Royal Jelly as a Therapeutic Intervention in Medication-Related Osteonecrosis of the Jaw (MRONJ): An Animal Model Study

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BACKGROUND: To evaluate the efficacy of royal jelly in managing experimentally created MRONJ model in rats. METHODS: Sixty rats were randomly allocated into control, bisphosphonate (BP), royal jelly (RJ), Treatment, and Preventive groups. A defect was created in the alveolar socket following tooth extraction in the mandible as a surgical procedure in all groups. Before surgery, RJ was administered orally to the RJ group. Zoledronic acid was administered intraperitoneally to induce osteonecrosis in BP, treatment, and preventive group rats. Treatment group rats received RJ orally post-surgery, while preventive group rats received it pre-surgery. Histological and radiographic evaluations were performed post-study completion. RESULTS: Micro-CT examinations demonstrated significantly improved values in RJ-received groups (RJ, treatment, and preventive) compared to BP and control groups (p < 0.001). Immunohistochemical analysis revealed higher mean IL-1β and TNF-α levels in the BP group. The highest IL-1β difference was between BP and preventive groups (p < 0.001). TNF-α expression levels in all RJ-received groups were comparatively close to those of the control group. CONCLUSION: RJ enhances soft and hard tissue healing in MRONJ rat models, suggesting its potential as a therapeutic or preventive agent in osteonecrosis management.