Influence of ozone therapy and Fibrin Rich in Platelets and Leukocytes (L-PRF) in the prevention and treatment of medicated related osteonecrosis of the jaw of senile female rats medicated with zoledronate

Abstract

Medicated Related osteonecrosis of the jaw (MRONJ) still deservesfull explanations about its etiopathology and its clinical management, which is still a medical-dental challenge.The use of adjuvant local therapies, such asthe application of ozonated oil and the use of platelet compounds, has shownpromising results in the prevention and treatment of MRONJ, given the potential for optimizationof tissue repair, but investigations are needed to understand the biological behavior of these therapies. The objective of this research will be to establish an analysiscomparison related to local therapies with the use of platelet-rich fibrin and thesuspension of ozonized oil on the reparative parameters of bone tissue related to inductionexperimental MRONJ in senile female rats. For this purpose, 45 rats, senile (18 months), of which 15will belong to the bone characterization group, 2 animals will be destined for blood donation forthe making of L-PRF and the remainders will be divided into 4 experimental groups (n=7).In the SAL group, the animals will be submitted to applications of 0.9% sodium chloride solutionand the ZOL group will receive application of zoledronate 100¼g/kg both every 3 days for 7weeks; the ZOL+L-PRF and ZOL+OZN600 groups, whose animals will be submitted to the applicationof zoledronate under the same protocol, receiving therapies with L-PRF and local application ofozonized sunflower oil 30ml - 600 mEq/kg at a concentration of 0.3 mg/kg, for 2minutes, respectively;The ZOL+L-PRF group will receive local therapy postoperativelyimmediately, while in the ZOL+OZN600 group ozone therapy will be administered inperiods of 0, 2 and 4 days after extraction of the lower left first molar. The euthanasia ofexperimental groups will occur 28 days after tooth extraction. The jaws will be parched,reduced and prepared for micro-CT, histological/histometric and Picrosirius analysisRed (PSR), in addition to clinical analyzes based on photographic records of the registered takenat the end of the experimental period.The data will be submitted to the normality curve fordetermination of the most appropriate test (p<0.05).