沙利度胺,颌骨坏死 z-bo 2020-11-11 373

　　Objective: To study the effect of thalidomide on bisphosphonate-related osteonecrosis of the jaw.

　　Method: 36 rats were randomly divided into groups A, B, and C, and received treatment with saline, zoledronic acid, zoledronic acid + thalidomide, respectively. After 3 weeks of treatment, the first molar of the left upper jaw of the rat was extracted. Four or eight weeks after tooth extraction, specimens were harvested to evaluate jaw osteonecrosis, microangiogenesis and cell apoptosis.

　　Results: 4 and 8 weeks after tooth extraction, no dead bones were exposed at the maxillary extraction wounds in rats, but some small fistulas were seen in some specimens of groups B and C. Histological examination showed that there was no dead bone in the specimens of group A, while small pieces of dead bone were seen around the extraction socket in groups B and C. The percentage of empty bone lacuna and the area of dead bone around the extraction socket of group B and C were significantly higher than that of group A (P<0.01), while the density of bone lacuna was significantly decreased. The microvessel density of group B and group C was also significantly lower than that of group A, which decreased by 25.87% and 55.27% at 4 weeks (P<0.01), and by 45.62% and 72.84% at 8 weeks (P<0.01) The number of apoptotic cells increased by 54.80% and 87.89% (P<0.01) at 4 weeks, and increased by 208.08% and 250.58% at 8 weeks (P<0.01).

　　Conclusion: Thalidomide aggravates the early stage osteonecrosis of the jaw induced by zoledronic acid; the effect of thalidomide and zoledronic acid on the osteonecrosis of the jaw is related to the inhibition of microangiogenesis.