Bisphosphonate therapy improves the outcome of conventional periodontal treatment: results of a 12-month, randomized, placebo-controlled study.
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.
Lane
Nancy
N
Division of Rheumatology, Department of Medicine, University of California-San Francisco, 1001 Potrero Avenue, San Francisco, CA 94110, USA. nelane@itsa.ucsf.edu
Armitage
Gary C
GC
Loomer
Peter
P
Hsieh
Susan
S
Majumdar
Sharmila
S
Wang
H-Y
HY
Jeffcoat
Marjorie
M
Munoz
Thelma
T
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
D004164:Diphosphonates; D000068296:Risedronic Acid; D012968:Etidronic Acid; D019386:Alendronate