Publication date: Available online 11 October 2018
Source: Journal of Oral and Maxillofacial Surgery
Author(s): Farzin Sarkarat, Alireza Modarresi, Nasim Chiniforush, Lilia Yazdanparast, Vahid Rakhshan
Abstract
Introduction
Except few case reports, there is no study on the efficacy of photodynamic therapy (PDT) in reducing or preventing bisphosphonate-related osteonecrosis of the jaws (BRONJ). This preliminary animal study assessed the effectiveness of this clinical treatment.
Methods
Zoledronic acid was administered to 20 rats for 5 weeks. Two weeks later, a first molar was extracted from each rat. The rats were randomized into control and PDT groups. PDT was performed in the experimental group following the surgery and at the weeks 1, 2, 3, 4, 5, 6, and 7 post-surgery. In the 8th week, BRONJ signs were evaluated by an observer blinded to the randomization. Rats were euthanized and underwent histopathologic and histomorphometric evaluation. Clinical signs were compared using Fisher test. Histomorphometric parameters were compared using Mann-Whitney U test (α=0.05).
Results
Two rats were lost from each group. Bone exposure was reduced from seven rats in the control to one in the PDT (P=0.010). The stage of BRONJ reduced significantly from seven stage-1 rats to only one stage-1 rat (P=0.010). PDT reduced inflammation considerably in terms of gingival eosinophils and lymphocytes and bone neutrophils, eosinophils, and lymphocytes. A higher percentage of live bone and a lower percentage of necrotic bone, empty lacunae, and neovascularization were observed in the PDT group. PDT also maintained bone remodeling, indicated by a high number of osteoclasts (all Mann-Whitney P values≤0.001).
Conclusions
Within the limitation of this preliminary animal study, PDT was found to be considerably effective clinically and histopathologically in reducing or preventing BRONJ in rats. Future human studies are needed to verify our results.
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