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The ZA and ZA\u2010AP groups received 0.125\u2009mg\/kg of ZA, while the DMAB and DMAB\u2010AP groups received 0.25\u2009mg\/kg of DMAB, both administered via intraperitoneal injection twice a week for 4\u2009weeks. One week after completing drug administration, endodontic access was performed on the distal occlusal fossa of the lower left first molars in all animals. AP was carried out in the distal canal of the ZA\u2010AP, DMAB\u2010AP, and CON\u2010AP groups using a size 10 K\u2010file with the aid of an electronic apex locator, extending beyond the apical foramen. In the other groups, the file was inserted up short of apex as determined by electronic apex locator measurement. Coronal sealing was performed and after 21\u2009days, the animals were euthanized, and visual analysis, micro\u2010CT, and histopathological assessments were conducted to evaluate the presence or absence of osteonecrosis. Statistical analysis was performed using frequency statistics and a GLM multivariate ANOVA model followed by Tukey's test with significance at <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>None of the animals exhibited bone exposure or other clinical signs associated with medication\u2010related osteonecrosis of the jaw. No cortical bone destruction, periosteal reaction, or bone sequestration was observed in the micro\u2010CT or histopathological assessments. Medication significantly influenced some micro\u2010CT parameters (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05), while the apical patency alone did not (<jats:italic>p<\/jats:italic>\u2009&gt;\u2009.05). When interacting with medication*apical patency, the ZA\u2010AP group showed a significantly lower percentage of bone volume and bone mineral density compared to the ZA group, a tendency not observed in DMAB groups (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Apical patency in rats treated with zoledronic acid or denosumab did not cause osteonecrosis of the jaw, only micro\u2010CT changes in bone microarchitecture that cannot be linked to osteonecrosis in zoledronic acid treated animals.<\/jats:p><\/jats:sec>","DOI":"10.1111\/iej.14207","type":"journal-article","created":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T04:09:36Z","timestamp":1738728576000},"page":"776-786","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The risk of osteonecrosis after apical patency during antiresorptive therapy in an animal model"],"prefix":"10.1111","volume":"58","author":[{"given":"Clara de Figueiredo","family":"Lopes","sequence":"first","affiliation":[{"name":"Department of Integrated Clinical Procedures, School of Dentistry Rio de Janeiro State University (UERJ)  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karem Paula","family":"Pinto","sequence":"additional","affiliation":[{"name":"Department of Integrated Clinical Procedures, School of Dentistry Rio de Janeiro State University (UERJ)  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4970-3757","authenticated-orcid":false,"given":"Claudio Malizia Alves","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Department of Integrated Clinical Procedures, School of Dentistry Rio de Janeiro State University (UERJ)  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenif Braga","family":"de Souza","sequence":"additional","affiliation":[{"name":"Laboratory of Experimental Surgery, School of Medical Sciences Rio de Janeiro State University (UERJ)  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo Tadeu","family":"Lopes","sequence":"additional","affiliation":[{"name":"Nuclear Engineering Program Federal University of Rio de Janeiro (UFRJ)  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana Terezinha Neves Novellino","family":"Alves","sequence":"additional","affiliation":[{"name":"Department of Oral Pathology Federal Fluminense University (UFF)  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2074-0834","authenticated-orcid":false,"given":"Erick M.","family":"Souza","sequence":"additional","affiliation":[{"name":"Departament of Endodontics Maranh\u00e3o Federal University (UFMA)  S\u00e3o Lu\u00eds Maranh\u00e3o 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