Abstract:

Background: We aimed to investigate the efficacy of teriparatide experimentally on rats after the development of osteonecrosis with bisphosphonate usage. Methods: Rats were divided randomly into four groups: I-Control group II-Zoledronic acid (ZA) III-ZA and teriparatide IV-ZA and antibiotic. Osteonecrosis was generated by injecting zoledronic acid to all groups except control group for 8 weeks. A week after ZA injections, mandibular left molar extraction was performed and bone defect were created in the same regions of all animals. Afterwards, teriparatide was subcutaneously injected to rats in the third group antibiotic was intraperitoneally injected to rats in the fourth group. Animals were sacrificed for the radiological, histological, biochemical and clinical evaluations. Results: Teriparatide therapy has not a statistically significant effect on radiological and biochemical aspects of bone healing (p>0.05). Teriparatide has not a positive effect clinically on bone healing after the development of osteonecrosis. However, application of this drug prevents further deterioration of osteonecrosis period clinically. Moreover, teriparatide has positive effects on soft tissue and bone healing histologically.  Conclusions: Bisphosphonate uptake that followed by tooth extraction has been identified to induce the development of osteonecrosis. On the other hand teriparatide therapy has partially positive effects in the treatment of these lesions. However, further experimental and clinical studies including large groups are required for the determination optimum dose and duration of this treatment modality.   Keywords: Bisphosphonate, osteonecrosis, teriparatide

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