Locally delivered bioactive agents as treatment modalities in the management of medication-induced osteonecrosis of the jaws

Recent literature suggests that suppressed bone healing and angiogenesis contributes significantly to the pathogenesis of Medication induced osteonecrosis of jaws (MRONJ), a complex condition commonly associated with anti-resorptive agents. This in vitro study evaluated the effect of locally delivered angiogenic growth factor (VEGF165) with or without osteogenic growth factor (BMP-7) to enhance bone healing, thereby preventing the occurrence of MRONJ. A chemically defined hydrogel (HyStem-HP, Glycosan Biosciences) containing a combination of thiolmodified hyaluronan, heparin and denatured collagen was crosslinked with thiol-reactive, PEGDA. To establish the in vitro release kinetics, 100 and 200 ng of rat VEGF165 (Biovision) or BMP-7 (250 and 500 ng/mL) was loaded into a 500 lL hydrogel prior to crosslinking (Hystem-HP).