Abstract
BackgroundThis systematic review and meta-analysis aimed to investigate the role of alendronate combined with step 2 of periodontal therapy in reducing probing pocket depth, improving clinical attachment level, and reducing bone defect depth in intra-bony and inter-radicular defects.MethodsRCTs with more than 6 months follow-up were included in this study. Risk of bias assessment was performed using the Cochrane collaboration tool. In addition, meta-analysis and trial sequential analysis were used to aggregate the available evidence.ResultsSeven studies met the inclusion criteria and were included in the systematic review. Topical application of alendronate during second step of periodontal therapy significantly improved PD and CAL.ConclusionLocal application of alendronate may confer a beneficial effect when applied during step II of periodontal therapy even if long term studies are needed to confirm these results.Clinical relevanceConsidering the emerging role of host-inflammatory response in treatment of periodontitis and the antiresorptive and osteostimulative properties of bisphosphonates, several studies are focusing on the role of alendronate as an addition to non-surgical periodontal therapy.
Highlights
This systematic review and meta-analysis aimed to investigate the role of alendronate combined with step 2 of periodontal therapy in reducing probing pocket depth, improving clinical attachment level, and reducing bone defect depth in intra-bony and inter-radicular defects
Clinical relevance: Considering the emerging role of host-inflammatory response in treatment of periodontitis and the antiresorptive and osteostimulative properties of bisphosphonates, several studies are focusing on the role of alendronate as an addition to non-surgical periodontal therapy
A shorter follow up was not considered as it would be unlike to reflect a meaningful difference in treatment response between test and control; (2) Types of participants: Adults (> = 18 years old), systematically healthy individuals diagnosed with periodontitis; (3) Types of intervention: Studies evaluating the adjunctive use of alendronate 1% gel administered locally during step 2 of periodontal therapy in intra-bony and inter-radicular defects; Comparison: patients receiving placebo or none adjunct treatment during step II of periodontal therapy; (4) Outcomes: Primary outcome: reduction in Probing depth (PD), Clinical attachment level (CAL) gain and bone defect depth
Summary
This systematic review and meta-analysis aimed to investigate the role of alendronate combined with step 2 of periodontal therapy in reducing probing pocket depth, improving clinical attachment level, and reducing bone defect depth in intra-bony and inter-radicular defects. Periodontitis is an inflammatory disease affecting tissues surrounding teeth, characterized by destruction of connective tissue attachment and alveolar bone [1] It is mainly caused by the bacterial biofilm which is responsible for the inflammatory and immunologic reaction that. To be effective, it needs to be administered in high dosage to maintain the necessary concentration of the drug at the osseous defect and systemic administration of BPs can cause several side effects to the gastro-intestinal tract, renal failure and severe hypocalcemia [14]. For these reasons local application might be more successful in controlling local concentration and reducing toxicities. The aim of this study was to systematically review the role of local 1% alendronate gel in non-surgical therapy of intra-bony and inter-radicular defects
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