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Osteoporosis International

, Volume 21, Issue 6, pp 957–967 | Cite as

PTH improves titanium implant fixation more than pamidronate or renutrition in osteopenic rats chronically fed a low protein diet

  • R. Dayer
  • T. C. Brennan
  • R. Rizzoli
  • P. Ammann
Original Article

Abstract

Summary

We evaluated the effects of parathyroid hormone (PTH), pamidronate, or renutrition on osseointegration of titanium implants in the proximal tibia of rats subject to prolonged low-protein diets. PTH improved mechanical fixation, microarchitecture, and increased pull-out strength. Pamidronate or renutrition had lesser effects. PTH can thus improve implant osseointegration in protein-malnourished rats.

Introduction

Protein malnutrition impairs implant osseointegration in rats. PTH and pamidronate prevent deleterious effects of protein restriction introduced just prior to implantation. Whether these treatments improve osseointegration after chronic protein deprivation, i.e., in osteopenic bone at time of implantation, is unknown. We evaluated effects of PTH, pamidronate, or renutrition on resistance to pull-out of titanium rods implanted into the rat tibiae following isocaloric low-protein intake.

Methods

Forty-one adult female rats received normal or isocaloric low-protein diets. Six weeks later, implants were surgically inserted into proximal tibiae. Following implantation, rats on low-protein diets were treated with PTH (1-34), pamidronate, saline vehicle, or normal protein diets, for another 8 weeks. Tibiae were removed for micro-computerised tomographic morphometry and evaluation of pull-out strength.

Results

Pull-out strength decreased in rats on isocaloric low-protein diets compared with normal protein group (−33.4%). PTH increased pull-out strength in low-protein group, even compared to controls from the normal protein group. PTH and pamidronate increased bone volume/tissue volume, bone-to-implant contact, and trabecular thickness, whilst trabecular separation was reduced, with a shift to more plate-like bone surrounding the implants.

Conclusions

PTH reversed the deleterious effects of long-term protein undernutrition on mechanical fixation and bone microarchitecture and improved implant osseointegration more than pamidronate or renutrition, likely through changes to structure model index.

Keywords

Implants Nutrition Pamidronate Parathyroid hormone Rodents 

Notes

Acknowledgements

The authors thank S. Clément for expert animal care, diet preparations, and blood collection; Dr. A. Laib for technical help in using µCT; Dr. M. Cattani, I. Badoud and V. Chatelain for biomechanical testing; and M. Perez for secretarial assistance. This research project was supported by Swiss National Research Foundation (Grant 3200BO-100714).

Conflicts of interest

None.

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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2009

Authors and Affiliations

  • R. Dayer
    • 1
  • T. C. Brennan
    • 1
  • R. Rizzoli
    • 1
  • P. Ammann
    • 1
  1. 1.Division of Bone Diseases (WHO Collaborating Center for Osteoporosis Prevention), Department of Rehabilitation and GeriatricsGeneva University Hospitals and Faculty of MedicineGeneva 14Switzerland

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