Effects of alendronate and hormone replacement therapy, alone and in combination, on saliva, periodontal conditions and gingival crevicular fluid matrix metalloproteinase-8 levels in women with osteoporosis.
OBJECTIVE
To compare the effects of hormone replacement therapy (HRT), alendronate and their combination on oral health of elderly postmenopausal women with osteoporosis.


METHODS
Sixty patients, aged 65-80 years (mean 71 years), with a T-score of bone mineral density of -2.5 s.d. or less at either the lumbar spine or the femoral neck, were randomized to receive 2 mg of estradiol plus 1 mg norethisterone acetate (HRT) (n = 20), 10 mg of alendronate (n = 18), or their combination (n = 22) for 2 years. Periodontal and oral status and mouth symptoms were recorded, and salivary analyses made at the beginning and at the end of the study. Gingival crevicular fluid (GCF) matrix metalloproteinase (MMP-8) levels were determined to address destructive events in periodontal tissue.


RESULTS
Resting salivary flow rate decreased by 19% (P < 0.05), and GCF MMP-8 tended to increase in the alendronate group. None of the regimens affected subjective feelings of dry or burning mouth. There were no significant changes in dental or periodontal status, stimulated flow rate or composition of saliva during the study.


CONCLUSIONS
Alendronate decreased resting salivary flow rate but otherwise HRT or alendronate separately or in combination had no effect on oral health in elderly women with osteoporosis.
Department of Obstetrics and Gynecology, University of Helsinki, Helsinki, Finland. sirpa.evio@hus.fi
S
S
Eviö
L
L
Tarkkila
T
T
Sorsa
J
J
Furuholm
M J
MJ
Välimäki
O
O
Ylikorkala
A
A
Tiitinen
J H
JH
Meurman
D000368:Aged; D000369:Aged, 80 and over; D019386:Alendronate / Q000008:administration & dosage / Q000627:therapeutic use*; D015519:Bone Density / Q000187:drug effects; D050071:Bone Density Conservation Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004958:Estradiol / Q000627:therapeutic use; D015914:Estrogen Replacement Therapy; D005260:Female; D005500:Follow-Up Studies; D005883:Gingival Crevicular Fluid / Q000187:drug effects* / Q000201:enzymology; D006801:Humans; D008137:Longitudinal Studies; D020784:Matrix Metalloproteinase 8 / Q000187:drug effects*; D009640:Norethindrone / Q000031:analogs & derivatives / Q000627:therapeutic use; D000077563:Norethindrone Acetate; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy*; D010519:Periodontium / Q000187:drug effects*; D010919:Placebos; D012463:Saliva / Q000187:drug effects* / Q000378:metabolism; D012636:Secretory Rate / Q000187:drug effects
D050071:Bone Density Conservation Agents; D010919:Placebos; D004958:Estradiol; D000077563:Norethindrone Acetate; D020784:Matrix Metalloproteinase 8; D009640:Norethindrone; D019386:Alendronate