Clinical and radiological improvement of periodontal disease in patients with type 2 diabetes mellitus treated with alendronate: a randomized, placebo-controlled trial

J Periodontol. 2001 Feb;72(2):204-9. doi: 10.1902/jop.2001.72.2.204.

Abstract

Background: Alendronate (ALN) is an aminobisphosphonate commonly used for osteoporosis in postmenopausal women. We studied the effect of ALN on bone loss prevention in type 2 diabetes mellitus patients with periodontal disease.

Methods: In a controlled double-blind, randomized study we evaluated prospectively diabetic patients paired by gender and years since diagnosis for 6 months. The study included 40 patients (20 men and 20 women), 50 to 60 years old, with more than 5 years since diagnosis of diabetes and established periodontitis. They were randomly allocated to alendronate (10 mg/daily) or placebo treatment for 6 months. The endpoints of treatment were: the distance between the alveolar bone border and the cemento-enamel-junction (CEJ) evaluated by means of digital radiographic imaging, a biochemical marker of bone resorption (urine N-telopeptide) (Ntx), and periodontal parameters. Metabolic control was assessed at baseline and after 6 months.

Results: Baseline and 6-month glycated hemoglobin levels were similar in both groups. Alendronate induced a significant decrease in NTx at 6 months (P = 0.006). Periodontal parameters improved in both groups. However, they were significantly better for the ALN treated group. Alveolar bone border-CEJ distance increased in the placebo, but decreased in the ALN group (P = 0.0003).

Conclusions: In type-2 diabetic patients, alendronate induced more improvement in alveolar bone crest height than control therapy. No differences in urinary N-telopeptide or glycated hemoglobin were observed in this short-term randomized controlled pilot trial.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alendronate / therapeutic use*
  • Alveolar Bone Loss / diagnostic imaging
  • Alveolar Bone Loss / pathology
  • Alveolar Bone Loss / prevention & control
  • Alveolar Process / diagnostic imaging
  • Alveolar Process / drug effects
  • Alveolar Process / pathology
  • Biomarkers / urine
  • Bone Resorption / urine
  • Case-Control Studies
  • Collagen / urine
  • Collagen Type I
  • Creatinine / urine
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / complications*
  • Double-Blind Method
  • Female
  • Follow-Up Studies
  • Glycated Hemoglobin A / analysis
  • Humans
  • Male
  • Middle Aged
  • Peptides / urine
  • Periodontitis / diagnostic imaging
  • Periodontitis / drug therapy*
  • Periodontitis / pathology
  • Placebos
  • Prospective Studies
  • Radiographic Image Enhancement
  • Statistics, Nonparametric
  • Tooth Cervix / pathology

Substances

  • Biomarkers
  • Collagen Type I
  • Glycated Hemoglobin A
  • Peptides
  • Placebos
  • collagen type I trimeric cross-linked peptide
  • Collagen
  • Creatinine
  • Alendronate