Periodontite experimental em ratos tratados com dose oncológica de zoledronato: análise da progressão da doença e avaliação da resposta periodontal ao tratamento mecânico convencional
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Data
2017-03-02
Autores
Araujo, Nathália Januario de [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
O objetivo do presente estudo foi avaliar a progressão da periodontite experimental (PE) e a resposta tecidual periodontal frente à raspagem e alisamento radicular (RAR) durante tratamento com dose oncológica de zoledronato. Foram utilizados 100 ratos (6 meses de idade) distribuídos aleatoriamente em 4 grupos experimentais: SAL (n=30), ZOL (n=30), SAL-RAR (n=20) e ZOL-RAR (n=20). O plano de tratamento medicamentoso teve duração de 8 semanas. Os ratos receberam injeções intraperitoneais de 0,45 ml de solução de cloreto de sódio 0,9% (Grupos SAL e SAL-RAR) ou 0,45 ml da mesma solução acrescida de 100 µg/Kg de zoledronato (ZOL e ZOL-RAR) com um intervalo de três dias entre as aplicações. Decorridas duas semanas de tratamento medicamentoso, foi instalada uma ligadura de algodão ao redor do primeiro molar inferior esquerdo. Nos grupos SAL e ZOL essa ligadura permaneceu até o final do experimento. Nos grupos SAL-RAR e ZOL-RAR após outras duas semanas a ligadura foi removida, e foi efetuada a RAR. A eutanásia foi efetuada nos grupos SAL e ZOL aos 14, 21 e 42 dias pós instalação da ligadura e nos grupos SAL-RAR e ZOL-RAR aos 7 e 28 dias pós tratamento local com RAR. Foi executado o processamento histológico das hemi-mandíbulas e os cortes histológicos foram submetidos à coloração pela hematoxilina-eosina (HE). Na região de furca do primeiro molar inferior foram efetuadas: análise histopatológica dos tecidos peridontais e análise histométrica da porcentagem de osso na região de furca (POF) e da porcentagem de osso necrótico na região de furca (PON). Os resultados foram submetidos a análise estatística. O grupo ZOL apresentou uma resposta inflamatória local mais exacerbada, maior POF e maior PON aos 14d, 21d e 42 pós instalação da ligadura em relação ao grupo SAL. Em ZOL-RAR a resposta inflamatória se mostrou mais exacerbada, não houve alteração da POF, e a PON se mostrou maior ao longo do tempo e em relação ao grupo que não recebeu tratamento periodontal. Conclui-se que o tratamento com dose oncológica de zoledronato reduz a perda óssea alveolar induzida pela PE, todavia, aumenta a quantidade de tecido ósseo alveolar necrótico, exacerba e prolonga a resposta inflamatória local, tanto nos sítios sem tratamento periodontal quanto nos sítios submetidos à RAR, ou seja, a doença periodontal e o tratamento mecânico periodontal convencional são importantes fatores de risco local para a ONM-M.
The present study aims to assess the progression of experimental periodontitis (EP) and the periodontal tissue response to scaling and root planing (SRP) during treatment with oncological dose of zoledronate. A total of 100 rats were used (6 months old) randomically distributed into 4 experimental groups: SAL (n=30), ZOL (n=30), SALSRP (n=20) e ZOL-SRP (n=20). Drug treatment plan lasted for 8 weeks. Intraperitoneal injections of 0,45 ml of sodium chloride solution 0,9% (Groups SAL and SAL-SRP) or 0,45 ml of the same solution adding 100 µg/Kg of zoledronate (ZOL and ZOL-SRP) were given to the rats within intervals of three days between injections. A cotton ligature was installed around the first left lower molar after two weeks of medicative treatment. At SAL and ZOL groups such ligature endured until the end of the experiment. At the groups SAL-SRP and ZOL-SRP ligature was removed two more weeks later and SRP was executed. Euthanasia was done at the groups SAL and ZOL after 14, 21 and 42 days from the ligature installation and at the groups SAL-SRP and ZOL-SRP after 7 and 28 days after local treatment with SRP. Hemimandibula was histological processing and executed and histological sections went under Hematoxylin and eosin staining (HE). At the furcal region of the first lower molar were executed: histopathological analysis of periodontal tissues and histometric analysis of bone percentage at the furcal region (BPF) and necrotic bone percentage at the furcal region (NPF). Results went under statistical analysis. ZOL group presented increased local inflammatory response, higther BPF and higher NPF at days 14, 21 and 42 after ligature installation in relation to SAL group. At ZOL-SRP, inflammatory response was increased, there was no BFP alteration, and NPF was higher throughout time in comparison to the group that had not received periodontal treatment. It can be concluded that treatment with oncological dose of zoledronate decreases alveolar bone loss induced by EP, on the other hand, it increases the amount of alveolar necrotic bone tissue, increases and extends local inflammatory response, either at sites with no periodontal treatment or the ones that went under SRP, in other words, periodontal disease and conventional mechanical periodontal treatment are important local risk factor for medication-related osteonecrosis of the jaw (MRONJ).
The present study aims to assess the progression of experimental periodontitis (EP) and the periodontal tissue response to scaling and root planing (SRP) during treatment with oncological dose of zoledronate. A total of 100 rats were used (6 months old) randomically distributed into 4 experimental groups: SAL (n=30), ZOL (n=30), SALSRP (n=20) e ZOL-SRP (n=20). Drug treatment plan lasted for 8 weeks. Intraperitoneal injections of 0,45 ml of sodium chloride solution 0,9% (Groups SAL and SAL-SRP) or 0,45 ml of the same solution adding 100 µg/Kg of zoledronate (ZOL and ZOL-SRP) were given to the rats within intervals of three days between injections. A cotton ligature was installed around the first left lower molar after two weeks of medicative treatment. At SAL and ZOL groups such ligature endured until the end of the experiment. At the groups SAL-SRP and ZOL-SRP ligature was removed two more weeks later and SRP was executed. Euthanasia was done at the groups SAL and ZOL after 14, 21 and 42 days from the ligature installation and at the groups SAL-SRP and ZOL-SRP after 7 and 28 days after local treatment with SRP. Hemimandibula was histological processing and executed and histological sections went under Hematoxylin and eosin staining (HE). At the furcal region of the first lower molar were executed: histopathological analysis of periodontal tissues and histometric analysis of bone percentage at the furcal region (BPF) and necrotic bone percentage at the furcal region (NPF). Results went under statistical analysis. ZOL group presented increased local inflammatory response, higther BPF and higher NPF at days 14, 21 and 42 after ligature installation in relation to SAL group. At ZOL-SRP, inflammatory response was increased, there was no BFP alteration, and NPF was higher throughout time in comparison to the group that had not received periodontal treatment. It can be concluded that treatment with oncological dose of zoledronate decreases alveolar bone loss induced by EP, on the other hand, it increases the amount of alveolar necrotic bone tissue, increases and extends local inflammatory response, either at sites with no periodontal treatment or the ones that went under SRP, in other words, periodontal disease and conventional mechanical periodontal treatment are important local risk factor for medication-related osteonecrosis of the jaw (MRONJ).
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Palavras-chave
Osteonecrose, Bifosfonatos, Ratos wistar, Raspagem subgengival