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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Molecular and Cellular Oncology
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1348118

Mitigating Jaw Osteonecrosis: Bioactive Glass and Pericardial Membrane Combination in a Rat Model

Provisionally accepted
Alexandre A. Pellicano Alexandre A. Pellicano 1Bernar M. Benites Bernar M. Benites 1Amanda F. Paschoa Amanda F. Paschoa 1Laura C. Oliveira Laura C. Oliveira 2Ana Carolina Pinheiro Campos Ana Carolina Pinheiro Campos 1Daniel O. Martins Daniel O. Martins 1Caroline C. Real Caroline C. Real 2Daniele De Paula Faria Daniele De Paula Faria 2Felipe P. Fonseca Felipe P. Fonseca 3Raquel C. Martinez Raquel C. Martinez 1Rosana L. Pagano Rosana L. Pagano 1Eduardo R. Fregnani Eduardo R. Fregnani 4*
  • 1 Laboratory of Neuroscience, Hospital Sírio-Libanês, Rua Daher Cutait, 69, São Paulo, SP, 01308-060, Brazil., São Paulo, Brazil
  • 2 Department of Radiology and Oncology, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 455, São Paulo, SP, 01246-903, Brazil., São Paulo, Brazil
  • 3 Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Belo Horizonte, MG, 31270-901, Brazil., Belo Horizonte, Brazil
  • 4 Instituto Sírio-Libanês de Ensino e Pesquisa (IEP), SAO PAULO, Brazil

The final, formatted version of the article will be published soon.

    Objectives: Bisphosphonates (BFs) show clinical effectiveness in managing osteoporosis and bone metastases but pose risks of bisphosphonate-related jaw osteonecrosis (BRONJ). With no established gold standard for BRONJ treatment, our focus is on symptom severity reduction. We aimed to assess the preventive effects of bioactive glass and/or pericardial membrane in a preclinical BRONJ model, evaluating their potential to prevent osteonecrosis and bone loss posttooth extractions in zoledronic acid (ZA)-treated animals.Methods: Rats, receiving ZA or saline biweekly for four weeks, underwent 1st and 2nd lower left molar extractions. Pericardial membrane alone or with F18 bioglass was applied post-extractions. Microarchitecture analysis and bone loss assessment utilized computerized microtomography (CT) and positron emission tomography (PET) with 18F-FDG and 18F-NaF tracers. Histological analysis evaluated bone injury. Results: Exclusive alveolar bone loss occurred post-extraction in the continuous ZA group, inducing osteonecrosis, osteolysis, osteomyelitis, and abscess formation. Concurrent pericardial membrane with F18 bioglass application prevented these outcomes. Baseline PET/CT scans showed no discernible uptake differences, but post-extraction 18F-FDG tracer imaging revealed heightened glucose metabolism at the extraction site in the ZA-treated group with membrane, contrasting the control group. Conclusion: These findings suggest pericardial membrane with F18 bioglass effectively prevents BRONJ in the preclinical model. Translational Potential of this Article: The imperative for novel therapeutic strategies aimed at facilitating alveolar bone repair remains paramount in the prevention of BRONJ subsequent to tooth extraction. Our investigation underscores that the combination of pericardial membrane and bioglass exhibits promising translational potential in the prevention of BRONJ.

    Keywords: Bisphosphonate-related osteonecrosis of the jaw, Zoledronic Acid, computed tomography, PET image, rat

    Received: 01 Dec 2023; Accepted: 17 Apr 2024.

    Copyright: © 2024 Pellicano, Benites, Paschoa, Oliveira, Pinheiro Campos, Martins, Real, De Paula Faria, Fonseca, Martinez, Pagano and Fregnani. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Eduardo R. Fregnani, Instituto Sírio-Libanês de Ensino e Pesquisa (IEP), SAO PAULO, Brazil

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.