Effect of adjuvant bisphosphonates on treatment of periodontitis: Systematic review with meta-analyses

Muniz, Francisco Wilker Mustafa Gomes; Silva, Bernardo Franco da; Goulart, Conrado Richel; Silveira, Taciane Menezes da; Martins, Thiago Marchi

doi:10.1016/j.jobcr.2021.01.008

Cited by 12 publications

(9 citation statements)

References 63 publications

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“…Periodontitis is the inflammation of the gingiva caused by bacterial flora, which could lead to the destructive of gingival tissues, or tooth loss, in more severe cases [76]. It can be caused by both local and systemic factors, and is easily influenced by factors such as immunity, oral hygiene habits, and many more [77].…”

Section: Periodontal Treatmentmentioning

confidence: 99%

Bisphosphonates and Their Connection to Dental Procedures: Exploring Bisphosphonate-Related Osteonecrosis of the Jaws

Lee,

Tsai,

Lee

et al. 2023

Cancers

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Bisphosphonates are widely used to treat osteoporosis and malignant tumors due to their effectiveness in increasing bone density and inhibiting bone resorption. However, their association with bisphosphonate-related osteonecrosis of the jaws (BRONJ) following invasive dental procedures poses a significant challenge. This review explores the functions, mechanisms, and side effects of bisphosphonates, emphasizing their impact on dental procedures. Dental patients receiving bisphosphonate treatment are at higher risk of BRONJ, necessitating dentists’ awareness of these risks. Topical bisphosphonate applications enhance dental implant success, by promoting osseointegration and preventing osteoclast apoptosis, and is effective in periodontal treatment. Yet, systemic administration (intravenous or intraoral) significantly increases the risk of BRONJ following dental procedures, particularly in inflamed conditions. Prevention and management of BRONJ involve maintaining oral health, considering alternative treatments, and careful pre-operative and post-operative follow-ups. Future research could focus on finding bisphosphonate alternatives with fewer side effects or developing combinations that reduce BRONJ risk. This review underscores the need for further exploration of bisphosphonates and their implications in dental procedures.

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Section: Periodontal Treatmentmentioning

confidence: 99%

Bisphosphonates and Their Connection to Dental Procedures: Exploring Bisphosphonate-Related Osteonecrosis of the Jaws

Lee,

Tsai,

Lee

et al. 2023

Cancers

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“…The animals assigned to receive SRP plus alendronate showed less local inflammation and better tissue repair, associated with higher expression of osteoprotegerin (OPG) immunolabeling, suggesting that the treatment employed might be effective in the treatment of PD in rats. A recent systematic review investigated the potential use of bisphosphonate as an adjuvant to SRP in 13 clinical trials [ 95 ]. The results of this systematic literature review demonstrated that locally or systemically administered alendronate reduced probing pocket depth and resulted in a gain of clinical attachment level and improved radiographic assessment.…”

Section: Bisphosphonatesmentioning

confidence: 99%

Pharmacological Therapies for the Management of Inflammatory Bone Resorption in Periodontal Disease: A Review of Preclinical Studies

Pavanelli

Menezes

Pereira

et al. 2022

BioMed Research International

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Periodontitis, a highly prevalent multicausal chronic inflammatory and destructive disease, develops as a result of complex host-parasite interactions. Dysbiotic bacterial biofilm in contact with the gingival tissues initiates a cascade of inflammatory events, mediated and modulated by the host’s immune response, which is characterized by increased expression of several inflammatory mediators such as cytokines and chemokines in the connective tissue. If periodontal disease (PD) is left untreated, it results in the destruction of the supporting tissues around the teeth, including periodontal ligament, cementum, and alveolar bone, which lead to a wide range of disabilities and poor quality of life, thus imposing significant burdens. This process depends on the differentiation and activity of osteoclasts, the cells responsible for reabsorbing the bone tissue. Therefore, the inhibition of differentiation or activity of these cells is a promising strategy for controlling bone resorption. Several pharmacological drugs that target osteoclasts and inflammatory cells with immunomodulatory and anti-inflammatory effects, such as bisphosphonates, anti-RANK-L antibody, strontium ranelate, cathepsin inhibitors, curcumin, flavonoids, specialized proresolving mediators, and probiotics, were already described to manage inflammatory bone resorption during experimental PD progression in preclinical studies. Meantime, a growing number of studies have described the beneficial effects of herbal products in inhibiting bone resorption in experimental PD. Therefore, this review summarizes the role of several pharmacological drugs used for PD prevention and treatment and highlights the targeted action of all those drugs with antiresorptive properties. In addition, our review provides a timely and critical appraisal for the scientific rationale use of the antiresorptive and immunomodulatory medications in preclinical studies, which will help to understand the basis for its clinical application.

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“…In turn, in patients with periodontal disease, BP can be used to reduce alveolar bone loss. A number of published studies report that women who took oral bisphosphonates during menopause showed an improvement in periodontal status and a higher level of alveolar bone compared to the control group [ 81 ].…”

Section: Periodontal Disease In Menopausal Womenmentioning

confidence: 99%

Changes in the Oral Cavity in Menopausal Women—A Narrative Review

Ciesielska

Kusiak

Ossowska

et al. 2021

IJERPH

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Oral health awareness during the menopausal period is essential to minimize the inevitable inconveniences which may occur due to hormonal changes. The decrease in estrogen hormone concentration impacts the oral mucosa in a similar way to the vaginal mucosa due to the presence of estrogen receptors in both of these structures. An estrogen deficiency also affects the maturation process of the oral mucosal epithelium and can lead to its thinning and atrophy, making it more susceptible to local mechanical injuries, causing a change in pain tolerance and problems in the use of removable prosthetic restorations. Mucosal epithelium during the menopausal period is more vulnerable to infections, candidiasis, burning mouth syndrome, oral lichen planus (OLP), or idiopathic neuropathy. Moreover, salivary glands are also hormone-dependent which leads to changes in saliva secretion and its consistency. In consequence, it may affect teeth and periodontal tissues, resulting in an increased risk of caries and periodontal disease in menopausal women. Due to the large variety of complaints and symptoms occurring in the oral cavity, menopausal women constitute a significant group of patients who should receive special preventive and therapeutic care from doctors and dentists in this particular period.

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Effect of adjuvant bisphosphonates on treatment of periodontitis: Systematic review with meta-analyses

Cited by 12 publications

References 63 publications

Bisphosphonates and Their Connection to Dental Procedures: Exploring Bisphosphonate-Related Osteonecrosis of the Jaws

Bisphosphonates and Their Connection to Dental Procedures: Exploring Bisphosphonate-Related Osteonecrosis of the Jaws

Pharmacological Therapies for the Management of Inflammatory Bone Resorption in Periodontal Disease: A Review of Preclinical Studies

Changes in the Oral Cavity in Menopausal Women—A Narrative Review

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