Efficacy of bisphosphonates for the control of alveolar bone loss in periodontitis

J Int Acad Periodontol. 2007 Jul;9(3):70-6.

Abstract

Periodontal disease is characterized by periodontal bone loss. For this reason, we conducted a study to test the effect of alendronate (ALN), an inhibitor of bone resorption, on alveolar bone mass. A total of 335 patients with periodontal disease (men = 162, women = 173), aged 30 to 79, were randomized to either placebo or ALN 70 mg once weekly. All patients received prophylaxis at baseline, and at 6, 12, and 18 months. Smokers accounted for 62% of patients, and 71% of the patients had severe periodontal disease. The primary efficacy endpoint was the change in alveolar bone loss (ABL). When all subjects were analyzed, 2 years of treatment with alendronate 70 mg once weekly did not significantly change either ABL or alveolar bone density (ABD) relative to placebo. However, in the subgroup of patients with low mandibular bone mineral density (BMD) at baseline, alendronate significantly reduced bone loss relative to placebo (p < 0.01). No such effect was seen in patients with normal baseline mandibular BMD. The overall and upper gastrointestinal safety and tolerability profile of alendronate after 2 years of treatment was very favorable compared to placebo. No cases of osteonecrosis of the jaw were observed. In summary, in patients with periodontal disease receiving prophylaxis, alendronate 70 mg once weekly was well tolerated, but did not have a detectable effect on alveolar bone loss, except in those patients with low mandibular BMD at baseline.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Alendronate / adverse effects
  • Alendronate / therapeutic use*
  • Alveolar Bone Loss / diagnostic imaging
  • Alveolar Bone Loss / drug therapy*
  • Alveolar Bone Loss / prevention & control
  • Alveolar Process / diagnostic imaging
  • Alveolar Process / drug effects
  • Alveolar Process / pathology
  • Analysis of Variance
  • Bone Density / drug effects
  • Bone Density Conservation Agents / adverse effects
  • Bone Density Conservation Agents / therapeutic use*
  • Female
  • Humans
  • Male
  • Mandibular Diseases / diagnostic imaging
  • Mandibular Diseases / drug therapy*
  • Mandibular Diseases / prevention & control
  • Middle Aged
  • Periodontitis / drug therapy
  • Periodontitis / prevention & control
  • Radiography

Substances

  • Bone Density Conservation Agents
  • Alendronate