title: Distinctive tooth-extraction socket healing: bisphosphonate versus parathyroid hormone therapy.
abstract: BACKGROUND
  Patients with osteoporosis who receive tooth extractions are typically on either oral bisphosphonate or parathyroid hormone (PTH) therapy. Currently, the consequence of these therapies on hard- and soft-tissue healing in the oral cavity is not clearly defined. The aim of this study is to determine the differences in the therapeutic effect on tooth-extraction wound healing between bisphosphonate and PTH therapies.
  
  
  METHODS
  Maxillary second molars were extracted in Sprague Dawley rats (n = 30), and either bisphosphonate (zoledronate [Zol]), PTH, or saline (vehicle control [VC]) was administered for 10 days (n = 10 per group). Hard-tissue healing was evaluated by microcomputed tomography and histomorphometric analyses. Collagen, blood vessels, inflammatory cell infiltration, and cathepsin K expression were assessed in soft tissue using immunohistochemistry, quantitative polymerase chain reaction, and immunoblotting.
  
  
  RESULTS
  Both therapies significantly increased bone fill and suppressed vertical bone loss. However, considerably more devital bone was observed in the sockets of rats on Zol versus VC. Although Zol increased the numbers of blood vessels, the total blood vessel area in soft tissue was significantly smaller than in VC. PTH therapy increased osteoblastic bone formation and suppressed osteoclasts. PTH therapy promoted soft-tissue maturation by suppressing inflammation and stimulating collagen deposition.
  
  
  CONCLUSIONS
  Zoledronate therapy deters whereas PTH therapy promotes hard- and soft-tissue healing in the oral cavity, and both therapies prevent vertical bone loss.
authors.affiliation: Department of Biologic and Materials Sciences, University of Michigan School of Dentistry, Ann Arbor, MI.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Kuroshima
authors.forename: Rodan B
authors.initials: RB
authors.lastname: Mecano
authors.forename: Ryuichiro
authors.initials: R
authors.lastname: Tanoue
authors.forename: Kiyono
authors.initials: K
authors.lastname: Koi
authors.forename: Junro
authors.initials: J
authors.lastname: Yamashita
mesh_terms: D000818:Animals; D001808:Blood Vessels / Q000187:drug effects; D015153:Blotting, Western; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D002118:Calcium / Q000097:blood; D056657:Cathepsin K / Q000187:drug effects; D003094:Collagen / Q000187:drug effects; D004164:Diphosphonates / Q000627:therapeutic use*; D007093:Imidazoles / Q000627:therapeutic use; D007150:Immunohistochemistry; D008437:Maxilla / Q000187:drug effects; D010006:Osteoblasts / Q000187:drug effects; D010010:Osteoclasts / Q000187:drug effects; D010012:Osteogenesis / Q000187:drug effects; D010281:Parathyroid Hormone / Q000627:therapeutic use*; D016133:Polymerase Chain Reaction; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D014081:Tooth Extraction; D020390:Tooth Socket / Q000187:drug effects* / Q000473:pathology; D014945:Wound Healing / Q000187:drug effects; D055114:X-Ray Microtomography / Q000379:methods; D000077211:Zoledronic Acid
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D010281:Parathyroid Hormone; D000077211:Zoledronic Acid; D003094:Collagen; D056657:Cathepsin K; C534133:Ctsk protein, rat; D002118:Calcium