Effect of Locally Delivered Bisphosphonates on Alveolar Bone: A Systematic Review and Meta-Analysis

Kc, Kumar; Bhattarai, Bishwa Prakash; Shrestha, Sanjit; Shrestha, Bijaya; Shrestha, Manash

doi:10.1016/j.jebdp.2021.101580

Cited by 3 publications

(2 citation statements)

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“…The main manifestations of periodontal diseases are periodontal soft tissue inflammation, probing bleeding, alveolar bone resorption and loss of attachment ( Kinane, 2001 ; Kinane et al., 2017 ). BPs has a strong anti-resorption effect so that BPs not only are used to treat diseases related to bone metabolism ( Barbosa et al., 2021 ), but also had a therapeutic potential in periodontal diseases ( Kc et al., 2021 ; Zymperdikas et al., 2021 ; Arena et al., 2022 ). Application of BPs in periodontal disease can inhibit osteoclast recruitment and induce osteoclasts apoptosis, thereby reducing alveolar bone resorption caused by periodontal tissue inflammation.…”

Section: Discussionmentioning

confidence: 99%

Zoledronic acid affects the process of Porphyromonas gingivalis infecting oral mucosal epithelial barrier: An in-vivo and in-vitro study

Sun

Kong

et al. 2023

Front. Cell. Infect. Microbiol.

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Zoledronic acid (ZA), one of the commonly used bisphosphonates, is mainly used for bone-metabolic diseases. Studies proved that ZA has adverse effects on oral soft tissues. As the first line of innate immunity, the gingival epithelium could be infected by periodontal pathogens, which is a key process of the initiation of periodontal diseases. Yet, how ZA affects the periodontal pathogens infecting the epithelial barrier remains unclear. This study aimed to investigate the influences of ZA on the process of Porphyromonas gingivalis (P. gingivalis) infecting the gingival epithelial barrier via in-vitro and in-vivo experiments. In the in-vitro experiments, under the condition of different concentrations of ZA (0, 1, 10, and 100 μM), P. gingivalis was used to infect human gingival epithelial cells (HGECs). The infections were detected by transmission electron microscope and confocal laser scanning microscope. Besides, the internalization assay was applied to quantify the P. gingivalis, which infected the HGECs, in the different groups. To evaluate the expression levels of pro-inflammatory cytokines, including interleukin (IL)-1β, IL-6, and IL-8, by infected HGECs, real-time quantitative reverse transcription-polymerase chain reactions were applied. In the in-vivo experiments, rats were given ZA solution (ZA group) or saline (control group) by tail intravenous injection for 8 weeks. Subsequently, we put ligatures around the maxillary second molars of all the rats and inoculated P. gingivalis to the gingiva every other day from day 1 to day 13. The rats were sacrificed on days 3, 7, and 14 for micro-CT and histological analyses. The in-vitro results manifested that the quantity of P. gingivalis that had infected HGECs increased with the ZA concentrations. Pro-inflammatory cytokines expression by HGECs were significantly increased by 100 μM ZA. In the in-vivo study, compared to the control group, more P. gingivalis was detected in the superficial layer of gingival epithelium in the ZA group. Besides, ZA significantly increased the expression level of IL-1β on day 14 and IL-6 on days 7 and 14 in gingival tissues. These findings suggest that the oral epithelial tissues of patients who receive high-dose ZA treatment may be more susceptible to periodontal infections, resulting in severe inflammatory conditions.

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Section: Discussionmentioning

confidence: 99%

Zoledronic acid affects the process of Porphyromonas gingivalis infecting oral mucosal epithelial barrier: An in-vivo and in-vitro study

Sun

Kong

et al. 2023

Front. Cell. Infect. Microbiol.

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“…MedNEXT Journal of Medical and Health Sciences marginal bone loss during the pre-loading and 1-year post-loading periods was observed when using bisphosphonate-coated dental implants [11]. In this aspect, bisphosphonate coating of dental implants is a promising tool for surface modification, aiming to improve the osseointegration process and clinical outcome.…”

Section: Vol 3 Iss 1 Year 2022mentioning

confidence: 99%

Clinical findings and main considerations of the use of bisphosphonate in dental implants: a concise systematic review

Henk

Manzini

2022

MedNEXT

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Introduction: In the scenario of dental implant and osseointegration, it is highlighted that the scope of modern dentistry is to restore the patient's normal comfort, function, esthetics, speech, and health. More than one million dental implants are performed each year in the USA. Bisphosphonates (BP) have been the best drug associated with a significant improvement in the quality of life of patients with bone diseases such as Paget's disease, bone metastases, osteogenesis imperfecta, hypercalcemia, and even severe osteoporosis. Objective: Aimed to carry out a concise systematic review of the main considerations regarding the use of bisphosphonate in osseointegration for dental implants. Methods: The present study followed by a systematic review model, following the rules of systematic review – PRISMA. The search strategy was performed in the PubMed, Scielo, Cochrane Library, Web of Science and Scopus, and Google Scholar databases. The Cochrane Instrument was used to assess the risk of bias of the included studies. Results: Bisphosphonate coating of dental implants is a promising tool for surface modification, aiming to improve the osseointegration process and clinical outcome. The biological effects of bisphosphonates are thought to be primarily associated with inhibition of osteoclasts, whereas their effects on osteoblast function are unclear. Thus, surfaces coated with bisphosphonates to stimulate osteoblast differentiation have been investigated by several in vitro studies with contradictory results. Conclusion: Based on results, osteoporosis is a metabolic condition that affects alveolar bone density, but it does not present problems for the installation of osseointegrated implants, as long as there is sufficient bone mass in the region where the tooth will be implanted. Locally administered bisphosphonates induce bone regeneration in periodontal defects and decrease the rate of marginal bone loss after dental implant therapy.

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Comparative evaluation of the clinical and radiographic efficacy of 0.05% zoledronate gel as local drug delivery system in treating intrabony defects in stage III grade B periodontitis patients with and without type‐2 diabetes mellitus—A randomized split‐mouth clinical trial

Raj

Mishra

Mohanty

et al. 2023

Clin Adv Periodontics

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BackgroundThis 6‐month randomized split‐mouth and placebo‐controlled clinical trial aimed to evaluate the clinical and radiographic efficacy of adjunctive use of 0.05% zoledronate (ZLN) gel as local drug delivery to scaling and root planing (SRP) in stage III, grade B periodontitis patients with and without controlled type‐2 diabetes mellitus (DM).MethodsA total of 120 infrabony sites were divided into two groups: Group‐1 (non‐diabetic periodontitis) and Group‐2 (periodontitis + DM). A total of 60 sites in each group were randomized to receive treatment with SRP + placebo gel (control) or SRP + 0.05% ZLN gel (test). Plaque index (PI), modified sulcus bleeding index (mSBI), pocket probing depth (PPD), and relative attachment levels (RAL) were assessed at baseline, 3 and 6 months, and digital intraoral periapical and cone‐beam computed tomography imaging were used to measure the linear and percentage reduction of intrabony defect depth (DD, DDR%) after 6 months.ResultsGroup‐1 showed significant reduction in PI (0.56 ± 0.15 and 0.52 ± 0.19 from 0.67 ± 0.17), mSBI (0.7 ± 0.60 and 0.47 ± 0.57 from 0.9 ± 0.48), PPD (4.6 ± 0.85 and 3.43 ± 0.63 from 6.5 ± 1.04) and gain in RAL (7.03 ± 0.85 and 5.93 ± 0.69 from 8.9 ± 1.09) in the ZLN‐treated sites than the placebo sites and also from Group‐2 sites after 3 and 6 months, respectively. A significant reduction in DD of 28.79% in Group‐1 and 22.20% in Group‐2 at ZLN sites was seen compared to placebo sites of both groups.ConclusionZLN gel applied subgingivally in infrabony pockets resulted in significant clinical improvements evident by probing depth reduction and gain in attachment levels along with radiographic evidence of more bone fill seen in non‐diabetic patients compared to diabetic periodontitis patients.

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Effect of Locally Delivered Bisphosphonates on Alveolar Bone: A Systematic Review and Meta-Analysis

Cited by 3 publications

References 44 publications

Zoledronic acid affects the process of Porphyromonas gingivalis infecting oral mucosal epithelial barrier: An in-vivo and in-vitro study

Zoledronic acid affects the process of Porphyromonas gingivalis infecting oral mucosal epithelial barrier: An in-vivo and in-vitro study

Clinical findings and main considerations of the use of bisphosphonate in dental implants: a concise systematic review

Comparative evaluation of the clinical and radiographic efficacy of 0.05% zoledronate gel as local drug delivery system in treating intrabony defects in stage III grade B periodontitis patients with and without type‐2 diabetes mellitus—A randomized split‐mouth clinical trial

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