title: Influence of local administration of pamidronate on extraction socket healing--a histomorphometric proof-of-principle pre-clinical in vivo evaluation.
abstract: OBJECTIVE
  To evaluate the influence of local administration of pamidronate histomorphometrically, adsorbed on a collagenated porcine bone substitute, on extraction socket healing.
  
  
  METHODS
  Two American Fox-hound dogs were used within this proof-of-principle study. Following endodontic treatment of the distal root of the three lower premolars, the teeth were hemisected, and the mesial roots were extracted flapless. The sockets were then loosely filled, in a split-mouth fashion, with a collagenated porcine bone substitute (Osteobiol Gen-Os; CPB), rehydrated either with 90 mg/ml pamidronate (Aredia(®) ; test) or with sterile saline (control). Extraction sockets were sealed with connective tissue punches obtained from the palate and secured with sutures. After 4 months of healing, specimens containing the socket sites and remaining roots were retrieved and histomorphometrically examined.
  
  
  RESULTS
  Histological evaluation of the sections revealed substantial differences in healing patterns. Control sites presented with various amounts of newly formed bone and no evidence of CPB inside the socket; in contrast, limited amounts of bone were observed at test sites, which were filled with CPB mainly embedded in connective tissue. Only minor differences were observed between test and control sites regarding vertical bone loss (buccal bone: -1.01 mm vs. -1.15 mm; lingual bone: -0.92 mm vs. -1.15 mm). Horizontal bone loss was nearly three times higher in control sites comparing to sites treated with pamidronate (-2.19 ± 1.81 mm vs. -0.80 ± 0.91 mm) at a level corresponding to 3 mm below the cemento-enamel junction (CEJ).
  
  
  CONCLUSIONS
  Local administration of pamidronate adsorbed on a collagenated porcine bone substitute in particulate form appeared to delay extraction socket healing, but may also reduce post-extraction dimensional changes in terms of horizontal bone width. Additionally, pamidronate appears to obstruct resorption of the porcine bone substitute.
authors.affiliation: Department of Periodontology, University Witten/Herdecke, Witten, Germany.|Periodontology Unit, UCL Eastman Dental Institute, London, UK.
authors.forename: Kai R
authors.initials: KR
authors.lastname: Fischer
authors.affiliation: Department of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden.
authors.forename: Andreas
authors.initials: A
authors.lastname: Stavropoulos
authors.affiliation: Department of Implant Dentistry, Faculty of Medicine and Dentistry, University of Murcia, Murcia, Spain.
authors.forename: José-Luis
authors.initials: JL
authors.lastname: Calvo-Guirado
authors.affiliation: Clinic for Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland.
authors.forename: David
authors.initials: D
authors.lastname: Schneider
authors.affiliation: Department of Periodontology, Julius-Maximilians-University Wuerzburg, Wuerzburg, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Fickl
mesh_terms: D000287:Administration, Topical; D000818:Animals; D001699:Biometry; D050071:Bone Density Conservation Agents / Q000008:administration & dosage*; D016025:Bone Transplantation / Q000379:methods*; D004164:Diphosphonates / Q000008:administration & dosage*; D004285:Dogs; D006651:Histocytochemistry; D000077268:Pamidronate; D014081:Tooth Extraction; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D000077268:Pamidronate
keywords: bisphosphonate; bone substitute; extraction sockets; histology; ridge alterations