Evaluation of the effect of Levofloxacin and Cefalexin derivative antibiotics on Implant Osseointegration in rat tibia
Abstract
Osseointegration refers to the process where an implant firmly and functionally bonds with the bone, establishing a stable union capable of bearing loads without any relative movement between the implant and the surrounding bone tissue. Post- surgery infections that may develop in the surgical area can negatively affect osseointegration, putting the success of the implant at risk. The objective of this research was to evaluate the impact of antibiotics derived from levofloxacin and cephalexin on the osseointegration of implants in the tibias of rats. A total of 21 female Sprague Dawley rats were utilized, randomly divided into three equal groups of seven rats each. Titanium implants measuring 2.5 mm in diameter and 4 mm in length were inserted into cavities created in the corticocancellous bone of the metaphyseal region of the right tibias of all animals. In the implant control group (n=7), no additional procedures were performed throughout the two- week experimental period. Subjects in the implant levofloxacin group (n=7) received subcutaneous injections of levofloxacin at a dose of 25 mg/kg, administered three times weekly for two weeks. Similarly, rats in the implant cephalexin group (n=7) were given subcutaneous injections of cephalexin at a dosage of 20 mg/kg, three times per week for two weeks. Two weeks after the operation, the implant samples in the tibias of the rats were subjected to biomechanical analysis using a digital torque device in order to evaluate the osseointegration process. As a result, it was observed that levofloxacin and cephalexin-derived antibiotics had a negative effect on implant osseointegration in the tibias of rats.
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Ozcan EC, Sokmen K, Karasu N, Bal A, Tanrisever M, Istek O, Kirtay M, Bozoglan A, Dundar S. Biomechanical Evaluation of the Osseointegration Levels of Implants Placed Simultaneously With Tibia, Femur, and Jaw Allogeneic Bone Grafts. J. Craniofac. Surg. [Internet]. 2025; 36(1):323-327. doi: https://doi.org/pszs DOI: https://doi.org/10.1097/SCS.0000000000010517
Gómez-deDiego R, Mang-de la Rosa MR, Romero-Pérez MJ, Cutando-Soriano A, López-Valverde-Centeno A. Indications and contraindications of dental implants in medically compromised patients: Update. Med. Oral Patol. Oral Cir. Bucal. [Internet]. 2014; 19(5):e483-9. doi: https://doi.org/pszt DOI: https://doi.org/10.4317/medoral.19565
Donos N, Akcali A, Padhye N, Sculean A, Calciolari E. Bone regeneration in implant dentistry: Which are the factors affecting the clinical outcome? Periodontol. 2000. [Internet]. 2023; 93(1):26-55. doi: https://doi.org/g8nptk DOI: https://doi.org/10.1111/prd.12518
Guglielmotti MB, Olmedo DG, Cabrini RL. Research on implants and osseointegration. Periodontol. 2000. [Internet]. 2019; 79(1):178-189. doi: https://doi.org/gpwcbp DOI: https://doi.org/10.1111/prd.12254
Albrektsson T, Johansson C. Osteoinduction, osteoconduction and osseointegration. Eur. Spine J. [Internet]. 2001; 10(Suppl 2):S96-S101. doi: https://doi.org/bbh8n6 DOI: https://doi.org/10.1007/s005860100282
Jensen LK, Koch J, Aalbaek B, Moodley A, Bjarnsholt T, Kragh KN, Petersen A, Jensen HE. Early implant- associated osteomyelitis results in a peri-implanted bacterial reservoir. APMIS. [Internet]. 2017; 125(1):38-45. doi: https://doi.org/f9gsqp DOI: https://doi.org/10.1111/apm.12597
Resnik RR, Misch C. Prophylactic antibiotic regimens in oral implantology: rationale and protocol. Implant. Dent. [Internet]. 2008; 17(2):142-150. doi: https://doi.org/drpwh3 DOI: https://doi.org/10.1097/ID.0b013e3181752b09
Hausman MR, Schaffler MB, Majeska RJ. Prevention of fracture healing in rats by an inhibitor of angiogenesis. Bone. [Internet]. 2001; 29(6):560-564. doi: https://doi.org/b94378 DOI: https://doi.org/10.1016/S8756-3282(01)00608-1
Keramaris NC, Calori GM, Nikolaou VS, Schemitsch EH, Giannoudis PV. Fracture vascularity and bone healing: a systematic review of the role of VEGF. Injury. [Internet]. 2008; 39(Suppl 2):S45-S57. doi: https://doi.org/cj5qvd DOI: https://doi.org/10.1016/S0020-1383(08)70015-9
Ganse B. Methods to accelerate fracture healing - a narrative review from a clinical perspective. Front Immunol. [Internet]. 2024; 15:1384783. doi: https://doi.org/pszv DOI: https://doi.org/10.3389/fimmu.2024.1384783
Perry AC, Prpa B, Rouse MS, Piper KE, Hanssen AD, Steckelberg JM, Patel R. Levofloxacin and trovafloxacin inhibition of experimental fracture-healing. Clin. Orthop. Relat. Res. [Internet]. 2003; 414:95-100. doi: https://doi.org/fpndfm DOI: https://doi.org/10.1097/01.blo.0000087322.60612.14
Maxwell A. The molecular basis of quinolone action. J. Antimicrob. Chemother. [Internet]. 1992; 30(4):409-414. doi: https://doi.org/dqz834 DOI: https://doi.org/10.1093/jac/30.4.409
Davis R, Bryson HM. Levofloxacin. A review of its antibacterial activity, pharmacokinetics and therapeutic efficacy. Drugs. [Internet]. 1994; 47(4):677-700. doi: https://doi.org/fszp56 DOI: https://doi.org/10.2165/00003495-199447040-00008
Shahabadi N, Hashempour S. DNA binding studies of antibiotic drug cephalexin using spectroscopic and molecular docking techniques. Nucleos. Nucleot. Nucl. Acids. [Internet]. 2019; 38(6):428-447. doi: https://doi.org/pszw DOI: https://doi.org/10.1080/15257770.2018.1562071
Papich MG, Lindeman C. Cephalexin susceptibility breakpoint for veterinary isolates: Clinical Laboratory Standards Institute revision. J. Vet. Diagn. Invest. [Internet]. 2017; 30(1):113-120. doi: https://doi.org/gcsn5t DOI: https://doi.org/10.1177/1040638717742434
Golestani S, Golestaneh A, Gohari AA. Comparative effects of systemic administration of levofloxacin and cephalexin on fracture healing in rats. J. Korean Assoc. Oral Maxillofac. Surg. [Internet]. 2022; 48(2):94-100. doi: https://doi.org/pszz DOI: https://doi.org/10.5125/jkaoms.2022.48.2.94
Holtom PD, Pavkovic SA, Bravos PD, Patzakis MJ, Shepherd LE, Frenkel B. Inhibitory effects of the quinolone antibiotics trovafloxacin, ciprofloxacin, and levofloxacin on osteoblastic cells in vitro. J. Orthop. Res. [Internet]. 2000; 18(5):721–727. doi: https://doi.org/c85q99 DOI: https://doi.org/10.1002/jor.1100180507
Zhang Q, Jing D, Zhang Y, Miron RJ. Histomorphometric Study of New Bone Formation Comparing Defect Healing with Three Bone Grafting Materials: The Effect of Osteoporosis on Graft Consolidation. Int. J. Oral Maxillofac. Implants. [Internet]. 2018; 33(3):645–652. doi: https://doi.org/gd97zm DOI: https://doi.org/10.11607/jomi.5879
Huddleston PM, Steckelberg JM, Hanssen AD, Rouse MS, Bolander ME, Patel R. Ciprofloxacin inhibition of experimental fracture healing. J. Bone Joint Surg. [Internet]. 2000; 82(2):161–173. doi: https://doi.org/psz2 DOI: https://doi.org/10.2106/00004623-200002000-00002