| Osteoporosis is a systemic bone metabolic disease characterized by reduction in bone mass and microarchitectural deterioration of bone tissue, leading to increased bone fragility and fracture risk. With an increasing aging population, osteoporosis has become a serious harmful to health of elderly people, especially high incidence in postmenopausal women. Postmenopausal osteoporosis caused by lack of estrogen, leads to abnormally high levels of bone turnover, active fuction of osteoclasts, bone formation inhibited, reducing bone strength, osteoporotic patients are susceptible to fracture. Dental implant restorations have become a conventional treatment to the edentulous and dentition defect. However, the key of success to dental implant is a good osseointegraion, and successful implant osseointegration mainly depends on the bone-to-implant bone mass and microarchitecture around implant surface. Due to decreased bone formation and inadequate bone mass, osteoporosis could lead to depressed implant stabilization, even result in implant loosing and failure. Therefore, to explore effective and rational therapeutic options to improve bone metabolism conditions, prevent the occurrence of osteoporotic fracture, and improve implant osseointegration in osteoporotic patients, has become an imperative problem in the field of dental implantology.A variety of alternative treatments in present clinical stage that can reduce fractures caused by osteoporosis risk, but all has its limitations. View of the existence of various adverse reactions in current medicine, it can not effectively increase bone mass with multi-target. To research the plant extract drugs containing of a variety of biologically active components, is an important way to explore anti-osteoporosis drugs. Recent studies have found that systemic treatment of traditional Chinese medicine Er-Zhi-Wan(EZW) had a good therapeutic effect on osteoporosis in ovariectomized rats, that can reduce the rate of bone turnover, increase femur bone density, improve biomechanical properties, improve bone trabecula microstructure, thereby reducing postmenopausal osteoporotic patients fracture risk, and without significant side effects while prevention and treatment postmenopausal osteoporosis.We hypothesized that EZW also had some positive effects on implant osseointegration in osteoporotic conditions.This research includes the following three parts:1. Effects of Er-Zhi-Wan on titanium implant osseointegration in femur of ovariectomized rats.To investigate the effect of systemic treatment with Er-Zhi-Wan on titanium implant osseointegration in femur of ovariectomized rats. The results showed that treatment with Er-Zhi-Wan could improve titanium implant osseointegration and mandibular microstructure in ovariectomized rats. Implants enhance stability increase bone-implant surface contact rate and peri-implant bone mass, improve peri-implant bone microstructure and peri-implant bone mineralization.2. Effects of Er-Zhi-Wan on Microarchitecture and Regulation of Wnt/p-cateni n Signaling Pathway in Alveolar Bone of Ovariectomized Rats.To investigate the effects of EZW on microarchitecture and regulation of Wnt signaling pathway in alveolar bone of ovariectomized rats. The results showed that EZW treatment on OVX rats significantly prevented the body weight gain, degradation of alveolar trabecular micro architecture and alveolar bone loss in ovariectomized rats.3. Effects of oleanolic acid and ursolic acid on proliferation, and osteoblastic or adipocytic differentiation of BMMSCs from osteoporotic rats.To inveatigate the effects of oleanolic acid and ursolic acid on proliferation, and osteoblastic or adipocytic differentiation of BMMSCs from osteoporotic rats. The results from cellular and molecular biologic levels revealed that oleanolic acid and ursolic acid could decrease the proliferation, and promote osteoblastic but inhibit adipocytic differentiation of BMMSCs from osteoporotic rats.In conclusion, results from this study in osteoporotic rats showed that systemic treatment with EZW could improve implant osseointegration and alveolar bone microstructure. Results from in vitro experiment revealed that oleanolic acid and ursolic acid influenced the proliferation and multii-directional differentiation of BMMSCs from osteoporotic rats, resulting in decreased proliferation, promoted osteoblastic and inhibited adipocytic differentiation of BMMSCs from osteoporotic rats. |
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