Surgical periodontal therapy for the management of intrabony/furcation defects with and without topically delivered Alendronate - a systematic review and meta-analysis.

Abstract

Objective: 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.

Method: 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.

Results: 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; I² = 0%) and 1.10 mm (95% CI, 0.65-1.54; P < 0.00001; I² = 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%).

Conclusions: 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.