title: Evaluation of the relative efficacy of an alloplast used alone and in conjunction with an osteoclast inhibitor in the treatment of human periodontal infrabony defects: a clinical and radiological study.
abstract: BACKGROUND
  Mucoperiosteal flap surgery stimulates varying amounts of alveolar bone loss due to accelerated osteoclastic activity [Regional Accelerated Phenomenon (RAP)]. Alendronate sodium inhibits osteoclastic activity and is thought to result in a net increase in osteoblastic activity. We undertook a preliminary study evaluating the effect of adjunctive use of topically delivered bisphosphonate alendronate (ALN) along with regenerative bone graft material in the treatment of periodontal infrabony defects.
  
  
  METHODS
  Fifteen patients with two-walled or three-walled infrabony defects were selected. In each patient, the infrabony defect of one side of arch was designated as group A (control site) and received hydroxyapatite (HA) bone graft material, while the infrabony defect on the contralateral side of same arch was designated as group B (test site) and received HA+200 μg drug solution of ALN.
  
  
  RESULTS
  Both the groups exhibited a highly significant reduction in probing depth and gain in clinical attachment level and linear bone fill at the end of 24 weeks. Comparative evaluation between the study groups revealed a statistically nonsignificant reduction in probing depth (P=0.128NS) and mean gain in attachment level (P=0.218NS). However, there was a statistically significant gain in linear bone fill (P=0.040*) in group B as compared to group A.
  
  
  CONCLUSIONS
  The results suggest that use of ALN along with graft material led to enhanced linear bone fill at the surgical site. This research provides a clue that bone-targeting properties of bisphosphonates can be harnessed along with regenerative materials to potentiate osseous regeneration.
authors: Department of Periodontics, Dr. H. S. J. Institute of Dental Sciences and Research, Chandigarh, India. jyoti.guptaa@yahoo.co.in
authors: Jyoti
authors: J
authors: Gupta
authors: Amarjit Singh
authors: AS
authors: Gill
authors: Poonam
authors: P
authors: Sikri
mesh_terms: D000328:Adult; D019386:Alendronate / Q000627:therapeutic use*; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000601:surgery*; D000539:Alveolar Process / Q000000981:diagnostic imaging / Q000473:pathology; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D018786:Bone Substitutes / Q000627:therapeutic use*; D055113:Chronic Periodontitis / Q000473:pathology / Q000601:surgery; D017886:Durapatite / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010010:Osteoclasts / Q000187:drug effects; D017622:Periodontal Attachment Loss / Q000473:pathology / Q000601:surgery; D010514:Periodontal Pocket / Q000473:pathology / Q000601:surgery; D011859:Radiography; D016037:Single-Blind Method; D016896:Treatment Outcome
chemical_list: D050071:Bone Density Conservation Agents; D018786:Bone Substitutes; D017886:Durapatite; D019386:Alendronate