Effect of different surgical procedures on bone healing in rabbit model treated with zoledronic acid

Abstract

Background: Medication-related osteonecrosis of the jaw (MRONJ) is a rare but serious complication of various drugs including bisphosphonates, denosumab, and antiangiogenic agents. Surgical intervention is known as a risk factor for MRONJ, however, the etiopathogenesis remains unclear. Whether different surgical procedures have different effects on bone healing needs further investigation. Objectives: To compare the risk of different surgical procedures of mandibular tooth extraction in inducing MRONJ. Methods: Twenty New Zealand White (NZW) rabbits received subcutaneous (s/c) injections of zoledronic acid (ZA; n = 10) or saline vehicle (n = 10) for four weeks until teeth extraction. The extraction was performed on the first premolar on both sides of mandible, the socket on one side was closed by sutures and the other side was left open. Rabbits then continued to receive zoledronic acid or saline till sacrifice at week four and week eight. After tooth extraction, rabbits were injected (s/c) with fluorochrome labeling solutions. The extraction sites were collected for microcomputed tomography and histomorphometric analysis. Findings and Conclusion: Thinner periodontal ligament space and higher bone mineral density were found in ZA treated group. More data are still under analysis.