Role of Bisphosphonates in Periodontal Diseases: Systematic Review

INTRODUCTION: The chief aim in managing periodontal diseases is the elimination of causative factors that may vary from pathogens to physical parameters. In the current systematic review, the effectiveness of “Bisphosphonate Therapy” as a supplement to “Scaling and Root Planing (SRP)” in the management of periodontitis is calibrated from the previous studies. MATERIALS AND METHODS: An extensive online search in the various databanks of EMBASE, Medline, Pubmed, and Scopus was conducted. The keywords searched were “Probing depth (PD)” which was the main endpoint, and variations in “Clinical Attachment Level (CAL)” and/or “Bone Defect (BD) fill” were the secondary variants that were searched for in the current study. The data collected were tabulated and compared using the means and the standard deviations. Using the random effect method the mean variations and the confidence intervals (95%) of the parameters were assessed. RESULTS: Eight studies were finalized. Alendronate was utilized as a supplement to SRP in seven studies, four of which employed topical administration and three of which used oral alendronate. A substantial grade of heterogeneity for Probing depth (P < 0.0001), Clinical Attachment Level (P = 0.007), and Bone Defect fill (P < 0.0001) was observed amongst groups when comparing the properties of adjunctive BT to SRP alone. In comparison to SRP alone, SRP with bisphosphonate treatment significantly reduced PD (P = 0.002), increased CAL (P = 0.008), and filled BD (P < 0.001). CONCLUSIONS: Although BT as an adjunct appears to be successful in treating periodontitis, its practical applicability is questionable due to the possibility of developing jaw osteonecrosis and the short-range follow-up of the research.