title: Bisphosphonate therapy improves the outcome of conventional periodontal treatment: results of a 12-month, randomized, placebo-controlled study.
abstract: BACKGROUND
  Bone loss in periodontitis results from inflammatory reactions that stimulate osteoclastic bone resorption. Bisphosphonates inhibit bone resorption and increase bone mass. This study evaluated the effect of bisphosphonate therapy as an adjunct to non-surgical periodontal treatment in patients with moderate to severe chronic periodontitis.
  
  
  METHODS
  Patients were randomized (2:1) to one of two bisphosphonate therapies or placebo for 1 year. All patients received non-surgical periodontal treatment (scaling, root planing) and periodontal maintenance therapy every 3 months. Clinical assessments at baseline and 6 and 12 months included clinical attachment level (CAL), probing depth (PD), and bleeding on probing (BOP). Periodontal bone mass was assessed by dental radiographs at baseline and 12 months using fractal analysis and digital subtraction radiography (DSR).
  
  
  RESULTS
  Seventy patients were randomized, 43 to the bisphosphonate group and 27 to the placebo group. Bisphosphonate therapy significantly improved CAL, PD, and BOP relative to the placebo group during the 6- to 12-month period (CAL, P = 0.0002; PD, P = 0.0156; BOP, P = 0.0079). There was no difference in the change in periodontal bone mass between the bisphosphonate and placebo groups as measured by fractal analysis and DSR.
  
  
  CONCLUSIONS
  These data suggest that bisphosphonate treatment improves the clinical outcome of non-surgical periodontal therapy and may be an appropriate adjunctive treatment to preserve periodontal bone mass.
authors: Division of Rheumatology, Department of Medicine, University of California-San Francisco, 1001 Potrero Avenue, San Francisco, CA 94110, USA. nelane@itsa.ucsf.edu
authors: Nancy
authors: N
authors: Lane
authors: Gary C
authors: GC
authors: Armitage
authors: Peter
authors: P
authors: Loomer
authors: Susan
authors: S
authors: Hsieh
authors: Sharmila
authors: S
authors: Majumdar
authors: H-Y
authors: HY
authors: Wang
authors: Marjorie
authors: M
authors: Jeffcoat
authors: Thelma
authors: T
authors: Munoz
mesh_terms: D019386:Alendronate / Q000627:therapeutic use; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000517:prevention & control*; D000704:Analysis of Variance; D017024:Chemotherapy, Adjuvant; D012534:Dental Scaling; D004164:Diphosphonates / Q000627:therapeutic use*; D004311:Double-Blind Method; D012968:Etidronic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D005260:Female; D017709:Fractals; D006801:Humans; D008297:Male; D008875:Middle Aged; D010512:Periodontal Index; D010518:Periodontitis / Q000188:drug therapy*; D011859:Radiography; D000068296:Risedronic Acid; D018709:Statistics, Nonparametric
chemical_list: D004164:Diphosphonates; D000068296:Risedronic Acid; D012968:Etidronic Acid; D019386:Alendronate