Edward Chengchuan KO
Takao, Formosa
MRONJ (Medication-Related OsteoNecrosis of Jaw) became one of the most challenging diseases for maxillofacial surgeons. Yet it has no definite protocol for treatment. Hyperbaric oxygen therapy (HBO) could increase wound healing though it is still controversial. Current studies indicate that bisphosphonates can inhibit fibronectin's formation and hence inhibit fibroblasts' proliferation and migration. This is one of the phenomena of inadequate wound healing with the consequent attack of MRONJ. No literature mentions the in vitro study regarding the influence of different oxygen conditions on the wound healing of the gingival fibroblasts. Our pilot study using the three kinds of bisphosphonates (including alendronate, zoledronate, and Ibandronate) reveals that hypoxia can cause injury on the bisphosphonates-treated gingival fibroblasts. Alendronate-treated gingival fibroblasts are the most sensitive group to the condition of hypoxia.
1. Hypoxia decreases the cell proliferation of the in vitro cultured human gingival fibroblasts (HGnF) under the treatment of bisphosphonates
2. Hypoxia decreases the wound healing of the in vitro gingival fibroblasts (HGnF) treated with the bisphosphonates
3. Hypoxia enhances the expression of HIF-1α in vitro gingival fibroblasts (HGnF) treated with bisphosphonates.
4. Both hypoxia and hyperbaric oxygen decreased the secretion of HIF-1α from BP-treated HGnF cells.
We know that hyperbaric oxygen could enhance the expression of fibronectin and collagen type I, but owing to the influence of bisphosphonates, cell proliferation and wound healing is still unstable even under the condition of hyperbaric oxygen.
