Histological, immunohistochemical and radiographic evaluation of Amitriptyline administration on the periodontium of albino rats (An experimental study)

Saudi Dent J. 2022 Sep;34(6):449-457. doi: 10.1016/j.sdentj.2022.06.010. Epub 2022 Jul 4.

Abstract

Background: Amitriptyline is a tricyclic antidepressant drug accustomed to treat depressive disorders. It recorded many side effects on different tissues.

Objective: To investigate reaction of Albino rats' periodontium after oral administration of Amitriptyline histologically and radiographically.

Methods: Fourteen adult male albino rats (150-200 g) were divided into two groups, control and experimental. Rats of experimental group received 10 mg⁄kg⁄day of Amitriptyline hydrochloride by oral gavage for four weeks. Mandibles were prepared for hematoxylin and eosin (H&E) and anti-osteopontin (Anti-OPN) immunohistochemistry staining. Bone mineral density was measured in mandibular alveolar bone. Statistical analysis for Anti-OPN and relative Hounsfield unit value (HU value) was performed using independent-samples t-test.

Results: Gingiva of experimental group showed epithelial degeneration with pyknotic nuclei and disintegration in lamina propria. Areas of separation in alveolar bone and degeneration of some regions in cementum were seen with apparent increase in periodontal ligament (PDL) thickness and its detachment from bone and cementum at some regions. Immunohistochemical examination of experimental group showed apparently increased immunopositivity in gingiva, cementocytes, osteocytes, cementum, bone matrices, fibroblasts and PDL fibers when compared to control group. Statistical analysis revealed insignificant difference of Anti-OPN area% in gingiva between both studied groups. While there was statistical significant increase of Anti-OPN area% in the other periodontium tissues and high statistical significant decrease of relative HU value in experimental group when compared to control.

Conclusions: Amitriptyline has destructive effect on periodontal tissues and statistically increases the expression of Anti-OPN in all periodontal tissues except gingiva and decreases bone mineral density.

Keywords: Amitriptyline; BMD, bone mineral density; CBCT, cone beam computed tomography; Cone beam CT; DVT, dental volumetric tomography; H&E, hematoxylin and eosin; HU value; HU value, Hounsfield unit value; OPN, Osteopontin; Osteopontin; PBS, phosphate buffered saline; PDL, periodontal ligament; Periodontium; SD, standard deviation; SSRIs, selective serotonin reuptake inhibitors; TCAs, tricyclic antidepressants; c.t, connective tissue; p-value, probability value.