Influência do diabetes e da corticoterapia no desenvolvimento da osteonecrose maxilar associada ao uso de alendronato de sódio

• Ano de defesa: 2011
• Autor(a) principal: Couto, Soraya de Azambuja Berti
• Orientador(a): Cherubini, Karen
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Pontifícia Universidade Católica do Rio Grande do Sul
• Programa de Pós-Graduação: Programa de Pós-Graduação em Odontologia
• Departamento: Faculdade de Odontologia
• País: BR
• Palavras-chave em Português: ODONTOLOGIA: DIABETES MELLITUS: OSSOS - NECROSE: RATOS - EXPERIÊNCIAS: MAXILARES
• Área do conhecimento CNPq: CNPQ::CIENCIAS DA SAUDE::ODONTOLOGIA
• Link de acesso: http://tede2.pucrs.br/tede2/handle/tede/1149

This study aimed to investigate the influence of corticotherapy and diabetes mellitus in the development of the osteonecrosis of the jaws associated with sodium alendronate. The sample consisted of 44 female rats, Wistar strain, randomly allocated into 4 groups: (1) 11 rats treated with sodium alendronate (alendronate group); (2) 11 rats treated with sodium alendronate and corticotherapy (corticosteroid group); (3) 11 rats treated with sodium alendronate and subjected to diabetes induction (diabetes group); (4) 11 rats treated with saline (control group). The animals were subjected to tooth extractions 90 days after starting the bisphosphonate therapy. Euthanasia was performed 21 days after the surgical procedures. Sections were stained by hematoxylin and eosin (H&E) and by immunohistochemistry technique using anti-BMP-4 and anti-MMP-13 antibodies. Histological evaluation consisted of quantitative analysis of epithelial tissue, connective tissue, inflammatory infiltrate, root fragments, microbial colonies, vital bone and osteonecrosis using the manual point counting technique (Image Pro Plus 4.5.1). BMP-4 and MMP-13 were evaluated with the semi-automated segmentation technique (Image Pro Plus 4.5.1). The results were analyzed by chi-square and Kruskal-Wallis tests (followed by the multiple comparisons test), stating the significance level at 5%. In the H&E analysis, inflammatory infiltrate, microbial colonies and osteonecrosis proportions were significantly higher in the diabetes group (p<0.05), while the other variables did not differ between the groups. The immunohistochemical expression of BMP-4 in the connective tissue was significantly higher in the corticosteroid group than in the alendronate group (p<0.05), whereas the other groups did not differ for this variable. BMP-4 in the bone area and MMP-13 did not significantly differ between the groups. In conclusion, diabetes can be considered as a risk factor for the development of osteonecrosis of the jaw associated with alendronate therapy. However, for corticotherapy this association was not observed.