Clinical and radiographic assessment of the effect of adjunctive alendronate in management of patients with chronic periodontitis

ABSTRACT

The ultimate goal of periodontal therapy is arresting the disease process, preventing disease recurrence and regenerating the lost periodontium. The prevention of bone loss associated with chronic periodontitis could be enhanced by modulating the host response as an adjunct to mechanical debridement. Alendronate, a member of the bisphosphonate family, had been shown to be a potent inhibitor of osteoclast-mediated bone resorption without adverse effects on matrix mineralization. The present study was designed to assess whether the systemic administration of alendronate is effective in improving periodontal disease in patients with chronic periodontitis. Twenty four patients with a mean age of 52.6+/- 2.3 years, with established chronic periodontitis have undergone initial periodontal therapy and divided into two equal age-matched groups. The participants in the experimental group received one tablet of alendronate 10 mg every morning for 6 months while those in the control group received one tablet of alendronate 10 mg every morning for 6 months while those in the control group received no drugs during the study period. At the base line and after 6 months, clinical periodontal parameters as plaque index [PI], papillary bleeding index [PBI], probing pocket depth [PPD], gingival recession and clinical attachment level [CAL] were recorded. Moreover, the bone mineral density [BMD] and the distance from the cement-enamel junction [CEJ] to the depth of osseous defect on standardized intraoral direct radiographs were evaluated. Although the clinical periodontal parameters were improved in both groups, the improvement in the experimental group was greater. However, the BMD and alveolar bone height were significantly increased in the experimental group [P <0.001 and p< 0.05 respectively], while they were non-significantly reduced in the control group. It could be concluded from the results of the present study that alendronate could be a valuable addition to initial periodontal therapy in the treatment of chronic periodontitis