Bisphosphonates as Supplement to Dental Treatment: A Network Meta-Analysis

Area of Science:

• Periodontology
• Pharmacology
• Evidence-Based Dentistry

Background:

• Bisphosphonates (BPs) are commonly used for bone diseases.
• Their role as an adjunct to dental treatment in non-bone disease patients is less understood.
• Periodontal disease management requires effective therapeutic adjuncts.

Purpose of the Study:

• To assess the clinical effectiveness of bisphosphonate (BP) administration as a supplement to conventional dental treatment.
• To compare different BPs and administration routes for periodontal treatment outcomes.
• To synthesize evidence from randomized controlled trials (RCTs) using a network meta-analysis.

Main Methods:

• Systematic search of 17 electronic databases and manual searches up to August 2020.
• Inclusion of seven RCTs involving 391 subjects assessing periodontal treatment effects.
• Network meta-analysis using a random-effects model to pool clinical measurements (e.g., probing depth, attachment gain).

Main Results:

• BP treatment showed significant short-term improvements in most clinical measurements compared to BP-naive controls.
• Alendronate demonstrated greater efficacy in reducing probing depth and increasing clinical attachment gain than zoledronate or alendronate/risedronate.
• Local application of alendronate gel was more effective than oral administration.

Conclusions:

• Bisphosphonate administration appears beneficial for short-term periodontal disease treatment, primarily by controlling inflammation.
• Alendronate, particularly in local gel form, shows promise for enhanced periodontal outcomes.
• Insufficient data precluded analysis of adverse effects and long-term outcomes.