A single dose of zoledronic acid reverses the deleterious effects of glucocorticoids on titanium implant osseointegration

Abstract

Our findings demonstrated that a single dose of ZOL is able to reverse the detrimental effects of glucocorticoids on the osseointegration of titanium implants, suggesting that ZOL therapy may improve the outcome of bone implants in patients with glucocorticoid-induced osteoporosis.

Effects of Chronic Stress and Alendronate Therapy on the Osseointegration of Titanium Implants

“…Although the mechanisms responsible for stress‐induced impairment of wound healing have not yet been totally elucidated, evidence suggests that the most prominent pathway is through activation of the HPA axis . Indeed, in vivo studies showed that the administration of glucocorticoids (GCs) delays soft tissue wound healing and impairs implant osseointegration …”

“…In the field of bone metabolism, many efforts have been made to develop strategies to stabilize the bone loss occasioned by diseases and drugs. In this context, bisphosphonates (BPs) have demonstrated positive effects on bone tissue, improving the osseointegration of implants and preventing bone loss induced by the administration of GC …”

No deleterious effect of low dose methotrexate on titanium implant osseointegration in a rabbit model

“…After trichotomy, the skin was cleansed, an incision of approximately 2 cm was made, and the tibia was exposed by blunt dissection. A unicortical implant bed was prepared and a screw-type, commercially pure titanium implant with a rough surface, 8.5 mm in length and 3.75 mm in diameter (Conexão Sistema de Protese Ltda, 1–2 µm porosity), was placed such that the screw thread was completely perpendicular into the bone cortex 16. Soft tissues were replaced and sutured.…”

“…Briefly, pieces were washed in running water for 24 hours, dehydrated in an ascending series of ethanol (40% to 100%), and subsequently embedded in methyl metacrylate blocks. Sections (80 microns) were obtained and stained with toluidine blue as described previously 16. …”

“…There is only a single case report on the effect of MTX on osseointegration, which describes a successful rehabilitation of a titanium implant in an elderly patient with severe osteoporosis and chronic polyarthritis whose treatment included MTX 13. In contrast, GC, which is an anti-inflammatory drug frequently prescribed in association with MTX for rheumatologic patients, was found to negatively affect osseointegration of titanium implants 14-16. The distinction of the deleterious effect of these drugs on bone metabolism is hampered by their concomitant use with multiple therapies in autoimmune diseases.…”