Department of Periodontics, Government Dental College and Research Institute, Bangalore, Karnataka, India.
J Periodontol. 2012 Jan;83(1):19-26. doi: 10.1902/jop.2011.110206. Epub 2011 May 24.
Bisphosphonates represent a class of pharmacologic agents that have a potentially important role in the treatment of periodontitis and bone disorders. The present study aims to explore the clinical efficacy of 1% alendronate (ALN) gel as a local drug delivery system in adjunct to scaling and root planing for the treatment of patients with aggressive periodontitis (AgP) compared to placebo gel.
Fifty-two intrabony defects from 17 patients with AgP were treated either with 1% ALN gel or placebo gel. ALN gel was prepared by adding ALN to a polyacrylic acid-distilled water mixture. Clinical parameters (modified sulcus bleeding index, plaque index, probing depth [PD], and clinical attachment level [CAL]) were recorded at baseline, 2 months, and 6 months, and radiographic parameters were recorded at baseline and 6 months. Defect fill at baseline and at 6 months was calculated on standardized radiographs by using image analysis software.
Mean PD reduction was greater in the ALN group (3.88 ± 1.39 mm) compared to placebo (1.65 ± 1.35 mm) at 6 months. Similarly, mean CAL gain was greater in the ALN group (3.27 ± 1.11 mm) than the placebo group (1.42 ± 1.70 mm) at 6 months. Furthermore, significantly greater mean percentage of bone fill was found in the ALN group (46.1% ± 9.48%) compared to the placebo group (2% ± 1.02%).
The results of the present study show local delivery of 1% ALN stimulates a significant increase in PD reduction, CAL gain, and improved bone fill compared to placebo gel as an adjunct to scaling and root planing in patients with AgP. However, long-term, multicentered, randomized, controlled clinical trials are required to know the clinical, histologic, and radiographic effect on bone regeneration in patients with AgP.
双膦酸盐是一类具有重要治疗牙周炎和骨骼疾病潜力的药物。本研究旨在探讨 1%阿仑膦酸钠（ALN）凝胶作为局部药物输送系统，与牙周刮治和根面平整联合应用于侵袭性牙周炎（AgP）患者的临床疗效，与安慰剂凝胶相比。
17 例侵袭性牙周炎患者的 52 个骨内缺损分别用 1%阿仑膦酸钠凝胶或安慰剂凝胶治疗。ALN 凝胶通过将 ALN 加入聚丙烯酸-蒸馏水混合物中制备而成。在基线、2 个月和 6 个月时记录临床参数（改良龈沟出血指数、菌斑指数、探诊深度[PD]和临床附着水平[CAL]），在基线和 6 个月时记录放射学参数。在基线和 6 个月时，使用图像分析软件对标准化 X 线片上的缺损填充进行计算。
6 个月时，ALN 组 PD 平均减少（3.88±1.39）mm，明显大于安慰剂组（1.65±1.35）mm。同样，ALN 组 CAL 平均增加（3.27±1.11）mm，明显大于安慰剂组（1.42±1.70）mm。此外，ALN 组的平均骨填充百分比（46.1%±9.48%）明显大于安慰剂组（2%±1.02%）。
本研究结果表明，与牙周刮治和根面平整联合应用时，局部给予 1%ALN 可显著促进 PD 减少、CAL 增加和骨填充改善，优于安慰剂凝胶。然而，需要进行长期、多中心、随机、对照临床试验，以了解 AgP 患者的临床、组织学和放射学对骨再生的影响。
