Osteoporosis International

, Volume 22, Issue 2, pp 693–702

Compromised osseous healing of dental extraction sites in zoledronic acid-treated dogs

  • M. R. Allen
  • D. J. Kubek
  • D. B. Burr
  • S. L. Ruggiero
  • T.-M. G. Chu
Original Article

DOI: 10.1007/s00198-010-1268-4

Cite this article as:
Allen, M.R., Kubek, D.J., Burr, D.B. et al. Osteoporos Int (2011) 22: 693. doi:10.1007/s00198-010-1268-4

Abstract

Summary

The goal of this study was to document how treatment with high doses of zoledronic acid affects dental extraction healing. Our results, showing significantly compromised osseous healing within the socket as well as presence of exposed bone and development of a sequestrum in one animal, provide a building block toward understanding osteonecrosis of the jaw.

Purpose

The goal of this study was to document how treatment with a bisphosphonate affects the bone tissue following dental extraction.

Methods

Skeletally mature female beagle dogs were either untreated controls (CON) or treated with intravenous zoledronic acid (ZOL). Following the extraction of the fourth premolars, healing was allowed for 4 or 8 weeks. Properties of the extraction site were assessed using microcomputed tomography (micro-CT) and dynamic histomorphometry.

Results

The initial infilling of the extraction socket with bone was not affected by ZOL, but subsequent removal of this bone was significantly suppressed compared to CON. After 8 weeks of healing, the alveolar cortical bone adjacent to the extraction socket had a remodeling rate of ∼50% per year in CON animals while ZOL-treated animals had a rate of <1% per year. One ZOL-treated animal developed exposed bone post-extraction which eventually led to the formation of a sequestrum. Assessment of the sequestrum with micro-CT and histology showed that it had features consistent with those reported in humans with osteonecrosis of the jaw.

Conclusions

These results, showing significantly compromised post-extraction osseous healing as well as presence of exposed bone and development of a sequestrum in one ZOL animal, provide a building block toward understanding the pathophysiology of osteonecrosis of the jaw.

Keywords

BisphosphonateHistomorphometryMandibleOsteonecrosisRemodeling

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2010

Authors and Affiliations

  • M. R. Allen
    • 1
  • D. J. Kubek
    • 1
  • D. B. Burr
    • 1
    • 2
    • 3
  • S. L. Ruggiero
    • 5
    • 6
  • T.-M. G. Chu
    • 3
    • 4
  1. 1.Department of Anatomy and Cell BiologyIndianapolisUSA
  2. 2.Department of Orthopedic SurgeryIndiana University School of MedicineIndianapolisUSA
  3. 3.Department of Biomedical Engineering ProgramIndiana University–Purdue University IndianapolisIndianapolisUSA
  4. 4.Department of Restorative DentistryIndiana University School of DentistryIndianapolisUSA
  5. 5.New York Center for Orthognathic and Maxillary SurgeryLake SuccessUSA
  6. 6.Department of Oral and Maxillofacial Surgery, School of Dental MedicineSUNY at Stony BrookStony BrookUSA