Local Single-Dose Teriparatide Administration for BRONJ Prevention: Insights from a Rat Model Study

Milad Etemadi Sh; Farshad Teimoori; MohammadSoroush Sehat; Seyed Mohammad Razavi; Golnaz Tajmiri

doi:10.1007/s12663-024-02301-6

Local Single-Dose Teriparatide Administration for BRONJ Prevention: Insights from a Rat Model Study

J Maxillofac Oral Surg. 2024 Dec;23(6):1500-1507. doi: 10.1007/s12663-024-02301-6. Epub 2024 Sep 5.

Authors

Milad Etemadi Sh^#¹, Farshad Teimoori^#², MohammadSoroush Sehat³, Seyed Mohammad Razavi⁴, Golnaz Tajmiri³

Affiliations

¹ Department of Oral and Maxillofacial Surgery, Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
² Department of Oral and Maxillofacial Surgery, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran.
³ Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Hezar Jerib Avenue, Isfahan, Iran.
⁴ Department of Oral and Maxillofacial Pathology, Dental Implant Research Center, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.

^# Contributed equally.

Abstract

Background: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) presents significant clinical challenges with uncertain treatment outcomes. Teriparatide, a fragment of human parathyroid hormone, shows potential in prevention strategies for BRONJ.

Objective: This study investigates the impact of a single local dose of teriparatide on BRONJ prevention in an animal model.

Methods: BRONJ was induced on 26 male Wistar rats via intraperitoneal injections of 0.06 mg/kg Zoledronic acid weekly for four weeks. Following tooth extraction under general anesthesia, rats were divided into two groups: one received teriparatide via Gelatamp in the tooth socket and the other as a local injection in the vestibule. Control groups received the treatment without teriparatide. Histopathological assessments for bone remodeling, osteoclast number, inflammation, angiogenesis, and necrosis were performed after four weeks.

Results: Histopathological analysis indicated a significant improvement in bone remodeling and new bone formation in both treatment groups compared to controls, with notably better outcomes in the injection group (p = 0.01). Necrosis in the Gelatamp group was significantly higher in the control group than in the treatment group (p = 0.01), and bone formation was significantly higher in the injection group compared to the Gelatamp group (p = 0.03).

Conclusion: Local administration of teriparatide significantly enhances bone remodeling and reduces necrosis, suggesting a potential role in the prevention of BRONJ. These findings support further clinical investigation into teriparatide as a preventive strategy against BRONJ.

Keywords: Bisphosphonate-associated osteonecrosis of the jaw; Local administration; Single dose; Teriparatide.

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