Effects of sunitinib targeted chemotherapy on the osseointegration of titanium implants

Targeted chemotherapies are novel therapeutic approaches for many malignancies. In contrast to conventional chemotherapies, which are given for a predetermined duration, treatment with targeted chemotherapies like sunitinib is routinely continuous over longer periods, sometimes years. During this prolonged treatment period, patients may need to restore their missing teeth with dental implants. The aim of this study was to examine the effect of the anti-angiogenic substance sunitinib targeted chemotherapy on the osseointegration of titanium implants in a rabbit model. Fourteen white New Zealand rabbits were randomly assigned to two groups of either oral sunitinib at 10 mg/kg twice per week dose for 4 weeks (n = 7) or placebo (n = 7). The first dose was given 2 days before the surgical intervention. Each rabbit received one titanium dental implant in the right distal femoral condyle. Four weeks following implant insertion, rabbits were sacrificed and bone specimens containing the implants were retrieved. Osseointegration of the implants was analyzed using micro-computed tomography and histomorphometric evaluation. Both micro-computed tomography and histomorphometric analysis showed that the osseointegration parameters, including the ratio of bone volume to total volume and bone-implant contact percent for the sunitinib group were significantly lower than those in the control group (P ≤ 0.05). Sunitinib targeted chemotherapy had a negative effect on the osseointegration of titanium implants inserted in a rabbit model.