Influence of infliximab therapy on bone healing post-dental extraction in rats

• Published in: Archives of oral biology 2020-04, Vol.112, p.104680-104680, Article 104680
• Main Authors: Ferreira-Junior, Antonio Ernando Carlos, Barros-Silva, Paulo Goberlânio de, Oliveira, Camila Carvalho de, Lima Verde, Maria Elisa Quezado, Sousa, Fabrício Bitu, Mota, Mário Rogério Lima, Lima-Júnior, Roberto César Pereira, Alves, Ana Paula Negreiros Nunes
• Format: Article
• Language: English
• Subjects: Bone remodeling; Dentistry; Infliximab; TNF-alfa
• ISSN: 0003-9969; 1879-1506
• DOI: 10.1016/j.archoralbio.2020.104680

•Infliximab can delay bone healing.•TNF-α is a important key to bone healing.•Less bone deposition is related to TNF blockade.•Infliximab can reduce the expression of bone metabolism markers. TNF-α, which acts directly on osteoclastogenesis, may modify bone turnover. Thus, the objective of this study was to evaluate the influence of infliximab on extraction socket healing. Eighty-four Wistar rats were randomized into two groups (infliximab EV 5 mg / kg or saline EV 1 ml / kg) and submitted to lower first molar extraction protocol. The animals were sacrificed 1, 3, 7, 14, 21 and 28 days after surgery. The jaws were subjected to radiographic, histomorphometric, histochemical (picrosirius red) and immunohistochemical (TNF-α, RANKL and OPG) analysis. No differences were observed between the groups in surgical difficulty parameters: mass of teeth, number of root fractures and surgical time. Lower area filling with bone as well as increased amounts of remaining cicatricial tissue were observed in the infliximab group at 14 days (p < 0.001). Lower scores for polymorphonuclear neutrophils were seen at 3 (p < 0.01) and 7 days (p < 0.001), lower mononuclear counts at 7 days (p < 0.01) and lower osteoclast counts at 7 and 14 days (p < 0.01 and p < 0.001, respectively). Additionally, reduced TNF-α, RANKL and OPG immunoreactivity were observed, especially at 7 days (p < 0.05). TNF-α inhibitor may alter the bone repair capacity after tooth extraction, especially in the initial repair periods, by lower expression of TNF α, RANKL and OPG. Thus, additional caution may be needed in patients who use this class of medication after dental extraction.