Evaluation of teriparatide effect on healing of autografted mandibular defects in rats

Medications Affecting Treatment Outcomes in Dentistry: Part 2

Today, it is common for medically complex patients who are receiving multiple medications, to seek routine and emergent dental care. It is essential for the practitioner to recognize and comprehend the impact of such medications on the patient's ability to tolerate the planned dental treatment and on dental treatment outcomes. An active appraisal of current literature is essential to stay abreast of emerging findings and understand their treatment implications. This article outlines the process of such active critical appraisal, illustrating key paradigms of the models that describe the impact of medications on treatment outcomes.

Teriparatide: an innovative and promising strategy for protecting the blood-spinal cord barrier following spinal cord injury

The blood-spinal cord barrier (BSCB) is disrupted within minutes of spinal cord injury, leading to increased permeability and secondary spinal cord injury, resulting in more severe neurological damage. The preservation of blood-spinal cord barrier following spinal cord injury plays a crucial role in determining the prognosis. Teriparatide, widely used in clinical treatment for osteoporosis and promoting fracture healing, has been found in our previous study to have the effect of inhibiting the expression of MMP9 and alleviating blood-brain barrier disruption after ischemic stroke, thereby improving neurological damage symptoms. However, there are limited research on whether it has the potential to improve the prognosis of spinal cord injury. This article summarizes the main pathological mechanisms of blood-spinal cord barrier disruption after spinal cord injury and its relationship with Teriparatide, and explores the therapeutic potential of Teriparatide in improving the prognosis of spinal cord injury by reducing blood-spinal cord barrier disruption.

Use of Plant Extracts in Polymeric Scaffolds in the Regeneration of Mandibular Injuries

Severe loss of bone mass may require grafting, and, among the alternatives available, there are natural biomaterials that can act as scaffolds for the cell growth necessary for tissue regeneration. Collagen and elastin polymers are a good alternative due to their biomimetic properties of bone tissue, and their characteristics can be improved with the addition of polysaccharides such as chitosan and bioactive compounds such as jatoba resin and pomegranate extract due to their antigenic actions. The aim of this experimental protocol was to evaluate bone neoformation in experimentally made defects in the mandible of rats using polymeric scaffolds with plant extracts added. Thirty rats were divided into group 1, with a mandibular defect filled with a clot from the lesion and no graft implant (G1-C, n = 10); group 2, filled with collagen/chitosan/jatoba resin scaffolds (G2-CCJ, n = 10); and group 3, with collagen/nanohydroxyapatite/elastin/pomegranate extract scaffolds (G3-CHER, n = 10). Six weeks after surgery, the animals were euthanized and samples from the surgical areas were submitted to macroscopic, radiological, histological, and morphometric analysis of the mandibular lesion repair process. The results showed no inflammatory infiltrates in the surgical area, indicating good acceptance of the scaffolds in the microenvironment of the host area. In the control group (G1), there was a predominance of reactive connective tissue, while in the grafted groups (G2 and G3), there was bone formation from the margins of the lesion, but it was still insufficient for total bone repair of the defect within the experimental period standardized in this study. The histomorphometric analysis showed that the mean percentage of bone volume formed in the surgical area of groups G1, G2, and G3 was 17.17 ± 2.68, 27.45 ± 1.65, and 34.07 ± 0.64 (mean ± standard deviation), respectively. It can be concluded that these scaffolds with plant extracts added can be a viable alternative for bone repair, as they are easily manipulated, have a low production cost, and stimulate the formation of new bone by osteoconduction.

Parathyroid Hormone 1 Receptor Signaling in Dental Mesenchymal Stem Cells: Basic and Clinical Implications

Parathyroid hormone (PTH) and parathyroid hormone-related protein (PTHrP) are two peptides that regulate mineral ion homeostasis, skeletal development, and bone turnover by activating parathyroid hormone 1 receptor (PTH1R). PTH1R signaling is of profound clinical interest for its potential to stimulate bone formation and regeneration. Recent pre-clinical animal studies and clinical trials have investigated the effects of PTH and PTHrP analogs in the orofacial region. Dental mesenchymal stem cells (MSCs) are targets of PTH1R signaling and have long been known as major factors in tissue repair and regeneration. Previous studies have begun to reveal important roles for PTH1R signaling in modulating the proliferation and differentiation of MSCs in the orofacial region. A better understanding of the molecular networks and underlying mechanisms for modulating MSCs in dental diseases will pave the way for the therapeutic applications of PTH and PTHrP in the future. Here we review recent studies involving dental MSCs, focusing on relationships with PTH1R. We also summarize recent basic and clinical observations of PTH and PTHrP treatment to help understand their use in MSCs-based dental and bone regeneration.

Effects of the different administration frequencies of teriparatide (PTH [1-34]) on new bone formation of expanded midpalatal sutures in rats: A histomorphometric and micro-computed tomography analysis

OBJECTIVE

The aim of the study was to evaluate the effect of 4 μg/kg teriparatide administered at intermittent and continuous frequencies on bone formation in the expanded midpalatal suture region using histomorphometric and micro-computed tomography (micro-Ct) analysis. Settings and sample population: In this study, 24 Sprague Dawley male rats were used.

METHODS

The experimental animals were divided into 3 groups as follows: Group 1: only maxillary expansion, Group 2: maxillary expansion with continuous teriparatide administration (2 μg in the morning and 2 μg in the evening) and Group 3: maxillary expansion with intermittent teriparatide administration (daily 4 μg/kg). The expansion appliance was fixed to maxillary incisors of all animals within the 5-day expansion period, followed by a 12-day retention phase. Animals were sacrificed at the end of the retention period, and specimens were evaluated by micro-Ct and histomorphometric analysis respectively.

RESULTS

The results of the histomorphometric analysis showed that Group 3 had the highest number of osteoblasts (1042 ± 90.76) (P < .01). In addition, the results of micro-Ct analysis revealed that Group 3 had the highest bone volume/total volume (16% ± 0), bone mineral density (173.82 ± 2.6 mgHA/cm³ ) and least midpalatal suture width (0.13 ± 0.001 mm) (P < .01). Osteoblasts number and micro-Ct analysis values of Group 2 were higher than those of Group 1 but no significant differences between them (P > .01).

CONCLUSION

Intermittently administered TP (4 μg/kg once a day) was seen to enhance bone formation and mineralization. In the future, it can be used in drug studies that will increase or stimulate bone formation as well as in the midpalatal suture area.

Evaluation of single-dose applied teriparatide effect on bone healing with histomorphometric and micro-ct analysis

The aim of the present study was to evaluate the effects of a single dose of locally administered teriparatide (TP) on healing critical-sized defects in rat mandibles through histomorphometric and microcomputed tomography (micro-CT) analyses. In this study, 48 Sprague-Dawley rats were used. The experimental animals were divided into 4 groups as follows: Group 1 had empty defects, Group 2 received autografts, Group 3 received allografts, and Group 4 received allografts combined with 40 μg of TP. Eight weeks after the surgical procedure, all rats were sacrificed, and all specimens were evaluated using micro-CT and histomorphometric analyses. The results of the histomorphometric analysis showed that Group 4 had the most new bone area (0.85 mm² ± 0.13 mm²) (p = 0.002) and the highest number of osteoblasts (86.61 ± 4.86) (p = 0.001). In addition, the results of the micro-CT analysis showed that Group 4 had the highest bone volume/total volume (23.27% ± 0.15%) (p = 0.001). The histomorphometric and micro-CT values of Group 2 were higher than those of Group 1 but lower than those of Group 3 and Group 4. The results of the study show that a single dose of locally administered TP has a positive effect on the integration of allografts. However, further studies are necessary to identify the mechanism of action and the effective minimum and maximum doses of locally administered TP.

Full-field strain of regenerated bone tissue in a femoral fracture model

The mechanical behaviour of regenerated bone tissue during fracture healing is key in determining its ability to withstand physiological loads. However, the strain distribution in the newly formed tissue and how this influences the way a fracture heals it is still unclear. X-ray Computed Tomography (XCT) has been extensively used to assess the progress of mineralised tissues in regeneration and when combined with in situ mechanics and digital volume correlation (DVC) has been proven a powerful tool to understand the mechanical behaviour and full-field three-dimensional (3D) strain distribution in bone. The purpose of this study is therefore to use in situ XCT mechanics and DVC to investigate the strain distribution and load-bearing capacity in a regenerating fracture in the diaphyseal bone, using a rodent femoral fracture model stabilised by external fixation. Rat femurs with 1 mm and 2 mm osteotomy gaps were tested under in situ XCT step-wise compression in the apparent elastic region. High strain was present in the newly formed bone (ε_p1 and ε_p3 reaching 29 000 µε and -43 000 µε, respectively), with a wide variation and inhomogeneity of the 3D strain distribution in the regenerating tissues of the fracture gap, which is directly related to the presence of unmineralised tissue observed in histological images. The outcomes of this study will contribute in understanding natural regenerative ability of bone and its mechanical behaviour under loading.

Histological assessment of the effects of teriparatide therapy on mandibular fracture healing: A preclinical study

OBJECTIVE

This study was performed to evaluate the effects of teriparatide therapy on mandibular fracture healing in a rat model.

SUBJECTS AND METHODS

A unilateral mandibular fracture, 5 mm posterior to the last molar tooth, was surgically created in 120 rats. Half of the animals received a daily subcutaneous injection of 2 μg/kg teriparatide while the control rats received normal saline, starting from the day of surgery until sacrifice. Twenty rats from each group were sacrificed on postoperative days 10, 20, and 30. The healing process was evaluated histologically and scored using a grading system (ranging from 1 to 10).

RESULTS

On day 10 the fracture gaps of the control and teriparatide groups were mainly filled with fibrous tissue and new trabecular bone, respectively. On day 20 a large amount of new trabecular bone and some areas of fibrocartilaginous tissue were seen in the fracture gaps of the control rats. In the teriparatide group the fracture area was entirely filled with trabecular bone, which in some areas had been replaced by mature bone. On day 30 the fracture gaps of the control group were entirely bridged by new trabecular bone, while in the teriparatide group they was predominantly filled with mature bone. At all three time-points the mean healing scores for the teriparatide group (6.20 ± 0.70, 8.50 ± 0.69, and 9.85 ± 0.37, respectively) were significantly higher (p < 0.001) than for the control group (4.90 ± 0.55, 7.15 ± 0.59, and 8.90 ± 0.64, respectively).

CONCLUSION

Based on the results of this study, teriparatide should be tested in humans in order to establish whether comparable results can be achieved.

Histological evaluation of the healing process of autografted mandibular bone defects in rats under treatment with zoledronate

OBJECTIVE

This study aims to evaluate the healing process of autografted mandibular bone defects in rats treated with zoledronate (ZOL).

SUBJECTS AND METHODS

A total of 180 Wistar rats were divided into four groups: group L received intravenous infusion of two doses of 0.06 mg/kg ZOL, nine weeks apart; group H received 0.06 mg/kg ZOL, while groups C and NC received normal saline at three-week intervals for nine weeks. Three weeks following the last infusion, a unilateral mandibular bone defect (5 mm) was created. Except in the NC group, all defects were repaired with autologous iliac bone graft. Fifteen animals from each group were sacrificed on postoperative Day 20, Day 40, and Day 60. Graft healing was scored using a histological grading system (ranging from 1 to 6).

RESULTS

Histological evaluations performed on postoperative Day 60 showed that the mandibular defects were mainly repaired with fibrous tissue in the NC and H groups (93.00% ± 7.51% and 82.67% ± 13.08%, respectively) and with bone in the C and L groups (75.33% ± 14.20% and 92.67% ± 8.84%, respectively). The percentage of fibrous tissue and bone as well as the healing score of the NC and H groups were significantly different (P = 0.001) from those of the C and L groups. However, these were not different between neither the NC and H groups nor the C and L groups.

CONCLUSION

Based on the results of the present study the hypothesis can be established that there also might be a dose-dependent effect of ZOL on the healing of bone grafts in humans. This hypothesis has to be verified or rejected in clinical trials.