Fluoride and Cortical Bone: A Histomorphometric Study in Rabbits

Abstract

Fluoride has been used in the treatment of osteoporosis because of its apparent ability to directly initiate bone formation. However, fluoride's therapeutic efficacy is controversial. Clinical trials in the range of 50 to 75 mg/day demonstrated severe side effects and a lack of consistent therapeutic benefits. Animal studies have not fully proven a positive effect of fluoride on bone strength. The objective of this study was to determine the histomorphometric changes in the cortical bone of rabbits caused by high doses of fluoride. The hypothesis was that high-dose fluoride intake enhances bone modeling and inhibits bone remodeling. Twenty-four young adult (four months old) female, Dutch Belted rabbits were randomly divided in two groups. The control group received no fluoride in their drinking water, while the experimental group received 100-ppm fluoride. Both groups received approximately 12-ppm fluoride in their food. A pair of tetracycline labels was given two weeks apart before initiation of the experiment. Fluoride treatment was given for six months. A terminal pair of calcein green labels was given before the animals were euthanized. Histomorphometric measurements were made using stereological point-hit and linear-intercept methods. The histomorphometric findings were correlated with fluoride serum and bone levels and also with strength tests. The study demonstrated that fluoride increases bone modeling by increasing periosteal bone apposition and endosteal bone resorption. The net effect of fluoride was an enlargement of the cortical bone and bone marrow and, therefore, the total tissue cross-section. However, the observed increase in bone mass produced by fluoride did not have a positive effect on the mechanical properties of bone. Fluoride did not produce a change in the primary histomorphometric parameters of osteoid surface (OS/BS%) or mineralizing surface (MS/BS%). Fluoride treatment produced an increase in the cortical periosteal modified mineral apposition rate (CPMAR). The remaining dynamic indices (i.e. endosteal MAR, remodeling MAR, cortical endosteal BFR and total BFR, activation frequency and formation period) were not affected by fluoride. The study failed to show an inhibitory effect of fluoride on bone remodeling.