Teriparatidin ilaçlarla ilişkili çene osteonekrozu tedavisindeki etkinliği: hayvan çalışması

Abstract

Amaç: Bu çalışmanın amacı, bifosfanat uygulamasını takiben diş çekimi sonrasında çene kemiklerinde oluşan osteonekrozun tedavisinde teriparatidin etkinliğinin deneysel olarak araştırılmasıdır.

Gereç ve Yöntemler: Wistar Albino ırkı 48 adet dişi rat rastgele 4 gruba ayrıldı: I-Kontrol grubu; II-Zoledronik asit (ZA); III-ZA ve teriparatid; IV-ZA ve antibiyotik. Osteonekroz oluşturmak için kontrol grubu dışındaki tüm gruplara 8 hafta boyunca zoledronik asit enjekte edildi. ZA enjeksiyonlarından bir hafta sonra tüm hayvanların alt çene sol azı dişleri çekildi ve çekim soketlerinde kemik defekti oluşturuldu. Bu işlemden sonra üçüncü gruptaki ratlara 2 ay boyunca subkutan olarak teriparatid, dördüncü gruptaki ratlara 2 hafta boyunca intraperitoneal antibiyotik enjekte edildi. Hayvanlar radyolojik, histolojik, biyokimyasal ve klinik değerlendirmeler için sakrifiye edildi.

Bulgular: Teriparatid uygulamasının biyokimyasal ve radyolojik açıdan kemik iyileşmesine istatistiksel olarak anlamlı bir etkisinin olmadığı tespit edilmiştir (p>0,05). Teriparatidin, osteonekroz geliştikten sonra klinik olarak iyileşmeye tam anlamıyla olumlu etkisinin olmadığı ama oluşan osteonekroz tablosunun daha da ilerlemesini engellediği gözlenmiştir. Ayrıca, ilacın histolojik olarak yumuşak doku ve kemik dokusu iyileşmesinde olumlu etkilerinin olduğu tespit edilmiştir.

Sonuç: Bifosfanat uygulamasını takiben diş çekimi işleminin osteonekroz gelişimine sebep olduğu gözlenmiştir. Ayrca, teriparatid uygulamasının bu lezyonların tedavisinde kısmen olumlu etkileri olduğu tespit edilmiştir. Bu tedavinin optimum doz ve süresinin belirlenmesi için geniş grupları içeren ileri deneysel ve klinik çalışmalara ihtiyaç vardır.

Anahtar Kelimeler: Bifosfonat, osteonekroz, teriparatid

Keywords

• Bifosfonat
• osteonekroz
• teriparatid

Teriparatide’s potential role in the treatment of medication-related osteonecrosis of the jaw: an animal study.

Abstract

Background: We aimed to investigate the efficacy of teriparatide experimentally on rats after the development of osteonecrosis with bisphosphonate usage.

Methods: Rats were divided randomly into four groups: I-Control group; II-Zoledronic acid (ZA); III-ZA and teriparatide; IV-ZA and antibiotic. Osteonecrosis was generated by injecting zoledronic acid to all groups except control group for 8 weeks. A week after ZA injections, mandibular left molar extraction was performed and bone defect were created in the same regions of all animals. Afterwards, teriparatide was subcutaneously injected to rats in the third group; antibiotic was intraperitoneally injected to rats in the fourth group. Animals were sacrificed for the radiological, histological, biochemical and clinical evaluations.

Results: Teriparatide therapy has not a statistically significant effect on radiological and biochemical aspects of bone healing (p>0.05). Teriparatide has not a positive effect clinically on bone healing after the development of osteonecrosis. However, application of this drug prevents further deterioration of osteonecrosis period clinically. Moreover, teriparatide has positive effects on soft tissue and bone healing histologically. 

Conclusions: Bisphosphonate uptake that followed by tooth extraction has been identified to induce the development of osteonecrosis. On the other hand teriparatide therapy has partially positive effects in the treatment of these lesions. However, further experimental and clinical studies including large groups are required for the determination optimum dose and duration of this treatment modality.  

Keywords: Bisphosphonate, osteonecrosis, teriparatide

Keywords

• Bisphosphonate
• osteonecrosis
• teriparatide

References

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