Teriparatide and the treatment of bisphosphonate-related osteonecrosis of the jaw: a rat model

Dentomaxillofac Radiol. 2014;43(1):20130144. doi: 10.1259/dmfr.20130144. Epub 2013 Oct 29.

Abstract

Objectives: The objectives of this study were to establish a bisphosphonate-related osteonecrosis of the jaw (BRONJ) rat model and to analyse the effects of teriparatide (TP) on this model.

Methods: Sprague-Dawley rats were divided into three groups: I-zoledronic acid (ZA, n = 10); II-ZA and teriparatide (ZA + TP, n = 10); III-control (n = 10). Osteonecrosis was induced by administering zoledronic acid to groups ZA and ZA + TP. A week after the injections, rats underwent extraction of the first left mandibular molar. Following a four week period, TP was administered to the ZA + TP group for 28 days. Upon killing, extraction sockets were examined clinically, radiologically and histopathologically.

Results: Clinical examination revealed necrotic bone exposure in none of the animals. MicroCT (µCT) examination showed that bone mineral density of the newly formed bone in the extraction socket was lower in the ZA group than in the ZA + TP group (p < 0.05). Histopathological examination revealed that only the ZA and ZA + TP groups developed osteonecrosis, and the osteonecrotic bone area in the ZA group was larger than that in the ZA + TP group (p < 0.05). Tartrate-resistant acid phosphatase (TRAcP) enzyme histochemistry revealed that the number of detached and large osteoclasts were higher in the ZA group than in other groups, whereas the number of apoptotic osteoclasts in both ZA and ZA + TP groups were higher than in the control group (p < 0.05).

Conclusions: Our data indicate that bisphosphonate-related osteonecrosis of the jaw model used in the present study is an attractive model to investigate treatment modalities and that TP might be an effective treatment in BRONJ.

Keywords: Microcomputed tomography; bisphosphonate-associated osteonecrosis of the jaw; tartrate-resistant acid phosphatase; teriparatide; zoledronic acid.

Publication types

  • Comparative Study

MeSH terms

  • Acid Phosphatase / analysis
  • Alveolar Process / drug effects
  • Alveolar Process / pathology
  • Animals
  • Apoptosis / drug effects
  • Biomarkers / analysis
  • Bisphosphonate-Associated Osteonecrosis of the Jaw / pathology
  • Bisphosphonate-Associated Osteonecrosis of the Jaw / prevention & control*
  • Bone Density / drug effects
  • Bone Density Conservation Agents / administration & dosage
  • Bone Density Conservation Agents / adverse effects
  • Bone Density Conservation Agents / therapeutic use*
  • Bone Marrow / drug effects
  • Bone Marrow / pathology
  • Cell Adhesion / drug effects
  • Cell Count
  • Diphosphonates / administration & dosage
  • Diphosphonates / adverse effects
  • Diphosphonates / therapeutic use
  • Disease Models, Animal
  • Female
  • Imidazoles / administration & dosage
  • Imidazoles / adverse effects
  • Imidazoles / therapeutic use
  • Injections, Intraperitoneal
  • Injections, Subcutaneous
  • Isoenzymes / analysis
  • Molar / surgery
  • Osteoclasts / drug effects
  • Osteoclasts / pathology
  • Osteogenesis / drug effects
  • Random Allocation
  • Rats
  • Rats, Sprague-Dawley
  • Tartrate-Resistant Acid Phosphatase
  • Teriparatide / administration & dosage
  • Teriparatide / therapeutic use*
  • Tooth Extraction
  • Tooth Socket / drug effects
  • Tooth Socket / pathology
  • X-Ray Microtomography
  • Zoledronic Acid

Substances

  • Biomarkers
  • Bone Density Conservation Agents
  • Diphosphonates
  • Imidazoles
  • Isoenzymes
  • Teriparatide
  • Zoledronic Acid
  • Acid Phosphatase
  • Tartrate-Resistant Acid Phosphatase