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Bilateral maxillary first molars were extracted at 9\u2009weeks old, and Grade IV titanium implants were placed in healed alveolar ridges 4\u2009weeks after starting treatment. Four weeks postimplantation, sites were randomly assigned to test (Load) or control (Non\u2010load) groups. The Load group received controlled mechanical loading (10\u2009N, 3\u2009Hz, 1800 cycles, 2\u2009days\/week) via implants for 2\u2009weeks. Peri\u2010implant bone quantity and quality parameters were assessed, including micro\u2010computed tomography (microCT)\u2010derived morphometry, bone\u2010related cell distribution, collagen composition and alignment, and sclerostin expression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      BRONJ stage 0\u2010like lesions, characterized by necrotic bone with epithelium coverage, were observed in all ALN\u2010treated maxillae. Despite comparable epithelial and microCT morphometry (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05), the Load group demonstrated significantly improved bone quality around implants, with reduced necrotic bone, higher osteocyte density, fewer osteoclasts and TRAP\u2010positive mononuclear cells at the crestal site (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05), and greater deposition of well\u2010aligned type I collagen (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Conversely, the Non\u2010load group exhibited substantially larger necrotic areas, increased empty lacunae, reduced osteocyte density, increased sclerostin expression, and more disorganized type III collagen (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study is the first to demonstrate that implant loading alleviates BRONJ stage 0\u2010like lesions by enhancing peri\u2010implant bone quality. Mechanical loading promotes peri\u2010implant bone health through cellular adaptation and extracellular matrix remodeling, even under BP\u2010treated osteoporotic\u2010like conditions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/clr.70064","type":"journal-article","created":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T16:54:42Z","timestamp":1762793682000},"page":"185-200","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Mechanical Loading Alleviates\n                    <scp>BRONJ<\/scp>\n                    \u2010Like Lesions Around Implants Under Osteoporotic\u00a0Conditions: An\u00a0In\u00a0Vivo Experimental Model"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-9226-5050","authenticated-orcid":false,"given":"Juo Pei","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Applied Prosthodontics, Graduate School of Biomedical Sciences 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