Effect of different doses of zoledronic acid in establishing of bisphosphonate-related osteonecrosis

Arch Oral Biol. 2015 Sep;60(9):1237-45. doi: 10.1016/j.archoralbio.2015.05.015. Epub 2015 Jun 6.

Abstract

Objectives: To establish osteonecrosis of the jaws in rats treated with different doses of zoledronic acid (ZA).

Methods: Male Wistar rats (n=6-7) received three consecutive weekly intravenous ZA infusions at doses of 0.04, 0.20 or 1.00mg/kg ZA or saline (control). Four weeks after the last administration, the animals were submitted to simple extraction of the lower left first molar. An additional dose of ZA was administered seven days later, and the animals were sacrificed 28 days after exodontia. Weight was measured and blood was collected weekly for analysis. The jaw was radiographically and microscopically examined along with the liver, spleen, kidney and stomach.

Results: All ZA doses showed a higher radiolucent area than the control (p<0.0001), but the dose of 0.04mg/kg did not show BRONJ. Doses of 0.20 and 1.00mg/kg ZA showed histological evidence of bone necrosis (p=0.0004). Anaemia (p<0.0001, r(2)=0.8073) and leucocytosis (p<0.0001, r(2)=0.9699) are seen with an increase of lymphocytes (p<0.0001, r(2)=0.6431) and neutrophils and monocytes (p=0.0218, r(2)=0.8724) in all the animals treated with an increasing dose of ZA. Haemorrhage and ectasia were observed in the spleen (p=0.0004) and stomach (p=0.0168) in a dose-dependent manner, and the animals treated with ZA showed a lower rate of weight gain (p<0.0001).

Conclusions: We designed a bisphosphonate-related osteonecrosis of the jaw model that reproduces radiographic and histological parameters and mimics clinical alterations such as leucocytosis, anaemia and idiosyncratic inflammatory post infusion reactions.

Keywords: Acute-phase reaction; Anaemia; Bisphosphonate-associated osteonecrosis of the jaw; Leukocytosis; Zoledronic acid.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Bisphosphonate-Associated Osteonecrosis of the Jaw / diagnostic imaging
  • Bisphosphonate-Associated Osteonecrosis of the Jaw / pathology*
  • Bone Density Conservation Agents / administration & dosage
  • Bone Density Conservation Agents / toxicity*
  • Diphosphonates / administration & dosage
  • Diphosphonates / toxicity*
  • Disease Models, Animal
  • Imidazoles / administration & dosage
  • Imidazoles / toxicity*
  • Kidney / drug effects
  • Liver / drug effects
  • Male
  • Radiography
  • Rats
  • Rats, Wistar
  • Spleen / drug effects
  • Stomach / drug effects
  • Zoledronic Acid

Substances

  • Bone Density Conservation Agents
  • Diphosphonates
  • Imidazoles
  • Zoledronic Acid