Application of a collagen scaffold saturated with platelet-rich plasma in prevention of bisphosphonate-related osteonecrosis of the jaw in the rat animal model

Background: Among the myriad adverse events of drugs in the oral cavity, Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is one of the most detrimental drug reactions that have ever been known. Objective: This study was aimed to investigate the success of applying collagen scaffold alone and platelet-rich plasma (PRP)þcollagen scaffold in prevention of zoledronic acid-induced BRONJ in the rat. Methods: A total of 17 male Wistar-rats were treated with 4 weekly doses of zoledronic acid. All rats were un- dergone bilateral tooth extraction of mandibular first molars and divided into three groups of scaffold þ PRP þ suture, scaffold þ suture, and suture only. All rats were scarified and clinical, radiological, histological and histomorphomerical evaluations were made on week 8 post-treatment. The soft tissue healing, bone mineralized density (BMD), number of osteoclasts and osteoblasts, necrotic bone (NB), intensity of inflammation and new bone formation (NBF) were analyzed. Results: BMD, number of osteoblasts and NBF variables proved to be statistically were higher in the treatment groups than the control group. In addition, the PRP þ scaffold group showed the better results in terms of BMD, number of osteoblasts and NBF than that of the scaffold alone group. Number of osteoclasts, inflammation in- tensity and osteonecrosis were also significantly different in the PRP þ scaffold group compared to the scaffold alone and the control groups. Conclusion: Application of a PRP-enriched collagen scaffold appeared to be a successful preventive treatment for BRONJ by effecting of the number of osteoblasts and osteoclasts, BMD, NBF, inflammation, and osteonecrosis.