title: Effect of local vs. systemic bisphosphonate delivery on dental implant fixation in a model of osteonecrosis of the jaw.
abstract: Locally applied bisphosphonates may improve the fixation of metal implants in bone. However, systemic bisphosphonate treatment is associated with a risk of osteonecrosis of the jaw (ONJ). We hypothesized that local delivery of bisphosphonate from the implant surface improves the fixation of dental implants without complications in a setting where systemic treatment induces ONJ. Forty rats were randomly allocated to 4 groups of 10. All groups received a titanium implant inserted in an extraction socket. Group I received the implants only. Group II received dexamethasone (0.5 mg/kg). Group III received dexamethasone as above plus alendronate (200 µg/kg). Group IV received zoledronate-coated implants and dexamethasone as above. The animals were sacrificed 2 weeks after tooth extraction. All 10 animals with systemic alendronate treatment developed large ONJ-like changes, while all with local treatment were completely healed. Implant removal torque was higher for the bisphosphonate-coated implants compared with the other groups (p < 0.03 for each comparison). Micro-computed tomography of the maxilla showed more bone loss in the systemic alendronate group compared with groups receiving local treatment (p = 0.001). Local bisphosphonate treatment appears to improve implant fixation in a setting where systemic treatment caused ONJ.
authors.affiliation: Department of Clinical and Experimental Medicine, Faculty of Medicine, Linköping University, Linköping, Sweden. jahan.abtahi@lio.se
authors.forename: J
authors.initials: J
authors.lastname: Abtahi
authors.forename: F
authors.initials: F
authors.lastname: Agholme
authors.forename: O
authors.initials: O
authors.lastname: Sandberg
authors.forename: P
authors.initials: P
authors.lastname: Aspenberg
mesh_terms: D000287:Administration, Topical; D019386:Alendronate / Q000008:administration & dosage / Q000009:adverse effects; D000818:Animals; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D059266:Bisphosphonate-Associated Osteonecrosis of the Jaw / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control; D050071:Bone Density Conservation Agents / Q000008:administration & dosage* / Q000009:adverse effects; D020099:Coated Materials, Biocompatible; D003758:Dental Implantation, Endosseous / Q000379:methods*; D019250:Dental Implants, Single-Tooth; D017268:Dental Prosthesis Retention / Q000295:instrumentation / Q000379:methods*; D003799:Dental Stress Analysis; D003907:Dexamethasone / Q000008:administration & dosage; D004164:Diphosphonates / Q000008:administration & dosage*; D016503:Drug Delivery Systems; D007093:Imidazoles / Q000008:administration & dosage*; D007275:Injections, Intravenous / Q000009:adverse effects; D008297:Male; D008437:Maxilla / Q000000981:diagnostic imaging; D016348:Osseointegration; D051381:Rats; D017207:Rats, Sprague-Dawley; D013499:Surface Properties; D020390:Tooth Socket / Q000601:surgery; D055114:X-Ray Microtomography; D000077211:Zoledronic Acid
chemical_list: D000893:Anti-Inflammatory Agents; D050071:Bone Density Conservation Agents; D020099:Coated Materials, Biocompatible; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid; D003907:Dexamethasone; D019386:Alendronate