Local Single-Dose Teriparatide Administration for Bronj Prevention: Insights From a Rat Model Study Publisher



Etemadi Sh M¹ ; Teimoori F² ; Sehat M³ ; Razavi SM⁴ ; Tajmiri G³
Source: Journal of Maxillofacial and Oral Surgery Published:2024

Abstract

Background: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) presents significant clinical challenges with uncertain treatment outcomes. Teriparatide, a fragment of human parathyroid hormone, shows potential in prevention strategies for BRONJ. Objective: This study investigates the impact of a single local dose of teriparatide on BRONJ prevention in an animal model. Methods: BRONJ was induced on 26 male Wistar rats via intraperitoneal injections of 0.06 mg/kg Zoledronic acid weekly for four weeks. Following tooth extraction under general anesthesia, rats were divided into two groups: one received teriparatide via Gelatamp in the tooth socket and the other as a local injection in the vestibule. Control groups received the treatment without teriparatide. Histopathological assessments for bone remodeling, osteoclast number, inflammation, angiogenesis, and necrosis were performed after four weeks. Results: Histopathological analysis indicated a significant improvement in bone remodeling and new bone formation in both treatment groups compared to controls, with notably better outcomes in the injection group (p = 0.01). Necrosis in the Gelatamp group was significantly higher in the control group than in the treatment group (p = 0.01), and bone formation was significantly higher in the injection group compared to the Gelatamp group (p = 0.03). Conclusion: Local administration of teriparatide significantly enhances bone remodeling and reduces necrosis, suggesting a potential role in the prevention of BRONJ. These findings support further clinical investigation into teriparatide as a preventive strategy against BRONJ. © The Association of Oral and Maxillofacial Surgeons of India 2024.