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Morphological and immunohistochemical features of tooth extraction sites in rats treated with alendronate, raloxifene, or strontium ranelate

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Abstract

Objective

The aim of this study was to evaluate morphological and immunohistochemical features of tooth extraction sites in rats subjected to different antiresorptive drugs.

Materials and methods

Wistar rats were allocated into 4 groups according to the treatment: (1) alendronate, (2) raloxifene, (3) strontium ranelate, and (4) control. The animals underwent tooth extraction (60th day of treatment) and afterwards were euthanized (90th day of treatment). Tooth extraction sites were analyzed by means of scanning electron microscopy (SEM), hematoxylin-eosin staining (H&E), and immunohistochemical staining (RANKL and OPG).

Results

On H&E analysis, the alendronate group showed greater amounts of non-vital bone, biofilm, inflammatory infiltrate and root fragment, and smaller amount of vital bone. The strontium ranelate group showed great amount of non-vital bone. This group also had lower levels of OPG, while the alendronate group showed lower OPG and RANKL than the other groups. On SEM analysis, the alendronate group showed a considerable number of microcracks on the alveolar bone surface and few Howship lacunae and lack of bone cells as well. The raloxifene, strontium ranelate, and control groups showed a large number of bone cells and Howship lacunae on the bone surface and few microcracks.

Conclusion

Alendronate therapy is associated with macro- and microscopic features of medication-related osteonecrosis of the jaw at tooth extraction sites, whereas raloxifene therapy is not, and strontium ranelate therapy is associated with non-vital bone.

Clinical relevance

Osteonecrosis of the jaws is a serious side effect of alendronate therapy, where tooth extraction is a major risk factor. Considering the significant number of patients undergoing antiresorptive therapies worldwide, the present study investigated whether raloxifene and strontium ranelate interfere with bone repair after tooth extraction in a similar way to bisphosphonates.

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Acknowledgment

We thank Dr. A. Leyva (USA) for English editing of the manuscript. This work was partially funded by Conselho Nacional de Desenvolvimento Científico e Tecnológico—CNPq, Brazil, code 140962/2016-6.

Funding

This work was partially funded by Conselho Nacional de Desenvolvimento Científico e Tecnológico – CNPq, Brazil, code 140962/2016-6.

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Authors and Affiliations

  1. Post-Graduate Program, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil

    Valesca Sander Koth, Fernanda Gonçalves Salum, Maria Antonia Zancanaro de Figueiredo & Karen Cherubini

  2. Serviço de Estomatologia—Hospital São Lucas, PUCRS, Av. Ipiranga, 6690 Sala 231, Porto Alegre, RS, 90610-000, Brazil

    Valesca Sander Koth, Fernanda Gonçalves Salum, Maria Antonia Zancanaro de Figueiredo & Karen Cherubini

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Valesca Sander Koth declares that she has no conflict of interest. Fernanda Gonçalves Salum declares that she has no conflict of interest. Maria Antonia Zancanaro de Figueiredo declares that she has no conflict of interest. Karen Cherubini declares that she has no conflict of interest.

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This study was approved by the Ethics Committee on Animals Use of the Pontifical Catholic University of Rio Grande do Sul (PUCRS, protocol #7700). All applicable international, national, and institutional guidelines for the care and use of animals were followed.

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Koth, V.S., Salum, F.G., de Figueiredo, M.A.Z. et al. Morphological and immunohistochemical features of tooth extraction sites in rats treated with alendronate, raloxifene, or strontium ranelate. Clin Oral Invest 25, 2705–2716 (2021). https://doi.org/10.1007/s00784-020-03585-x

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