The comparative evaluation of 1% alendronate gel as local drug delivery system in chronic periodontitis in smokers and non smokers: Randomized clinical trial

Abstract

Introduction: Periodontitis is a progressive disease of microbial origin involving the loss of supporting tissues of the teeth resulting from host inflammatory and immunologic reactions. The standard approach to the prevention and treatment of periodontal diseases for a number of years has been mechanical therapy and if required surgical intervention Researcher thought of creating a treatment modality where by altering the host response, the destructive host mechanisms could be interfered affecting the final outcome of the disease process. Aim: The present study aims to explore the efficacy of local delivery of a 1% Alendronate (ALN) gel as an adjunct to scaling and root planing (SRP) for the treatment of infrabony periodontal pockets in smokers and non-smoker with Chronic Periodontitis. Materials and method: 60 infrabony periodontal pockets in patients with chronic periodontitis between the age group of 30-50 years were selected. The study consisted of 2 groups smoker and nonsmoker. A gel based drug delivery system of Alendronate was formulated. 0.1 ml alendronate gel and 0.1 ml placebo gel was placed at the experimental and control sites respectively following root planing. Clinical and radiographic parameters were recorded at baseline, three months and six months. Results: Alendronate was effective in improving clinical and radiographic parameters compared to placebo. Alendronate showed better result in non smoker group when compared with smoker group. Conclusion: This Study showed improvements in clinical parameters both at the control and experimental sites. However, the experimental sites (Alendronate) showed greater improvement as compared to the control sites (Placebo). A significant gain in alveolar crest height and defect fill was measured radiographically at non smoker Alendronate group.

Evaluation of the Efficacy of 1% Alendronate Gel as Adjunctive Treatment in Class II Furcation Defects (Clinical, Radiographic and Biochemical Study)

“…In addition, there was a statistically significant difference at 3 and 6 months in group II when compared to group I. These results are in agreement to Pradeep et al (2016) (24) and Sheokanda et al (2018) (25) who reported that topical application of alendronate showed a gain in bone density and improved bone mass after 6 m observational period.…”

Bisphosphonates as Supplement to Dental Treatment: A Network Meta-Analysis

“…Following removal of duplicates and elimination based on title and abstract (Appendix Table 4), 108 full texts remained for further assessment. From those, 97 articles were excluded for various reasons, and thus 11 studies (Rocha et al 2004; Lane et al 2005; Graziani et al 2009; Sharma and Pradeep 2012a, 2012b; Pradeep et al 2013, 2017; Sharma et al 2017; Gupta et al 2018; Ipshita et al 2018; Sheokand et al 2019) were included in the qualitative synthesis. From the latter, the study by Graziani et al (2009) was omitted from the quantitative synthesis due to missing data that could not be retrieved.…”

“…From the latter, the study by Graziani et al (2009) was omitted from the quantitative synthesis due to missing data that could not be retrieved. Furthermore, the studies by Sharma and Pradeep (2012b), Sharma et al (2017), and Sheokand et al (2019) reported data on the basis of the assessed tooth sites rather than the examined patients and were thus included only in the qualitative evaluation to avoid bias due to pooling of different statistical units.…”

“…From the 11 included RCTs, 3 were found to present high risk of bias (Rocha et al 2004; Graziani et al 2009; Sheokand et al 2019), while 7 studies were judged with “some concerns” (Lane et al 2005; Sharma and Pradeep 2012a, 2012b; Pradeep et al 2013, 2017; Sharma et al 2017; Gupta et al 2018), and 1 study was considered to present low risk of bias (Ipshita et al 2018) (Appendix Table 5).…”

Aplicación del gel de alendronato al 1 % como coadyuvante en la terapia periodontal

“…3 A lo largo del tiempo, el tratamiento para la periodontitis fue puramente mecánico y/o quirúrgico; sin embargo, en la actualidad, se están buscando tratamientos alternativos que contribuyan a la regeneración ósea guiada. [4][5][6] Una de estas alternativas, como coadyuvante, es el uso de bifosfonatos, destacando el alendronato, el cual se ha comprobado que inhibe la producción de interleukina-1α (IL), IL-6 y TNF causada por los monocitos y la reabsorción ósea, desencadenando propiedades osteoestimulativas. [7][8][9] En un estudio realizado en las diáfisis del fémur del ratón, la aplicación directa de alendronato aceleró y promovió, localmente, la regeneración ósea, comportándose como material osteoinductivo; además mejoró la calidad de tejido óseo neoformado y la densidad del tejido óseo.…”