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Sildenafil Transiently Delays Early Alveolar Healing of Tooth Extraction Sockets
Elysse Orchard1, Wanda Green2, Renjith Parameswaran Nair3
1Department of Animal Resources, Louisiana State University Health Sciences Center, 1501 Kings Highway, Shreveport, Louisiana 71130, USA.
Clinics in Surgery
|June 23, 2018
Summary
Sildenafil, a PDE5 inhibitor, temporarily delays early alveolar bone healing by inhibiting cell replication and osteoblast differentiation. This suggests a negative impact of cyclic GMP on the initial inflammatory phase of bone repair.
Area of Science:
- Biomedical Engineering
- Regenerative Medicine
- Oral Surgery
Background:
- Bone regeneration mimics embryonic development and requires robust vascularization.
- Impaired angiogenesis, common in aging and diseases, compromises bone repair.
- Endothelial cyclic Guanosine Monophosphate (cGMP) promotes angiogenesis; sildenafil inhibits its breakdown.
Purpose of the Study:
- To investigate the effect of sildenafil on early alveolar bone regeneration after tooth extraction.
- To determine if sildenafil's pro-angiogenic mechanism impacts the initial stages of bone healing.
Main Methods:
- Sildenafil (10 mg/kg/day) was administered orally to rats post-exodontia.
- Evaluated clot dissolution, granulation tissue formation, and cell proliferation on day 4.
- Assessed expression of osteoblast differentiation markers (Cbfa-1/Runx2, osteopontin).
- Compared results with control groups and animals treated with hydrolysis-resistant cGMP.
Main Results:
- Sildenafil delayed clot dissolution and granulation tissue formation.
- Significantly reduced replicating cell counts on day 4 in treated rats.
- Decreased numbers of osteoblast differentiation markers in sildenafil-treated animals.
- Hydrolysis-resistant cGMP mimicked sildenafil's effects, indicating cGMP's negative role in early healing.
Conclusions:
- Sildenafil temporarily retards crucial early events in alveolar bone healing.
- Elevated cGMP levels may negatively impact the initial inflammatory phase of bone repair.
- Further research is needed to understand the long-term implications and potential therapeutic window for PDE5 inhibitors in bone regeneration.
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