Parathyroid hormone enhances gap healing and osseointegration in orthopedic porous coated titanium implants: a correlative micro-computed tomographic, histomorphometric and biomechanical analysis

Abstract

Background Parathyroid hormone, with its anabolic effect on bone formation, has shown excellent outcomes of curing postmenopausal osteoporosis as well as enhancing osseointegration around orthopaedic and stomatologic implants.The purpose of the present study is to test if low-dose intermittent PTH (1–34) treatment could achieve a satisfactory osseointegration in 2-mm peri-implant gaps, as to provide a new idea for improving the stability of such prosthesis, which will be of great clinical value. Methods A custom-made titanium implant was implanted on the calvarium of New Zealand White rabbits. 48 male rabbits were randomly divided into control and PTH group. PTH group received subcutaneous injection of PTH (20 μg/day, 5 days/week). Animals were sacrificed at 4 and 8 weeks after surgery. Quantitative micro-computed tomography, histology and biomechanical pull-out testing were performed to evaluate the gap healing at implantation site. Results Analysis of micro-computed tomography demonstrated that PTH group achieved more new bone formation in 2-mm gaps and on bone-implant interface. Quantitatively, significant differences were observed between two groups in regard to BIC and BV/TV at each time-point. Histological staining revealed that PTH group had a superiority in trabecular number, thickness, separation and better osseointegration compared to control group. As for biomechanical pull-out testing, PTH group also showed significant improvement of ultimate force than control group. Conclusions Low-dose intermittent administration of PTH for 4 and 8 weeks enhances early osseointegration and fixation of orthopedic implants surrounded by a 2-mm gap in terms of increased bone regeneration and mechanical stability. These findings suggest PTH a potential for reducing the postoperative complications of implants by improving bone healing at peri-implant gaps.

Osseointegration Potential Assessment of Bone Graft Materials Loaded with Mesenchymal Stem Cells in Peri-Implant Bone Defects

“…Micro-computed tomography (micro-CT) analysis of bone regeneration at the implantbone interface was performed as described in our previous studies [2,[40][41][42]. After the dissection of the tibia, the whole bone blocks containing the implants were removed and fixed in 10% neutral buffered formalin.…”

Advances in Osteoporosis Therapy: Focus on Osteoanabolic Agents, Secondary Fracture Prevention, and Perioperative Bone Health

“…Osteoanabolics have greater potential to rapidly improve bone stock preoperatively, which improves primary implant stability in animals [ 145 ]. Postoperative use of osteoanabolics may also promote implant osseointegration, as shown by increased bone-implant contact and pull-out strength in animals treated with teriparatide [ 146 ], abaloparatide [ 113 ], or Scl-Ab [ 145 , 147 ]. The ability of Scl-Ab to stimulate bone formation and inhibit resorption may have particular value for promoting and maintaining implant osseointegration [ 147 ].…”

Effect of intraoral administration of parathyroid hormone on osseous and soft tissue healing around implants in ovariectomized rat maxillae

“…Each q-value associated with the assessment parameters related to soft tissue corresponded to the respective p-value (Table 4). Several animal studies showed increases in bone formation or trabecular bone thickness around implants with systemic intermittent PTH administration (Gao et al, 2022;Mair et al, 2009;Skripitz et al, 2005;Uchida et al, 2020). In those studies, implants were inserted in long bones and in non-osteoporosis conditions.…”