Effect of hyaluronic acid on the prevention of medication-related osteonecrosis of the jaw in a bisphosphonate-treated rat model


Gachayev K., ŞİMŞEK KAYA G., Kaya M., ÖZALP Ö., Altunay B., TORU ATEŞER H. S.

BMC Oral Health, cilt.25, sa.1, 2025 (SCI-Expanded, Scopus) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 25 Sayı: 1
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1186/s12903-025-07268-5
  • Dergi Adı: BMC Oral Health
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, MEDLINE, Directory of Open Access Journals
  • Anahtar Kelimeler: Bisphosphonate, Bone healing, Hyaluronic acid, MRONJ
  • Akdeniz Üniversitesi Adresli: Evet

Özet

Background: Medication-related osteonecrosis of the jaw (MRONJ) remains a major clinical concern due to its complex pathogenesis and low treatment success rates. Hyaluronic acid (HA), a widely used biomaterial, has demonstrated regenerative and angiogenic potential. Aim: This study investigated the effects of HA on the onset of MRONJ following tooth extraction in bisphosphonate (BP)-treated rats. Methods: Twenty-four adult male Wistar albino rats were randomly allocated to three groups: control (saline), medication control (zoledronic acid: ZA), and experimental (ZA + HA). Animals received ZA (0.06 mg/kg, intraperitoneally, weekly for 4 weeks), followed by extraction of the lower left first molar. In the ZA + HA group, HA gel was locally applied into the socket. Rats were euthanized 28 days postoperatively. Socket healing was evaluated using micro-computed tomography (micro-CT) parameters [bone volume fraction (BV/TV), bone surface density (BS/BV), trabecular number (Tb.N), trabecular thickness (Tb.Th), trabecular separation (Tb.Sp)] and histomorphometric analysis of bone formation and osteocyte lacunae. Results: Micro-CT analysis showed that rats in the ZA + HA and control groups exhibited significantly higher BV/TV, BS/BV, Tb.Th, and Tb.N and lower Tb.Sp compared with the ZA group (p < 0.05). Histomorphometric analysis confirmed reduced bone formation and a greater number of empty osteocyte lacunae in the ZA group, whereas the ZA + HA group demonstrated bone regeneration comparable to controls. Conclusion: Local application of HA may inhibit the onset of MRONJ and enhance post-extraction bone healing in BP-exposed bone.