Ali A Rizwan, Patnana Arun Kumar, Kumar Pravin, Pathak Karishma, Chugh Ankita, Chaudhry Kirti
Department Of Dentistry, All India Institute Of Medical Sciences, Jodhpur, India.
Department Of Dentistry, All India Institute Of Medical Sciences, Rajkot, India.
Evid Based Dent. 2025 May 26. doi: 10.1038/s41432-025-01165-0.
Alendronate (ALN) are pyrophosphates which prevent bone resorption and aid in periodontal regeneration. The present review aimed to evaluate the success of surgical periodontal therapy in the management of intrabony/ furcation defects with and without topical application of ALN.
Using combinations of different search terms, the authors searched the standard electronic databases for randomised controlled trials. Version 2 of the Cochrane risk of bias tool for randomised trials was used for quality appraisal. The random-effects model was used for the statistical analysis of estimated effect sizes. The overall quality of evidence was assessed using GRADEpro GDT software.
Nine studies satisfying all inclusion criteria were selected for qualitative analysis, and six studies with homogeneous data were selected for quantitative analysis. The overall risk of bias had "low" concerns in one study, "some" concerns in four studies, and "high" concerns in four studies. The pooled analysis showed that the experimental group showed a significant reduction in periodontal probing depth(PPD) and defect depth(DD) with a standard mean difference(SDM) of 1.06 mm (95% CI, 0.77-1.34; P < 0.00001; I = 0%) and 1.10 mm (95% CI, 0.65-1.54; P < 0.00001; I = 56%) respectively, significant improvement in the clinical attachment level (CAL) with SDM of 1.03 mm (95% CI, 0.42-1.64; P = 0.0009; I2 = 76%).
The topical application of ALN has been shown to enhance the effectiveness of surgical periodontal therapy by reducing the PPD and DD and increasing the CAL; however, the certainty of evidence remains very low to low.
阿仑膦酸盐（ALN）是一种焦磷酸盐，可防止骨吸收并有助于牙周再生。本综述旨在评估手术牙周治疗在伴有或不伴有局部应用ALN的情况下治疗骨内/根分叉缺损的成功率。
作者使用不同搜索词的组合，在标准电子数据库中检索随机对照试验。采用Cochrane随机试验偏倚风险工具第2版进行质量评估。随机效应模型用于估计效应大小的统计分析。使用GRADEpro GDT软件评估证据的总体质量。
选择9项符合所有纳入标准的研究进行定性分析，选择6项数据同质的研究进行定量分析。总体偏倚风险在1项研究中为“低”关注，4项研究中为“一些”关注，4项研究中为“高”关注。汇总分析表明，实验组的牙周探诊深度（PPD）和缺损深度（DD）显著降低，标准均差（SMD）分别为1.06毫米（95%CI，0.77 - 1.34；P < 0.00001；I² = 0%）和1.10毫米（95%CI，0.65 - 1.54；P < 0.00001；I² = 56%），临床附着水平（CAL）显著改善，SMD为1.03毫米（95%CI，0.42 - 1.64；P = 0.0009；I² = 76%）。
已表明局部应用ALN可通过降低PPD和DD以及增加CAL来提高手术牙周治疗的有效性；然而，证据的确定性仍然非常低到低。
