Bisphosphonates (BPs) are used for the treatment of osteoporosis. This study evaluated changes in bone microdamage with BP treatment duration. Fifty-one iliac crest biopsies were obtained from Caucasian women, ages 41 to 87 years, who were previously diagnosed and treated for osteoporosis with oral BPs for 1-16 years duration. Patients diagnosed with any disease, drug, or substance abuse that may affect bone metabolism were excluded. Bone samples were sectioned, stained, and histologically examined using light and fluorescence microscopy. Bone area, number and length of microcracks were quantified. Following adjustment for age, BMD, BV/TV, trabecular thickness, and turnover, regression analysis revealed a relationship between microcrack density and treatment duration (p=0.018). No significant relationship was observed between microcrack length and treatment duration. This study provides novel data relating microdamage with varying BP treatment duration in human bone. Given information from other studies showing that microdamage amounts are related to changes in bone biomechanics, the BP treatment duration related changes in microdamage shown offer new information that may help optimize osteoporosis treatment.

Huntington’s disease (HD) is a heritable, neurodegenerative disorder characterized by motor, cognitive, and psychiatric disturbances. The progressive disease is caused by an unstable CAG expansion within the gene that normally encodes for the huntingtin protein (Htt). The expanded mutant form of Htt (mHtt) is expressed ubiquitously throughout patients’ bodies; however, neuronal degeneration is prominent only in the corpus striatum and, to a lesser extent, the cortex. The Ras homolog Rhes is also preferentially localized to the striatum. The putative co-factor Rhes has been shown to act with mHtt to cause neuronal death. Simvastatin, a lipid lowering drug, and zoledronate, a nitrogen bisphosphonate, act on the mevalonate pathway, which gives both Rhes and its target cells, binding sites. The current study aimed to interrupt the mevalonate pathway and inactivate, via de-prenylation, Rhes in CD-1 mice exposed to 3-nitroproprionic acid, a neurotoxin that mimics HD mitochondrial dysfunction and striatal degeneration. Results suggest that drug treatment does not rescue motor impairments and may potentiate 3-NP damage. The persistent motor deficits are discussed in relation to possible Rhes de-prenylation.

A periodontite é uma doença de natureza multifatorial e infecciosa, que resulta na inflamação e perda dos tecidos de suporte dos dentes. Essa inflamação é causada por bactérias associadas ao biofilme, causando a perda progressiva de inserção. Os bisfosfonatos são fármacos com capacidade de inibir a reabsorção óssea, atuando nas células clásticas. O presente estudo teve como objetivo investigar os efeitos do alendronato, um bisfosfonato nitrogenado com grande potência antireabsortiva, na evolução da doença periodontal induzida em ratos, bem como a possível presença de necrose óssea no processo alveolar. Foram utilizados 48 ratos Wistar albinos, do sexo masculino, com 3 meses de vida e peso médio de 250g. Os animais foram divididos aleatoriamente em dois grupos: Alendronato (ALN) e Controle (CON). A periodontite foi induzida com a inserção de um fio de seda 4.0 no sulco gengival do segundo molar superior. Os ratos do grupo ALN, receberam doses diárias de 2,5 mg/kg durante 7 dias antes e 7, 14, 21 e 30 dias após a indução da doença; o grupo CON recebeu solução salina estéril. Nos tempos citados as maxilas foram fixadas, descalcificadas e incluídas em parafina ou resina Spurr. Os cortes foram corados com HE, para análise morfológica, e histomorfométrica. Alguns cortes foram submetidos à imuno-histoquímica para detecção de RANKL e OPG. Foi utilizado o método TRAP, marcador de osteoclastos e microscopia eletrônica de transmissão para análise ultraestrutural. O ALN inibiu a reabsorção da crista alveolar de todos os grupos tratados. As células clásticas apresentaram-se em estado latente. No grupo controle a crista alveolar foi reabsorvida e o TRAP revelou clastos ativos, achados confirmados pela microscopia eletrônica de transmissão. A expressão de RANKL, molécula ativadora da célula clástica, não foi inibida pela droga. A expressão de OPG foi aumentada nos animais tratados. Os animais do grupo tratado durante 21 e 30 dias, apresentaram sinais de osteonecrose na crista alveolar, como lacunas de osteócitos vazias e regiões exposta de osso. Os resultados demonstraram que o uso de alendronato durante a doença periodontal inibe a reabsorção óssea e que durante tempos prolongados pode gerar osteonecrose na região da crista óssea. / Periodontitis is an infectious disease of multifactor nature that results in the inflammation of the tissues supporting the teeth. This inflammation is caused by accumulation of biofilm and causes progressive insertion and bone loss. The bisphosphonates are drugs with the capability to inhibit the activity of clastic cells. The aim of this study was to investigate the effects of alendronate, a nitrogenated bisphosphonate with high antiresorptive power on experimental periodontal disease, and to analyze the possible presence of osteonecrosis in the rat alveolar process. Forty-eight male Wistar rats, three months old, with 250g weight were used. The animals were randomly divided into two groups: Alendronate (ALN) and Control (CON). The periodontitis was induced with a 4.0 silk wire inserted into the gingival sulcus around the right upper second molar. The ALN rats, received daily doses of 2.5 mg/kg alendronate (ALN) for 7 days before the induction of periodontitis; the treatment continued for additional 7, 14, 21 or 30 days. The CON rats, received sterile saline solution. In the time points cited, the maxillae were fixed, decalcified and embedded in Spurr resin or paraffin. The specimens were morphologically analyzed in HE stained sections, after which histomorphometry was carried out. Some stained sections were used for immunolabeling for RANKL and OPG. The osteoclasts were marker by tartrate-resistant acid phosphatase (TRAP) histochemistry. The ultrathin sections were examined in a transmission electron microscope. ALN reduced the activity of osteoclasts and significantly decreased the resorption of the alveolar crest. In the control group the alveolar crest appeared resorbed, while TRAP showed active osteoclasts, findings confirmed by transmission electron microscopy. The expression of RANKL, an osteoclast-activating molecule, was not inhibited by the drug. The expression of OPG was increased in the treated animals. The animals of the group treated for 21 and 30 days showed signs of osteonecrosis of the alveolar crest, as empty osteocyte lacunae in the exposed bone regions. The results showed that the use of ALN for periodontal disease inhibited bone resorption; when it was administered for prolonged periods it can cause osteonecrosis in the bone crest area.

O reparo ósseo de alvéolos após exodontia dos molares superiores em um modelo animal em ratos Wistar (Rattus norvegicus, albinus) de osteonecrose dos maxilares associada ao uso de bisfosfonatos foi avaliado através de analise microscópica e molecular. Foram utilizados 48 ratos (Rattus norvegicus, albinus, Wistar) machos, com 12 semanas de vida e peso aproximado de 300 gramas, que foram dividos em 4 grupos. Cada grupo era composto por 12 animais, sendo 2 grupos experimentais AZ e AZ-Cirúrgico (AZ-C), que foram submetidos a administração de ácido zoledrônico, 0,6 mg/kg a cada 28 dias com um total de 5 doses e 2 grupos controles CO e CO-Cirúrgico (CO-C) com administração de cloreto de sódio 0,9% no mesmo volume e frequencia do ácido zoledrônico. Todas as soluções foram administradas por via intraperitoneal. O grupo AZ-C e o grupo CO-C foram submetidos a exodontia do primeiro, segundo e terceiro molares superiores 45 dias após a primeira aplicação das soluções. Todos os animais foram eutanasiados após 150 dias do início do experimento (105 dias após as exodontias). As maxilas dos animais foram avaliadas macroscopicamente para presença de lesões espontâneas e com uma sonda clinica número 5 as regiões das exodontias dos molares foram avaliadas para presença ou ausência de solução continua do epitélio. Após feita a avaliação macroscópica as regiões das exodontias dos molares superior esquerdo e do lado contralateral de cada animal foram submetidas a análises qualitativa e quantitativa para presença de sequestros ósseos, restos radiculares, área de osteonecrose, área de espaço trabecular, área de reação periosteal, através de estudos por microscopia óptica pela coloração Hematoxilina e Eosina. Análise quantitativa da expressão do RNAm de proteínas envolvidas no processo de reparo ósseo RANK, RANKL, OPG e VEGF, pelo método de reação em cadeia da polimerase em tempo real (RealTimePCR) também foi realizada. A avaliação macroscópica mostrou que 91,66% dos animais do grupo AZ-C e 41,66% do grupo CO-C apresentaram solução de continuidade do epitélio, sendo estatisticamente significante maior no grupo em terapia com ácido zoledrônico pelo este exato de Fischer (p<0,05). Todos animais do grupo AZ-C e nenhum do grupo CO-C apresentaram sequestros ósseos e todos os animais apresentaram presença de restos radiculares na análise microscópica. A área de osteonecrose foi maior nos animais do grupo AZ-C do que no grupo CO-C (p<0,005), não havendo diferença estatística entre as áreas de espaço trabecular, reação periosteal e osso total. Na análise molecular de RANK, RANKL, OPG e VEGF não houve diferença estatisticamente significante entre os grupos CO, AZ, COC e AZ-C, mesmo quando comparadas áreas de exodontia com áreas com dentes. Estes resultados levam a conclusão que o modelo animal utilizado no presente estudo é um modelo seguro, que o ácido zoledrônico interferiu no reparo ósseo dos alvéolos, causando um atraso na remodelação óssea da região e uma maior incidência de osteonecrose e sequestros ósseos. O ácido zoledrônico não afetou a expressão de RANK, RANKL, OPG e VEGF 105 dias após as exodontias. / The alveolar bone repair following extraction of maxillary molars in an animal model of bisphosphonate related osteonecrosis of the jaws in Wistar rats (Rattus norvegicus, Albinus) was assessed through microscopic and molecular analysis. A total of 48 rats (Rattus norvegicus, Albinus, Wistar rats) with 12 weeks old and weighing approximately 300 grams were used, they were divided into 4 groups. Each group consisted of 12 animals, with 2 experimental groups AZ and AZ-Cirúrgico (AZ-C), who underwent the administration of zoledronic acid, 0.6 mg / kg every 28 days with a total of 5 doses. And 2 control groups CO and CO-Cirúrgico (CO-C) with administration of sodium chloride at 0.9% in the same volume and frequency of zoledronic acid. All solutions were administered intraperitoneally. The group AZ-C and CO-C underwent to extraction of the first, second and third molars 45 days after the first application of the solutions. All animals were sacrificed after 150 days from the beginning of the experiment (105 days after extractions). The maxilla of the animals were assessed macroscopically for the presence of spontaneous lesions, and with a clinical probe number five the regions of the molar extractions were evaluated for the presence or absence of loss of continuity of the oral epithelium. After macroscopic evaluation, the upper left molar and contralateral side of the extraction regions of each animal were submitted to qualitative and quantitative analyzes for the presence of bone sequestrum, root fragments, osteonecrosis area, trabecular space area, area of periosteal reaction, through optical microscopic studies by hematoxylin and eosin staining. And quantitative analysis of mRNA expression of proteins involved in bone repair (RANK, RANKL, OPG and VEGF), by the method of RealTimePCR were carried out. Macroscopic evaluation showed that 91.66% of the AZ -C group and 41.66% of the CO-C group presented a loss of continuity of the epithelium, which was statistically significant higher in the zoledronic acid group according to the Fisher test (p<0.05). All animals in group AZ-C and none in CO-C group showed bone sequestrum and all animals in both groups had root fragments in microscopic analysis. The area of osteonecrosis was higher in the animals of AZ-C group than in CO-C (p<0.005), with no statistical difference between the areas of trabecular space, periosteal reaction and total bone. In the molecular analysis of RANK, RANKL, OPG e VEGF there was no statistically significant difference between the CO, AZ, CO-C e AZ-C groups, even when extraction regions were compared to non extractions areas. These results lead to the conclusion that the animal model described used in this study is a reliable model and zoledronic acid interferes with alveolar bone repair causing a delay in bone emodeling and a higher incidence of osteonecrosis and bone sequestrum. Zoledronic acid did not affect the expression of RANK, RANKL, OPG and VEGF 105 days after dental extractions.

No description available.

Bisphosphonates (BPs) have been used clinically as anti-resorptive/cancer agents with confounded clinical outcomes and uncertain/conflicting biological understanding. This study was designed to evaluate the impact of clinically used anti-resorption drug alendronate (ALN) on cancer-bone metastasis and bone biology using novel 3D cancer-bone interaction model systems. To test the effects of ALN on the cancer-bone metastasis/interactions and bone biology we have utilized a novel 3D Co-cultures of live mouse neonatal calvarial bone organs with oral squamous cancer cells in a roller tube model systems (Curtin et al, 2012) in the absence and presence of ALN. These model systems under bone resorption and formation conditions were evaluated by chemical, biochemical, and histological analyses of the used media and calvarial bones. At the end of 8 days, the calvarial bones co-cultured with oral cancer cell lines in the absence and presence of ALN were processed for histological observations, TRAP and ALP enzyme activities, and neutral red staining. These studies were complemented by the effects of ALN on oral cancer cells under 2D classic cell culture conditions. In 3D-bone organ cultures under resorption conditions, oral cancer cells induce differentiation of osteoclasts and bone resorption and inclusion of ALN inhibited cancer-induced bone resorption. However, in both bone resorption and formation models the oral cancer cells colonized the bone and while treatment with ALN inhibits bone resorption, no effect on bone colonization was evident. Contrary to those under 2D cell culture conditions exposure to ALN of confluent and non-confluent oral cancer cells in the absence of live bone impacted oral cancer cells significantly in a dose dependent manner. Our studies using live bone organ cultures with oral cancer cells under specific dissociated bone remodeling stages, viz., resorption or formation only, revealed major and significant biological events which led to the conclusions that: (a) In the absence of bone in 2D cultures oral cancers are sensitive to ALN treatment whereas in the 3D live bone microenvironment tumors are resistant to ALN drug therapy, and (b) oral cancer-bone metastasis is independent of bone remodeling stage.

O reparo ósseo de alvéolos após exodontia dos molares superiores em um modelo animal em ratos Wistar (Rattus norvegicus, albinus) de osteonecrose dos maxilares associada ao uso de bisfosfonatos foi avaliado através de analise microscópica e molecular. Foram utilizados 48 ratos (Rattus norvegicus, albinus, Wistar) machos, com 12 semanas de vida e peso aproximado de 300 gramas, que foram dividos em 4 grupos. Cada grupo era composto por 12 animais, sendo 2 grupos experimentais AZ e AZ-Cirúrgico (AZ-C), que foram submetidos a administração de ácido zoledrônico, 0,6 mg/kg a cada 28 dias com um total de 5 doses e 2 grupos controles CO e CO-Cirúrgico (CO-C) com administração de cloreto de sódio 0,9% no mesmo volume e frequencia do ácido zoledrônico. Todas as soluções foram administradas por via intraperitoneal. O grupo AZ-C e o grupo CO-C foram submetidos a exodontia do primeiro, segundo e terceiro molares superiores 45 dias após a primeira aplicação das soluções. Todos os animais foram eutanasiados após 150 dias do início do experimento (105 dias após as exodontias). As maxilas dos animais foram avaliadas macroscopicamente para presença de lesões espontâneas e com uma sonda clinica número 5 as regiões das exodontias dos molares foram avaliadas para presença ou ausência de solução continua do epitélio. Após feita a avaliação macroscópica as regiões das exodontias dos molares superior esquerdo e do lado contralateral de cada animal foram submetidas a análises qualitativa e quantitativa para presença de sequestros ósseos, restos radiculares, área de osteonecrose, área de espaço trabecular, área de reação periosteal, através de estudos por microscopia óptica pela coloração Hematoxilina e Eosina. Análise quantitativa da expressão do RNAm de proteínas envolvidas no processo de reparo ósseo RANK, RANKL, OPG e VEGF, pelo método de reação em cadeia da polimerase em tempo real (RealTimePCR) também foi realizada. A avaliação macroscópica mostrou que 91,66% dos animais do grupo AZ-C e 41,66% do grupo CO-C apresentaram solução de continuidade do epitélio, sendo estatisticamente significante maior no grupo em terapia com ácido zoledrônico pelo este exato de Fischer (p<0,05). Todos animais do grupo AZ-C e nenhum do grupo CO-C apresentaram sequestros ósseos e todos os animais apresentaram presença de restos radiculares na análise microscópica. A área de osteonecrose foi maior nos animais do grupo AZ-C do que no grupo CO-C (p<0,005), não havendo diferença estatística entre as áreas de espaço trabecular, reação periosteal e osso total. Na análise molecular de RANK, RANKL, OPG e VEGF não houve diferença estatisticamente significante entre os grupos CO, AZ, COC e AZ-C, mesmo quando comparadas áreas de exodontia com áreas com dentes. Estes resultados levam a conclusão que o modelo animal utilizado no presente estudo é um modelo seguro, que o ácido zoledrônico interferiu no reparo ósseo dos alvéolos, causando um atraso na remodelação óssea da região e uma maior incidência de osteonecrose e sequestros ósseos. O ácido zoledrônico não afetou a expressão de RANK, RANKL, OPG e VEGF 105 dias após as exodontias. / The alveolar bone repair following extraction of maxillary molars in an animal model of bisphosphonate related osteonecrosis of the jaws in Wistar rats (Rattus norvegicus, Albinus) was assessed through microscopic and molecular analysis. A total of 48 rats (Rattus norvegicus, Albinus, Wistar rats) with 12 weeks old and weighing approximately 300 grams were used, they were divided into 4 groups. Each group consisted of 12 animals, with 2 experimental groups AZ and AZ-Cirúrgico (AZ-C), who underwent the administration of zoledronic acid, 0.6 mg / kg every 28 days with a total of 5 doses. And 2 control groups CO and CO-Cirúrgico (CO-C) with administration of sodium chloride at 0.9% in the same volume and frequency of zoledronic acid. All solutions were administered intraperitoneally. The group AZ-C and CO-C underwent to extraction of the first, second and third molars 45 days after the first application of the solutions. All animals were sacrificed after 150 days from the beginning of the experiment (105 days after extractions). The maxilla of the animals were assessed macroscopically for the presence of spontaneous lesions, and with a clinical probe number five the regions of the molar extractions were evaluated for the presence or absence of loss of continuity of the oral epithelium. After macroscopic evaluation, the upper left molar and contralateral side of the extraction regions of each animal were submitted to qualitative and quantitative analyzes for the presence of bone sequestrum, root fragments, osteonecrosis area, trabecular space area, area of periosteal reaction, through optical microscopic studies by hematoxylin and eosin staining. And quantitative analysis of mRNA expression of proteins involved in bone repair (RANK, RANKL, OPG and VEGF), by the method of RealTimePCR were carried out. Macroscopic evaluation showed that 91.66% of the AZ -C group and 41.66% of the CO-C group presented a loss of continuity of the epithelium, which was statistically significant higher in the zoledronic acid group according to the Fisher test (p<0.05). All animals in group AZ-C and none in CO-C group showed bone sequestrum and all animals in both groups had root fragments in microscopic analysis. The area of osteonecrosis was higher in the animals of AZ-C group than in CO-C (p<0.005), with no statistical difference between the areas of trabecular space, periosteal reaction and total bone. In the molecular analysis of RANK, RANKL, OPG e VEGF there was no statistically significant difference between the CO, AZ, CO-C e AZ-C groups, even when extraction regions were compared to non extractions areas. These results lead to the conclusion that the animal model described used in this study is a reliable model and zoledronic acid interferes with alveolar bone repair causing a delay in bone emodeling and a higher incidence of osteonecrosis and bone sequestrum. Zoledronic acid did not affect the expression of RANK, RANKL, OPG and VEGF 105 days after dental extractions.

Conselho Nacional de Desenvolvimento CientÃfico e TecnolÃgico / A periodontite, a principal causa de perda de dentes em adultos, à uma doenÃa inflamatÃria onde ocorre perda do osso alveolar e destruiÃÃo das fibras do ligamento periodontal. Tanto as bactÃrias periodontopatogÃnicas como os fatores provenientes do hospedeiro sÃo necessÃrios para o desenvolvimento e progressÃo desta patologia. Os bisfosfonatos constituem uma nova classe de drogas, os quais inibem a reabsorÃÃo do osso causando alteraÃÃes morfolÃgicas ou apoptose nos osteoclastos. O objetivo do presente estudo foi investigar os mecanismos envolvidos no efeito de um bisfosfonato Alendronato DissÃdico (AD) na doenÃa periodontal experimental (DPE), comparando seus efeitos com a doxiciclina, tratamento jà estabelecido. A DPE foi induzida passando-se fio de nÃilon 3.0 em torno do segundo molar superior esquerdo de ratos Wistar fÃmeas, permanecendo durante 11d. AD (0,25mg/kg, s.c.) foi administrado 30 minutos antes e diariamente (tratamento preventivo) ou AD (0,25mg/kg, s.c.), DX (5 ou 10 mg/kg) ou salina (0,2ml) foram injetados a partir do 5 dia da induÃÃo da DPE (tratamento curativo). Os parÃmetros avaliados foram: Ãndice de perda Ãssea (IPO), anÃlise histopatolÃgica e microbiolÃgica, imunohistoquÃmica, migraÃÃo de neutrÃfilos, mieloperoxidase (MPO), leucogramas realizados antes e apÃs a cirurgia (6h e 1, 7 e 11 dias) e variaÃÃo da massa corpÃrea. No IPO, AD reduziu consideravelmente a reabsorÃÃo Ãssea tanto de forma preventiva como curativa sendo comparÃvel à doxiciclina. Na anÃlise histopatolÃgica, o periodonto dos animais tratados com AD mostrou preservaÃÃo do osso alveolar, cemento e das fibras colÃgenas, alÃm de reduÃÃo do infiltrado neutrofÃlico gengival de 6h. Esta inibiÃÃo da migraÃÃo neutrofÃlica foi confirmada atravÃs da MPO e em modelo de peritonite abdominal e o leucograma mostrou uma reduÃÃo da neutrofilia. A imunohistoquÃmica mostrou que o AD diminuiu a marcaÃÃo para TNF em 6h e 11d. No microbiolÃgico, AD inibiu qualitativamente o crescimento de bactÃrias caracterÃsticas da DP, tais como pigmentados e Fusobacterium nucleatum. AD promoveu um aumento na massa corpÃrea em relaÃÃo ao grupo salina. Esses resultados mostram que o AD possui importante atividade na DPE, sugerindo a relevÃncia de testes clÃnicos dos bisfosfonatos no tratamento da doenÃa periodontal / Periodontitis, the major cause of teeth loss in adults, is an inflammatory disease in which occurs alveolar bone resorption and collagen fibers destruction. Bacteria and host factors are necessary to the development of this pathology. Bisphosphonates are a new class of drugs that inhibit bone resorbtion by causing morphological alterations or death of osteoclasts. The objetive of this study is to investigate the effect of the bisphosphonate Dissodic Alendronate (DA) in periodontitis, comparing it with the doxicicline (DX), treatment currently used. Periodontitis was induced by a nylon thread ligature surgically placed around the cervix of the second left maxillary molars of female Wistar rats. Animals were treated with DA (0.25 mg/kg, s.c.) 30 minutes before periodontits induction and daily until sacrifice on 11th day (preventive group). Additionally, saline, DA or DX (5 or 10 mg/kg) were injected s.c. from 5th day and daily up to the 11th day of periodontal disease (curative treatment). The parameters analysed were alveolar bone loss (ABL), histopathologic and microbiological analysis, immunohistochemistry, myeloperoxidase (MPO), neutrophil migration, leukogram measured before and after challenge (6h and 1, 7 and 11 days) and body mass variation. AD, as curative or preventive treatment, reduced this alveolar bone loss similar DX. Histopatologically, the periodontium of animals treated with DA showed preservation of alveolar bone, cementum and collagen fibers of periodontal ligament, and reduced neutrophilic and mononuclear cell infiltrate. This effect on neutrophilic infiltrate was confirmed by MPO and in model of peritonitis induced by carrageenan. In imunohistochemistry, there was marked reduction of immunostaining for TNF in the group treated with DA compared to the saline group. In microbiologic analysis, DA inhibited the growth of bacteria involved in periodontitis. DA increased body mass compared to saline group. These results support clinical testing of bisphosphonates in the treatment of periodontal disease

A periodontite é uma doença de natureza multifatorial e infecciosa, que resulta na inflamação e perda dos tecidos de suporte dos dentes. Essa inflamação é causada por bactérias associadas ao biofilme, causando a perda progressiva de inserção. Os bisfosfonatos são fármacos com capacidade de inibir a reabsorção óssea, atuando nas células clásticas. O presente estudo teve como objetivo investigar os efeitos do alendronato, um bisfosfonato nitrogenado com grande potência antireabsortiva, na evolução da doença periodontal induzida em ratos, bem como a possível presença de necrose óssea no processo alveolar. Foram utilizados 48 ratos Wistar albinos, do sexo masculino, com 3 meses de vida e peso médio de 250g. Os animais foram divididos aleatoriamente em dois grupos: Alendronato (ALN) e Controle (CON). A periodontite foi induzida com a inserção de um fio de seda 4.0 no sulco gengival do segundo molar superior. Os ratos do grupo ALN, receberam doses diárias de 2,5 mg/kg durante 7 dias antes e 7, 14, 21 e 30 dias após a indução da doença; o grupo CON recebeu solução salina estéril. Nos tempos citados as maxilas foram fixadas, descalcificadas e incluídas em parafina ou resina Spurr. Os cortes foram corados com HE, para análise morfológica, e histomorfométrica. Alguns cortes foram submetidos à imuno-histoquímica para detecção de RANKL e OPG. Foi utilizado o método TRAP, marcador de osteoclastos e microscopia eletrônica de transmissão para análise ultraestrutural. O ALN inibiu a reabsorção da crista alveolar de todos os grupos tratados. As células clásticas apresentaram-se em estado latente. No grupo controle a crista alveolar foi reabsorvida e o TRAP revelou clastos ativos, achados confirmados pela microscopia eletrônica de transmissão. A expressão de RANKL, molécula ativadora da célula clástica, não foi inibida pela droga. A expressão de OPG foi aumentada nos animais tratados. Os animais do grupo tratado durante 21 e 30 dias, apresentaram sinais de osteonecrose na crista alveolar, como lacunas de osteócitos vazias e regiões exposta de osso. Os resultados demonstraram que o uso de alendronato durante a doença periodontal inibe a reabsorção óssea e que durante tempos prolongados pode gerar osteonecrose na região da crista óssea. / Periodontitis is an infectious disease of multifactor nature that results in the inflammation of the tissues supporting the teeth. This inflammation is caused by accumulation of biofilm and causes progressive insertion and bone loss. The bisphosphonates are drugs with the capability to inhibit the activity of clastic cells. The aim of this study was to investigate the effects of alendronate, a nitrogenated bisphosphonate with high antiresorptive power on experimental periodontal disease, and to analyze the possible presence of osteonecrosis in the rat alveolar process. Forty-eight male Wistar rats, three months old, with 250g weight were used. The animals were randomly divided into two groups: Alendronate (ALN) and Control (CON). The periodontitis was induced with a 4.0 silk wire inserted into the gingival sulcus around the right upper second molar. The ALN rats, received daily doses of 2.5 mg/kg alendronate (ALN) for 7 days before the induction of periodontitis; the treatment continued for additional 7, 14, 21 or 30 days. The CON rats, received sterile saline solution. In the time points cited, the maxillae were fixed, decalcified and embedded in Spurr resin or paraffin. The specimens were morphologically analyzed in HE stained sections, after which histomorphometry was carried out. Some stained sections were used for immunolabeling for RANKL and OPG. The osteoclasts were marker by tartrate-resistant acid phosphatase (TRAP) histochemistry. The ultrathin sections were examined in a transmission electron microscope. ALN reduced the activity of osteoclasts and significantly decreased the resorption of the alveolar crest. In the control group the alveolar crest appeared resorbed, while TRAP showed active osteoclasts, findings confirmed by transmission electron microscopy. The expression of RANKL, an osteoclast-activating molecule, was not inhibited by the drug. The expression of OPG was increased in the treated animals. The animals of the group treated for 21 and 30 days showed signs of osteonecrosis of the alveolar crest, as empty osteocyte lacunae in the exposed bone regions. The results showed that the use of ALN for periodontal disease inhibited bone resorption; when it was administered for prolonged periods it can cause osteonecrosis in the bone crest area.

Thesis (M.A.)--Boston University, 2008. / The use of bisphosphonate has become more widespread for the treatment of bone metastasis, multiple myeloma, osteoporosis, Paget's disease and other bone malignancies. Osteonecrosis of the jaw (ONJ) has been recently recognized as a possible complication of the use of bisphosphonate therapy. This study includes a review of the literature on the mechanism of action of bisphosphonate and its potential association to the development of osteonecrosis of the jaw. The inhibitory effects of bisphosphonates on osteoclasts and its antiangiogenic properties have been examined as possible mechanisms to induce osteonecrosis of the jaw. The incidence of ONJ in osteoporosis patients receiving bisphosphonate treatment is <1 in 100,000, and in between 1% and 10% in patients with malignancy (Hess et al., 2008). The results of this study suggest a higher incidence of osteonecrosis of the jaw in patients under long term use of nitrogen containing bisphosphonate. The incidence of bisphosphonate associated ONJ in the first 4 to 12 months of therapy was of 1.5% and it increased to 7.7% after 37 to 48 months [Bamias] Additional risk factors include dental extractions, invasive dental procedures and trauma. It is not yet clear, however, if other drugs that affect bone turnover may induce similar complications. This study suggests an association of bisphosphonates to the development of osteonecrosis of the jaw. There is no evidence that bisphosphonates cause osteonecrosis of the jaw. An evaluation of the published data indicates that more research is necessary to understand the relationship of bisphosphonates and osteonecrosis of the jaw.