백서에서 발치후 비스포스포네이트 관련 악골 괴사를 예방하기 위한 탄산수소나트륨의 효과

Abstract

I. Objective Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is defined as the presence of exposed bone in the jaw that does not heal more than 8 weeks in patients who has been bisposphonates (BPs) treatment history and who has not undergone radiation therapy in the head and neck region. Osteonecrosis associated with bisphosphonates is developed in the jaw highly more than another bone, the treatment of BRONJ is very difficult. Therefore, it is necessary to focus on the prevention of BRONJ to reduce its incidence rate. The purpose of this study was to evaluate the healing effect of sodium bicarbonate on extraction sockets after injection of zoledronic acid in rats.

II. Materials and methods A total of 10 female Sprague-Dawley rats were intramuscularly injected with the zoledronic acid of 0.1mg/kg, 3 times a week for 8 weeks. Then, the maxillary first molars on both sides were extracted. The left extraction site was covered using collagen sponge with sodium bicarbonate, and the right extraction site was left without any other treatment. The rats were euthanized after 8 weeks, and the extraction sockets were examined by clinical, radiological, and histological evaluation.

III. Results Normal healing of the extraction socket was observed from the experimental group (left side) treated with sodium bicarbonate while the bone exposure was observed from the control group (right side). Histological findings for the control group showed loss of continuity of the epithelium above the extraction socket. Although new bone was formed in some parts, as the bone was exposed. Control group showed delayed healing of tooth extraction socket compared to the experimental group.

IV. Conclusion Sodium bicarbonate showed the possibility of a positive effect on wound healing to prevent BRONJ. Further studies are needed for sufficient experimental data before applied to patients.