title: Effectiveness of alendronate as an adjunct to scaling and root planing in the treatment of periodontitis: a meta-analysis of randomized controlled clinical trials.
abstract: OBJECTIVE
  Alendronate has been proposed as a local and systemic drug treatment used as an adjunct to scaling and root planing (SRP) for the treatment of periodontitis. However, its effectiveness has yet to be conclusively established. The purpose of the present meta-analysis was to assess the effectiveness of SRP with alendronate on periodontitis compared to SRP alone.
  
  
  METHODS
  Five electronic databases were used by 2 independent reviewers to identify relevant articles from the earliest records up to September 2016. Randomized controlled trials (RCTs) comparing SRP with alendronate to SRP with placebo in the treatment of periodontitis were included. The outcome measures were changes in bone defect fill, probing depth (PD), and clinical attachment level (CAL) from baseline to 6 months. A fixed-effect or random-effect model was used to pool the extracted data, as appropriate. Mean differences (MDs) with 95% confidence intervals (CIs) were calculated. Heterogeneity was assessed using the Cochrane χ2and I2tests.
  
  
  RESULTS
  After the selection process, 8 articles were included in the meta-analysis. Compared with SRP alone, the adjunctive mean benefits of locally delivered alendronate were 38.25% for bone defect fill increase (95% CI=33.05-43.45;P<0.001; I2=94.0%), 2.29 mm for PD reduction (95% CI=2.07-2.52 mm;P<0.001; I2=0.0%) and 1.92 mm for CAL gain (95% CI=1.55-2.30 mm;P<0.001; I2=66.0%). In addition, systemically administered alendronate with SRP significantly reduced PD by 0.36 mm (95% CI=0.18-0.55 mm;P<0.001; I2=0.0%) and increased CAL by 0.39 mm (95% CI=0.11-0.68 mm;P=0.006; I2=6.0%).
  
  
  CONCLUSIONS
  The collective evidence regarding the adjunctive use of alendronate locally and systemically with SRP indicates that the combined treatment can improve the efficacy of non-surgical periodontal therapy on increasing CAL and bone defect fill and reducing PD. However, precautions must be exercised in interpreting these results, and multicenter studies evaluating this specific application should be carried out.
authors.affiliation: Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University College of Stomatology, Chongqing, China .
authors.forename: Jin
authors.identifier: 0000-0002-4164-1395
authors.initials: J
authors.lastname: Chen
authors.affiliation: Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University College of Stomatology, Chongqing, China .
authors.forename: Qian
authors.identifier: 0000-0003-0962-8147
authors.initials: Q
authors.lastname: Chen
authors.affiliation: Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University College of Stomatology, Chongqing, China .
authors.forename: Bo
authors.identifier: 0000-0002-2125-6967
authors.initials: B
authors.lastname: Hu
authors.affiliation: Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University College of Stomatology, Chongqing, China .
authors.forename: Yunji
authors.identifier: 0000-0002-2691-8042
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University College of Stomatology, Chongqing, China .
authors.forename: Jinlin
authors.identifier: 0000-0002-0224-6640
authors.initials: J
authors.lastname: Song
keywords: Alendronate; Meta-analysis; Periodontitis; Root planing