Clinical and radiological improvement of periodontal disease in patients with type 2 diabetes mellitus treated with alendronate: a randomized, placebo-controlled trial.
BACKGROUND
Alendronate (ALN) is an aminobisphosphonate commonly used for osteoporosis in postmenopausal women. We studied the effect of ALN on bone loss prevention in type 2 diabetes mellitus patients with periodontal disease.


METHODS
In a controlled double-blind, randomized study we evaluated prospectively diabetic patients paired by gender and years since diagnosis for 6 months. The study included 40 patients (20 men and 20 women), 50 to 60 years old, with more than 5 years since diagnosis of diabetes and established periodontitis. They were randomly allocated to alendronate (10 mg/daily) or placebo treatment for 6 months. The endpoints of treatment were: the distance between the alveolar bone border and the cemento-enamel-junction (CEJ) evaluated by means of digital radiographic imaging, a biochemical marker of bone resorption (urine N-telopeptide) (Ntx), and periodontal parameters. Metabolic control was assessed at baseline and after 6 months.


RESULTS
Baseline and 6-month glycated hemoglobin levels were similar in both groups. Alendronate induced a significant decrease in NTx at 6 months (P = 0.006). Periodontal parameters improved in both groups. However, they were significantly better for the ALN treated group. Alveolar bone border-CEJ distance increased in the placebo, but decreased in the ALN group (P = 0.0003).


CONCLUSIONS
In type-2 diabetic patients, alendronate induced more improvement in alveolar bone crest height than control therapy. No differences in urinary N-telopeptide or glycated hemoglobin were observed in this short-term randomized controlled pilot trial.
Rocha
M
M
Instituto de Investigaciones Médicas, Universidad de Guanajuato, León, México.
Nava
L E
LE
Vázquez de la Torre
C
C
Sánchez-Márin
F
F
Garay-Sevilla
M E
ME
Malacara
J M
JM
D019386:Alendronate / Q000627:therapeutic use*; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000473:pathology / Q000517:prevention & control; D000539:Alveolar Process / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology; D015415:Biomarkers / Q000652:urine; D001862:Bone Resorption / Q000652:urine; D016022:Case-Control Studies; D003094:Collagen / Q000652:urine; D024042:Collagen Type I; D003404:Creatinine / Q000652:urine; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010455:Peptides / Q000652:urine; D010518:Periodontitis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D010919:Placebos; D011446:Prospective Studies; D011856:Radiographic Image Enhancement; D018709:Statistics, Nonparametric; D019237:Tooth Cervix / Q000473:pathology
D019386:Alendronate; D015415:Biomarkers; D003094:Collagen; D024042:Collagen Type I; D003404:Creatinine; D006442:Glycated Hemoglobin; D010455:Peptides; D010919:Placebos; C052929:collagen type I trimeric cross-linked peptide