Role of Periapical Diseases in Medication-Related Osteonecrosis of the Jaws

Biomed Res Int. 2017:2017:1560175. doi: 10.1155/2017/1560175. Epub 2017 Oct 4.

Abstract

Objective: The present study aimed to investigate the role of periapical diseases in inducing medication-related osteonecrosis of the jaws (MRONJ) using an ovariectomized (OVX) mice model.

Materials and methods: Twenty C57BL/6N female mice were randomly assigned to two groups. All mice were subjected to bilateral ovariectomy and then treated with oncologic dose of zoledronic acid (ZA) or vehicle for twelve weeks. Eight weeks after commence of drug administration, a pulpal exposure (PE) operation was performed on the first right lower molar to induce periapical periodontitis; the contralateral non-PE tooth was used as control. All animals were sacrificed four weeks after pulpal exposure, and the mandibles were harvested for radiological and histomorphometrical analysis.

Results: Micro computed tomography (μ-CT) examination demonstrated that periapical diseases significantly increased alveolar bone resorption, and the resorption was greatly attenuated by ZA treatment. Concurrent ZA therapy significantly increased bone density and histological osteocyte necrosis in the presence of periapical lesions.

Conclusion: ZA treatment reduced bone absorption resulting from periapical disease but increased the risk of developing MRONJ in the ovariectomized mouse model.

MeSH terms

  • Alveolar Bone Loss / drug therapy
  • Alveolar Bone Loss / physiopathology
  • Animals
  • Bone Density / drug effects
  • Bone Density Conservation Agents / administration & dosage
  • Diphosphonates / administration & dosage*
  • Disease Models, Animal
  • Humans
  • Imidazoles / administration & dosage*
  • Jaw / drug effects
  • Jaw / physiopathology
  • Mandible / drug effects
  • Mandible / physiopathology
  • Mice
  • Molar / drug effects
  • Molar / physiopathology
  • Molar / surgery
  • Necrosis / physiopathology*
  • Osteocytes / drug effects
  • Osteonecrosis / chemically induced
  • Osteonecrosis / drug therapy*
  • Osteonecrosis / physiopathology
  • Periapical Diseases / drug therapy*
  • Periapical Diseases / physiopathology
  • Tomography, X-Ray Computed
  • Zoledronic Acid

Substances

  • Bone Density Conservation Agents
  • Diphosphonates
  • Imidazoles
  • Zoledronic Acid