
| | - Luiz Guilherme Fiorin
- Department of Diagnosis and Surgery, Division of Periodontics, São Paulo State University "Júlio de Mesquita Filho", UNESP, Araçatuba, Brazil; Nucleus of Study and Research in Periodontics and Implantology (NEPPI), School of Dentistry, Sao Paulo, State University (Unesp), Aracatuba, SP, Brazil
| | - Juliano Milanezi de Almeida
- Department of Diagnosis and Surgery, Division of Periodontics, São Paulo State University "Júlio de Mesquita Filho", UNESP, Araçatuba, Brazil; Nucleus of Study and Research in Periodontics and Implantology (NEPPI), School of Dentistry, Sao Paulo, State University (Unesp), Aracatuba, SP, Brazil.
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Pharmacological Therapies for the Management of Inflammatory Bone Resorption in Periodontal Disease: A Review of Preclinical Studies. BIOMED RESEARCH INTERNATIONAL 2022; 2022:5832009. [PMID: 35547360 PMCID: PMC9085331 DOI: 10.1155/2022/5832009] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/28/2022] [Accepted: 04/13/2022] [Indexed: 02/06/2023]
Abstract
Periodontitis, a highly prevalent multicausal chronic inflammatory and destructive disease, develops as a result of complex host-parasite interactions. Dysbiotic bacterial biofilm in contact with the gingival tissues initiates a cascade of inflammatory events, mediated and modulated by the host's immune response, which is characterized by increased expression of several inflammatory mediators such as cytokines and chemokines in the connective tissue. If periodontal disease (PD) is left untreated, it results in the destruction of the supporting tissues around the teeth, including periodontal ligament, cementum, and alveolar bone, which lead to a wide range of disabilities and poor quality of life, thus imposing significant burdens. This process depends on the differentiation and activity of osteoclasts, the cells responsible for reabsorbing the bone tissue. Therefore, the inhibition of differentiation or activity of these cells is a promising strategy for controlling bone resorption. Several pharmacological drugs that target osteoclasts and inflammatory cells with immunomodulatory and anti-inflammatory effects, such as bisphosphonates, anti-RANK-L antibody, strontium ranelate, cathepsin inhibitors, curcumin, flavonoids, specialized proresolving mediators, and probiotics, were already described to manage inflammatory bone resorption during experimental PD progression in preclinical studies. Meantime, a growing number of studies have described the beneficial effects of herbal products in inhibiting bone resorption in experimental PD. Therefore, this review summarizes the role of several pharmacological drugs used for PD prevention and treatment and highlights the targeted action of all those drugs with antiresorptive properties. In addition, our review provides a timely and critical appraisal for the scientific rationale use of the antiresorptive and immunomodulatory medications in preclinical studies, which will help to understand the basis for its clinical application.
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Aguirre JI, Castillo EJ, Kimmel DB. Preclinical models of medication-related osteonecrosis of the jaw (MRONJ). Bone 2021; 153:116184. [PMID: 34520898 PMCID: PMC8743993 DOI: 10.1016/j.bone.2021.116184] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/15/2021] [Accepted: 09/07/2021] [Indexed: 01/20/2023]
Abstract
Medication-related osteonecrosis of the jaw (MRONJ) is a potentially severe adverse event affecting patients with cancer and patients with osteoporosis who have been treated with powerful antiresorptives (pARs) or angiogenesis inhibitors (AgIs). pARs, including nitrogen-containing bisphosphonates (N-BPs; e.g., zoledronic acid, alendronate) and anti-RANKL antibodies (e.g., denosumab), are used to manage bone metastases in patients with cancer or to prevent fragility fractures in patients with osteoporosis. Though significant advances have been made in understanding MRONJ, its pathophysiology is still not fully elucidated. Multiple species have been used in preclinical MRONJ research, including the rat, mouse, rice rat, rabbit, dog, sheep, and pig. Animal research has contributed immensely to advancing the MRONJ field, particularly, but not limited to, in developing models and investigating risk factors that were first observed in humans. MRONJ models have been developed using clinically relevant doses of systemic risk factors, like N-BPs, anti-RANKL antibodies, or AgIs. Specific local oral risk factors first noted in humans, including tooth extraction and inflammatory dental disease (e.g., periodontitis, periapical infection, etc.), were then added. Research in rodents, particularly the rat, and, to some extent, the mouse, across multiple laboratories, has contributed to establishing multiple relevant and complementary preclinical models. Models in larger species produced accurate clinical and histopathologic outcomes suggesting a potential role for confirming specific crucial findings from rodent research. We view the current state of animal models for MRONJ as good. The rodent models are now reliable enough to produce large numbers of MRONJ cases that could be applied in experiments testing treatment modalities. The course of MRONJ, including stage 0 MRONJ, is characterized well enough that basic studies of the molecular or enzyme-level findings in different MRONJ stages are possible. This review provides a current overview of the existing models of MRONJ, their more significant features and findings, and important instances of their application in preclinical research.
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Affiliation(s)
- J I Aguirre
- Department of Physiological Sciences, University of Florida (UF), Gainesville, FL, United States of America.
| | - E J Castillo
- Department of Physiological Sciences, University of Florida (UF), Gainesville, FL, United States of America.
| | - D B Kimmel
- Department of Physiological Sciences, University of Florida (UF), Gainesville, FL, United States of America
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Leite de Marcelos PGC, Perez DEDCP, Soares DM, de Araújo SS, Evêncio LB, Pontual MLDA, Ramos-Perez FMDM. The effects of zoledronic acid on the progression of experimental periodontitis in rats: histological and microtomographic analyses. J Periodontal Implant Sci 2021; 51:264-275. [PMID: 34387046 PMCID: PMC8367644 DOI: 10.5051/jpis.2001100055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 04/02/2021] [Accepted: 04/12/2021] [Indexed: 01/06/2023] Open
Abstract
Purpose Periodontitis is considered a local risk factor for medication-related osteonecrosis of the jaws (MRONJ). However, little is known about the progression of periodontitis in the presence of zoledronic acid (ZOL). The aim of this study was to evaluate the effects of the systemic use of ZOL on the progression of experimental periodontitis (EP) in rats, as ZOL could modulate the progression of periodontitis and concomitantly cause MRONJ in individuals with periodontitis. Methods Forty-eight male Wistar rats were randomly distributed in 6 groups (n=8 each). To induce EP, ligatures were placed around the right first mandibular molars. Three groups were treated with ZOL (0.15 mg/kg/week, intraperitoneal), and 3 with 0.9% saline solution (controls). In the ZOL/Lig30 and ZOL/Lig 15 groups, after 4 weeks of treatment with ZOL, EP was induced and euthanasia was performed after 30 and 15 days of EP induction, respectively. In both groups, the animals continued to receive ZOL after EP until the end of the experiment. In the Lig/ZOL group, EP was induced first, and 15 days later, ZOL was administered for 8 weeks, with euthanasia 1 week after the last dose. After euthanasia, the mandibles were evaluated using micro-computed microtomography (micro-CT) and histomorphometry. Bone loss was measured, and the presence of osteonecrosis was evaluated histologically. The data were evaluated using the Student t-test and the Mann-Whitney test, with a significance level of 5%. Results In the Lig/ZOL group, micro-CT revealed less alveolar bone resorption in the distal root (P<0.01) than in the control group (Lig/Con). Histomorphometric analysis confirmed less alveolar bone resorption in the Lig/ZOL group (P=0.001). Histologically, osteonecrosis was more common in the ZOL groups. Conclusion ZOL decreased alveolar bone resorption in rats with EP. However, it presented a higher risk for MRONJ.
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Affiliation(s)
| | - Danyel Elias Da Cruz Perez Perez
- Department of Clinical and Preventive Dentistry, Oral Pathology and Oral Radiology Sections, Universidade Federal de Pernambuco School of Dentistry, Recife, PE, Brazil.
| | - Diego Moura Soares
- Department of Clinical and Preventive Dentistry, Oral Pathology and Oral Radiology Sections, Universidade Federal de Pernambuco School of Dentistry, Recife, PE, Brazil
| | - Samuel Silva de Araújo
- Department of Clinical and Preventive Dentistry, Oral Pathology and Oral Radiology Sections, Universidade Federal de Pernambuco School of Dentistry, Recife, PE, Brazil
| | | | - Maria Luiza Dos Anjos Pontual
- Department of Clinical and Preventive Dentistry, Oral Pathology and Oral Radiology Sections, Universidade Federal de Pernambuco School of Dentistry, Recife, PE, Brazil
| | - Flávia Maria De Moraes Ramos-Perez
- Department of Clinical and Preventive Dentistry, Oral Pathology and Oral Radiology Sections, Universidade Federal de Pernambuco School of Dentistry, Recife, PE, Brazil
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Storrer CLM, Deliberador TM, Giovanini AF, Crivellaro V, Zielak JC, Romito GA. Effect of alendronate on the progression of periodontitis induced by Porphyromonas gingivalis and Fusobacterium nucleatum: a study in rats. Clin Oral Investig 2016; 20:2565-2573. [DOI: 10.1007/s00784-016-1769-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 02/29/2016] [Indexed: 01/03/2023]
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