Kritik boyutlu kemik defektlerinde denosumab ve ozon uygulamasının kemik iyileşmesi üzerine etkisinin araştırılması

Year 2024, Volume: 25 Issue: 2, 38 - 45, 28.06.2024

Ersin Keskin , Beyza Kaya , Ayfer Aktaş

Abstract

Amaç: Maksillofasiyal cerrahide herhangi bir sebeple oluşan defektlerin iyileşmesini hızlandırmak amacıyla çeşitli ilaçlar kullanılmaktadır. Bu ilaçlar arasında osteoporoz hastalığında kullanılan bifosfonat grubu ilaçlardan denosumabın , yeni kemik oluşumu üzerinde olumlu etkileri olduğu çeşitli çalışmalarda gösterilmiştir. Genel tıp alanında ve dişhekimliğinde yaygın kullanımı olan ozon ise yine kemik yapımı üzerinde olumlu etkileri olan alternatif bir tedavi olarak son yıllarda yaygın olarak kullanılmaktadır. Bu çalışmanın amacı rat kalvaryumlarında oluşturulan kritik boyutlu defektlerde denosumab ve ozon uygulamaları yaparak, yeni kemik oluşumunun değerlendirilmesidir.
Gereç ve Yöntem: Çalışmamızda 40 adet Spraque Dawley cinsi erkek rat kullanıldı. Ratlar 4 gruba ayrıldı. Kontrol grubuna sadece greft konuldu. Ozon grubu (O) ve ozon ve denosumab (O-D) gruplarına greft uygulandıktan sonra 15 saniye süreyle topikal ozon uygulandı. Denosumab grubu (D) ve ozon ve denosumab(O-D) grubuna 8 hafta süresinde 4 haftada bir olmak üzere subkütan (s.c) 10 mg/kg Prolia(denosumab) enjekte edildi. Her gruptan 5 hayvan 4. hafta sonunda, grupdaki diğer 5 hayvan ise 8. hafta sonunda sakrifiye edildikten sonra histopatolojik incelemeler yapıldı. Gruplar arasındaki farklılıklar istatistiksel analizlerle değerlendirilmiştir.
Bulgular: Yapılan histopatolojik inceleme sonrası greft+ozon ve greft+denosumab uygulanan gruplarda sadece greft yerleştirilen kontrol grubuna kıyasla daha iyi kemik oluşumu gözlendi. Kontrol grubu dışındaki diğer gruplar birbirleriyle kıyaslandığında istatistiksel olarak anlamlı bir fark olmasa da denosumab uygulanan gruplarda ozon grubuna göre daha fazla yeni kemik oluşumu belirlendi.
Sonuç: Çalışmamızın sonucunda ozon ve denosumab uygulamasının yeni kemik yapımı üzerine olumlu katkısı olduğunu ancak bu konuda daha fazla çalışma yapılması gerektiğini düşünmekteyiz.

Keywords

Rat, ozon, denosumab, yeni kemik yapımı

Investigation of the effect of denosumab and ozone application on bone healing in critical size bone defects

Abstract

Aims: In maxillofacial surgery, various drugs are used in order to accelerate the recovery of defects caused by any reason. Several studies have shown that denosumab from bisphosphonate group drugs used in osteoporosis patients has positive effects on new bone formation. In general medicine and dentistry, ozone is in widespread use as an alternative treatment and has positive effects on new bone formation. The aim of this study was to evaluate new bone formation by performing denosumab and ozone on critical-sized rat calvarium defects.
Methods: In our study, 40 Sprague Dawley rats were used. Rats were divided into 4 groups. Only grafts were placed in the control group. After applying graft to ozone group (O) and ozone and denosumab (O-D) groups, topical ozone was applied for 15 seconds. Denosumab group (D) and O-D group were injected subcutaneously (s.c) 10 mg/kg Prolia (denosumab) every 4 weeks for 8 weeks. 5 animals from each group at the end of week 4, while the other five animals in the group at the end of 8 weeks after being sacrificed for histopathological examination was performed. The differences between the groups were evaluated by statistical analysis.
Results: After histopathological examination, better bone formation was observed in the ozone and denosumab treated groups compared to the control group. There was no statistically significant difference between the groups except for the control group, however, new bone formation was determined in the groups treated with denosumab compared to the ozone group.
Conclusion: As a result of our study, we believe that the application of ozone and denosumab has a positive effect on the formation of new bone, but more comprehensive studies on the subject are needed.

Keywords

Rat, ozone, denosumab, new bone formation

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