Gingival crevicular fluid osteocalcin before and after treatment of human periodontal osseous defects with collagen membrane [biomend] alone or in combination with alendronate

ABSTRACT

The objective of this study was to evaluate the effect of Biomend as GTR alone or in combination with local application of alendronate in management of interproximal osseous defects in chronic periodontitis. Furthermore, to investigate the effect of these modalities of treatment on the crevicular fluid levels of osteocalcin. A total of 14 matched defects were chosen from 8 patients with severe chronic periodontitis. Seven defects were treated with collagen membrane in combination with local application of alendronate sodium, while 7 defects were treated with collagen membrane only. All patients were subjected to thorough clinical examination in selected sites, including gingival index, probing depth and probing attachment level. These parameters were taken before surgery and at 3 and 6 months post-surgically. These patients were also subjected to densitometric evaluation before and at 3 and 6 month post-surgically. Gingival crevicular fluid [GCF] was collected from selected sites presurgically and at 3 and 6 months post-surgically. An enzyme linked immunoassay kit [Gla type Osteocalcin Ela Kit] was utilized for the detection of osteocalcin. The results of the present study showed that both treatment modalities were effective in management of interproximal osseous defects, however, the adjunctive use of alendronate to GTR offered a more favorable clinical outcome as well as better improvement in bone density. A significant increase in GCF osteocalcin was noticed after both treatment modalities, particularly in the alendronate group. However, on comparing both groups, no significant difference was observed at various periods of follow up. Also, a significant correlation was found between GCF osteocalcin and bone density at the end of follow up period. This increase in GCF osteocalcin might be a result of bone remodeling associated with an increased osteoblastic activity which occurred during healing. It appears that osteocalcin acted as a bone formation marker during this stage of healing