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Previous issue date: 2015-07-17 / Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is an important side-effect of bisphosphonates. The condition has high morbidity and its treatment is difficult, where many therapies have been tried including antibiotics, surgical interventions, and also some alternative therapies such as low-level laser therapy, platelet-rich plasma and hyperbaric oxygen therapy (HBOT). Nevertheless, there is no consensus about the effectiveness of HBOT in BRONJ. The aim of the present study was to investigate the effect of HBOT on tooth extraction site in rats treated with bisphosphonate. Thirty-five Wistar rats were treated with zoledronic acid, subjected to tooth extractions and allocated into groups according to HBOT regimen: (1) 7 days of HBOT; (2) 14 days of HBOT; (3) without HBOT (7-day control); (4) without HBOT (14-day control). The site of tooth extractions was analyzed by histomorphometry and immunohistochemistry. Bone exposure volume did not significantly differ between pre- and post-HBOT or between test groups and controls.At 7 days, the HBOT group showed amounts of epithelium and root fragment that were significantly less than the control. At 14 days, non-vital bone was significantly less in the HBOT group than in the control. HBOT groups compared to each other showed higher amounts of non-vital bone and less root fragment at 7 days. The HBOT group showed at 7 days lower expression of VEGF, RANKL, BMP-2 and OPG compared to the control, whereas at 14 days, there was no significant difference. Comparing HBOT groups at 7 and 14 days to each other, VEGF and OPG showed significantly higher expression at 14 days, whereas RANKL and BMP-2 did not show any significance.Conclusion: HBOT can reduce the amounts of non-vital bone microscopically detected in tooth extraction sites of rats subjected to bisphosphonate therapy. The effect seems to occur in a dose-dependent mode. Further studies are required to clarify the mechanisms accounting for this effect. / A osteonecrose maxilar associada aos bisfosfonatos (bisphosphonate-related osteonecrosis of the jaw, BRONJ) ? um importante efeito adverso desses f?rmacos. A condi??o exibe elevada morbidade e dif?cil tratamento, sendo que v?rias modalidades terap?uticas t?m sido empregadas, entre as quais se destacam antibioticoterapia, interven??es cir?rgicas e terapias alternativas como a terapia a laser de baixa intensidade, plasma rico em plaquetas e oxigenoterapia hiperb?rica (hyperbaric oxygen therapy, HBOT). Entretanto, n?o existe consenso sobre a efetividade da HBOT no tratamento da BRONJ. O presente estudo teve por objetivo investigar o efeito da HBOT em s?tio de exodontias em ratos sob tratamento com bisfosfonatos. Trinta e cinco ratos Wistar foram tratados com ?cido zoledr?nico, submetidos a exodontias e distribu?dos em grupos de acordo com o regime de HBOT recebido: (1) 7 dias de HBOT; (2) 14 dias de HBOT; (3) sem HBOT (controle de 7 dias); (4) sem HBOT (controle de 14 dias). O s?tio das exodontias foi analisado por meio de histomorfometria e imunoistoqu?mica. O volume de exposi??o ?ssea n?o diferiu significativamente entre os per?odos pr?- e p?s-HBOT, nem entre grupo-teste e controle.Aos 7 dias, o grupo HBOT exibiu propor??o de epit?lio e resto radicular significativamente menor que o controle. Aos 14 dias, a propor??o de osso n?o-vital foi significativamente menor no grupo HBOT que no controle. Quando os grupos-teste foram comparados entre si, foi observada maior propor??o de osso n?o-vital e menor propor??o de resto radicular aos 7 dias. O grupo HBOT exibiu, aos 7 dias, express?o de VEGF, RANKL, BMP-2 e OPG significativamente menor que o controle, enquanto aos 14 dias essa diferen?a n?o foi significativa. Quando os grupos-teste foram comparados entre si, VEGF e OPG exibiram express?o significativamente maior aos 14 dias, enquanto RANKL e BMP-2 n?o exibiram diferen?a significativa.Conclus?o: A HBOT est? associada a menor propor??o de osso n?o-vital detectado microscopicamente em s?tios de exodontias de ratos submetidos a terapia com bisfosfonato. O efeito parece ser dose-dependente e novos estudos s?o necess?rios para esclarecer os mecanismos respons?veis por esse efeito.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/6372 |
| Date | 17 July 2015 |
| Creators | Silva, Miguel Luciano |
| Contributors | Cherubini, Karen |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Odontologia, PUCRS, Brasil, Faculdade de Odontologia |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | -8096554818733665164, 600, 600, 600, 4673435736271820140, -2070498469879244349 |
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