Mucoperiosteal flaps are used to access the bone and root surface in a wide range of periodontal procedures and in implant surgery. We have demonstrated that the mucoperiosteal surgical flap of the rat mandible produces a transient burst of alveolar bone resorption similar to the clinical observations in humans. This resorptive activity, when coupled with local irritation factors, may cause confined alveolar bone loss. Recently, we have demonstrated that an amino bisphosphonate, which is used in preventing systemic bone resorption in osteoporosis and other bone diseases, reduces alveolar bone resorption in the rat model when administered systemically. In this study we evaluated the effect of local delivery of the amino bisphosphonate on bone resorption associated with mucoperiosteal flaps. Following mucoperiosteal flap elevation in the premolar and molar region of the rat mandible, a surgical pellet soaked with amino bisphosphonate was locally applied on the exposed bone surface and covered by flap. The results show that local delivery of amino bisphosphonate reduces significantly alveolar bone resorption activated by mucoperiosteal flap surgery. This study suggests that local application of amino bisphosphonate can be used as an adjunct in therapy for reducing bone resorption following surgery. J Periodontol 1997;68:884–889.

Following elevation of a full thickness flap a transient burst of regional remodeling occurs. This phenomenon is termed in orthopedic surgery as regional accelerated phenomenon (RAP), beginning with accelerated resorption activity followed by a slow process of bone regeneration. Recently we have demonstrated that a mucoperiosteal surgical flap of rat mandible is producing a typical RAP process. Bisphosphonates are synthetic compounds that are taken up preferentially by the skeleton and suppress osteoclast‐mediated bone resorption by a mechanism that is not yet fully understood. Amino bisphosphonate has been shown to inhibit active bone resorption without interfering with bone formation. In this study we evaluated the effect of amino bisphosphonate on bone resorption associated with a mucoperiosteal flap used as a resorptive model. We compared the effect of amino bisphosphonate in rats using IV administration with topical application at 3 dose levels. The results show that topical application of all 3 doses (0.15, 0.75, and 1.5 mg/ml) had no inhibiting effect on bone resorption after surgery, while IV administration at 0.5 mg/kg body weight significantly reduced the bone resorption. Interestingly, in the non‐operated side, amino bisphosphonate increased mineral density. J Periodontol 1995;66:999–1003.

A specific cementum attachment protein (CAP) was identified in human cementum and found to bind with high affinity to non-demineralized root surfaces, hydroxyapatite and fibronectin. Attempting to elucidate the biological function of this protein and its possible role in cementogenesis the capacity of CAP to promote selective cell migration towards and attachment of various periodontal derived cell populations to root surfaces in vitro was assessed. Human gingival fibroblasts (HGF), periodontal ligament cells (HPC), and alveolar bone cells (HABC) were labeled with [3H]Thymidine during their exponential growth phase. Root slices, 300 microns thick, were incubated with increasing concentrations of CAP. Untreated and fibronectin (FN) treated root slices served as negative and positive controls, respectively. Migration was assessed by placing root slices on confluent layers of labeled cells maintained in serum free medium and determining the number of cells migrated onto the root surface 3 days thereafter. Attachment was assessed by incubating root slices with labeled cell suspensions for 2 h and determining the number of attached cells. CAP promoted both cell migration and attachment dose dependently. HABC responded better than HPC and HGF to CAP treated root slices, and HPC response was higher than that of HGF. Cell attachment was dose dependently inhibited by synthetic RGD peptides. FN did not affect the migration of HGF, barely enhanced that of HABC, and was less potent than CAP at enhancing the migration of HPC. FN was more effective than CAP in promoting the attachment of HGF to root slices, but it was as potent as CAP in supporting the attachment of HPC and HABC.(ABSTRACT TRUNCATED AT 250 WORDS)

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