Local alendronate increases fixation of implants inserted with bone compaction: 12‐week canine study

Abstract

Bone compaction has been shown to increase initial implant fixation. Furthermore, bone compaction creates a peri-implant zone of autograft that exerts osteoconductive properties. We have previously shown that locally applied bisphosphonate (alendronate) at 4-week observation can preserve the autograft generated by bone compaction. We now investigate whether the increased amount of autograft, seen at 4 weeks, can increase implant osseointegration and biomechanical fixation. Porous-coated titanium implants were bilaterally inserted with bone compaction into the proximal part of tibia of 10 dogs. On the right side, local bisphosphonate was injected into the bone cavity prior to bone compaction immediately prior to implant insertion. On the left side, saline was used as control. Observation period was 12 weeks. Locally applied bisphosphonate significantly increased biomechanical implant fixation (approximately twofold), bone-to-implant contact (1.2-fold), and peri-implant bone volume fraction (2.3-fold). This study indicates that local alendronate treatment can increase early implant osseointegration and biomechanical fixation of implants inserted by use of bone compaction. Long term effects remain unknown. ß

The Effect of Soaking Allograft in Bisphosphonate: A Pilot Dose-response Study

“…We observed an enhancing effect on new bone formation with our low dose of zoledronate but an inhibitory effect with our high dose of zoledronate. This is in accordance with other studies in which an increase in biomechanical fixation correlated to an increase in amount of bone [7,15,16]. However, an increase in bone volume fraction resulting from preservation of allograft with a high dose of zoledronate did not correlate with an increase in biomechanical fixation.…”

“…One explanation for this augmenting effect could be the preserving effect of zoledronate on the allograft, thus prolonging its osteoconductive effect and thereby increasing new bone formation. This has been observed in other studies [2,3,15,16]. The amount of new bone in the low-dose group was similar in magnitude as reported by others [3].…”

Hydroxyapatite, polycaprolactone and alendronate composites for bone regeneration in rabbits' olecranon: histological features

“…In some reported cases, periosteal reaction was observed, but it was probably related to bone callus resulting from small fracture regeneration (Somford et al, 2009). The local administration of ALN, however, can cause bone compaction that can be exploited in the prior preparation of areas that will receive the implant fixation (Jakobsen et al, 2007). The mechanism and clinical significance of periosteal reaction seen in the context of this work needs to be further investigated.…”

Effects of local alendronate administration on bone defect healing. Histomorphometric and radiological evaluation in a rabbit model

“…In their study on tibial implants, Jakobsen et al 20,21 used alendronate solution with local administration, and determined the optimal concentration to be 2 mg/mL. For the repair of skull defects in rats, Toker et al 19 used alendronate solution at the concentration of 1 mg/mL.…”