Avaliação do cálcio, fósforo, paratormônio e fosfatase alcalina séricos em ratos sob efeito de medicamentos antirreabsortivos e exodontia

Abstract

Medication-related osteonecrosis of the jaw (MRONJ) is a severe and debilitating bone pathology whose etiopathogenesis is not fully understood, and there is still no effective standard treatment for the condition. Since the first reports, in 2003, a possible correlation between serum parameters of bone metabolism and the development of MRONJ has been investigated. However, the findings are contrasting and there is still no consensus in the scientific community regarding such an association. The aim of this study is to measure the bone serum parameters of calcium, phosphorus, parathormone (PTH) and alkaline phosphatase (AP) of 36 male Wistar rats at risk stage for MRONJ. For this reason, the animals received applications of anti- resorptive drugs: alendronate (AL), 1 mg/Kg; zoledronic acid (ZL), 0.06 mg/Kg; denosumab (Dmab), 0.25 mg/Kg. After the treatments, the animals underwent extraction of the healthy lower right molar. After 28 days of the extraction, euthanasia was performed by total exsanguination and simultaneous blood samples were obtained for biochemical evaluation of calcium, phosphorus, PTH and AP. Administration of AL or ZL was found to reduce serum calcium concentration (P ˃ 0.05), whereas administration of Dmab increased it (P ˃ 0.05). In the three medications studied, there was a decline in phosphorus concentration, which was significant only in animals that received ZL (P < 0.05). No variations in PTH concentration were observed in any of the three treatments. Serum AP activity increased with Dmab treatment (P ˃ 0.05) and decreased with AL or ZL administration (P ˃ 0.05). Knowing the behavior of bone serum parameters is essential to deepen the understanding of the etiopathogenesis of MRONJ. Serum parameters may be useful in future research on preoperative preventive strategies in patients at risk who need to undergo oral surgical interventions.