Bisphosphonates (BPs) are widely used to treat bone disorders, prevent skeletal-related events, and manage bone metastasis. These drugs are synthetic analogs of pyrophosphate and primarily function by inhibiting osteoclast activity. However, increasing evidence suggests that they also have an effect on osteoblasts. This systematic review aims to evaluate how bisphosphonates affect osteoblasts by summarizing findings from in vitro studies on the impact of BPs on osteoblast lineage cells, addressing the following question: “ Do bisphosphonates affect osteoblast cell lineage function? ”. For this purpose, the PICO framework was followed, and 36 articles were selected for inclusion in this review. The data suggest that the molecular mechanisms in osteoblasts can vary depending on the specific type of bisphosphonate, as well as the concentration and duration of treatment, leading to either stimulation or inhibition of osteogenesis. Additionally, studies have shown that certain BPs, such as zoledronic acid, can interfere with osteoblast differentiation, proliferation, gene expression, and mineralization capacity, potentially impairing bone healing. On the other hand, other drugs, such as alendronate, demonstrate more positive effects on cell function. Some drugs, such as pamidronate and clodronate, exhibited mixed effects; however, it was observed that high concentrations of these drugs can lead to cytotoxic effects. Despite these adverse effects, it is important to recognize that the clinical benefits of managing bone disorders often outweigh the potential risks highlighted in this review.

(1) Background: This study evaluates the effects of photobiomodulation (PBM) therapy on the peri-implant bone healing of implants with a machined surface (MS) and treated surface (TS). (2) Methods: Topographic characterization of the surfaces (scanning electron microscopy [SEM]- energy dispersive X-ray spectroscopy [EDX]) was performed before and after implant removal. Twenty rabbits were randomly divided into four groups: MS and TS groups (without PBM therapy) and LMS and LTS groups (with PBM therapy). After implant placement, the stability coefficient (ISQ) was measured. In the periods of 21 and 42 days, the ISQ was measured again, followed by biomechanical analysis. (3) Results: The surfaces of the TS implants showed topographic differences compared with MS implants. The ISQ values of the LMS were statistically significant when compared with those of the MS at 42 days (p < 0.001). The removal torque values of the LMS were statistically significant when compared with those of the MS at 21 days (p = 0.023) and 42 days (p = 0.023). For SEM, in general, the LMS, TS and LTS presented high bone tissue coverage when compared to MS. (4) Conclusions: The PBM therapy modulated the osseointegration process and was evidenced mainly on the machined surface.

(1) Objective: The aim of this study was to assess the biological behavior of bone tissue on a machined surface (MS) and modifications made by a laser beam (LS) and by a laser beam incorporated with hydroxyapatite (HA) using a biomimetic method without thermic treatment (LHS). (2) Methods: Scanning electron microscopy coupled with energy-dispersive X-ray spectrometry (SEM/EDX) was performed before and after installation in the rabbit tibiae. A total of 20 Albinus rabbits randomly received 30 implants of 3.75 × 10 mm in the right and left tibias, with two implants on each surface in each tibia. In the animals belonging to the 4-week euthanasia period group, intramuscular application of the fluorochromes calcein and alizarin was performed. In implants placed mesially in the tibiofemoral joint, biomechanical analysis was performed by means of a removal torque (N/cm). The tibias with the implants located distally to the joint were submitted for analysis by confocal laser microscopy (mineral apposition rate) and for histometric analysis by bone contact implant (%BIC) and newly formed bone area (%NBA). (3) Results: The SEM showed differences between the surfaces. The biomechanical analysis revealed significant differences in removal torque values between the MSs and LHSs over a 2-week period. Over a 4-week period, both the LSs and LHSs demonstrated removal torque values statistically higher than the MSs. BIC of the LHS implants were statistically superior to MS at the 2-week period and LHS and LS surfaces were statistically superior to MS at the 4-week period. Statistical analysis of the NBA of the implants showed difference between the LHS and MS in the period of 2 weeks. (4) Conclusions: The modifications of the LSs and LHSs provided important physicochemical modifications that favored the deposition of bone tissue on the surface of the implants.

This study aimed to evaluate the biomechanical behavior of five different fixation methods used in bilateral sagittal split osteotomy (BSSO), focusing on their performance with miniplates and monocortical screws during 10-mm advancement and 20º counterclockwise rotation of the occlusal plane. A three-dimensional model of a human mandible, derived from computerized tomography scans and including all teeth except the third molars, was utilized. The BSSO procedure was simulated using SolidWorks 2017 CAD software (Dassault Systemes, SolidWorks Corp, USA) according to the techniques outlined by Epker. Five fixation models were tested: Model M1, one straight 4-hole miniplate with four monocortical screws; Model M2, two straight 4-hole miniplates with eight monocortical screws; Model M3, one 10-hole double miniplate with two bridges and ten monocortical screws; Model M4, one 8-hole 20º angled double miniplate with two bridges and eight monocortical screws; and Model M5, one semi-curved 6-hole miniplate with six monocortical screws. Each model was subjected to two loading patterns: 100 N posteriorly and 50 N anteriorly. The biomechanical performance was analyzed qualitatively and quantitatively, focusing on the bone, screws, and plates. Models M1 and M3 exhibited the poorest biomechanical stability; Model M2 demonstrated the highest stability; and Model M5 showed the best load distribution. A model using two straight 4-hole plates offers more stable osteosynthesis, whereas a semi-curved plate with six nonlinear screws ensures effective load distribution with reduced stress concentration.

This study aimed to biomechanically evaluate ten different fixation methods following SSRO, simulating a 10mm mandibular advancement, with variations in plate position, angulation, and the use of bicortical screws. Fifty polyurethane hemimandibles were randomly assigned to ten groups (n=5). SSRO was performed and stabilized using different configurations of 2.0mm plates and screws. Fixation methods included monocortical plates in varying angulations and positions, dual-plate systems, and hybrid techniques incorporating bicortical screws. All specimens underwent three-point compression testing using a universal testing machine. Peak compressive force and displacement were recorded. The best biomechanical performance was observed in the group using two straight plates placed laterally at a +20° angle (Group 5). Groups employing hybrid or dual-plate systems performed significantly better than those using a single plate. Bicortical screws reduced horizontal displacement but were less effective alone in resisting vertical compressive forces. Dual-plate fixation with specific angulation improves resistance to compressive forces in large mandibular advancements. The use of a single plate is not recommended unless combined with bicortical screw support.