BACKGROUND: Previous systematic reviews showed additional benefit of adjuvant bisphosphonates (BP) in the treatment of periodontitis. In contrast, it is unclear the effect of BP in patients with diabetes and smokers, its pooled effect when administered locally or systemically is also unknown. OBJECTIVES: This study aimed to systematically review the literature about the use of BP as adjuvant to nonsurgical scaling and root planning (SRP). METHODOLOGY: This study followed the PRISMA guideline. This study included randomized clinical trials that administered locally or systemically BPs as adjuvant for periodontal treatment. Five databases were used. Meta-analyses were performed, using the pooled mean differences (MD) for clinical attachment level (CAL) and probing pocket depth (PPD). Standard mean difference (SMD) was used for radiographic assessment (RADIO). Subgroup analyses were performed for locally delivered meta-analyses, considering diabetes and smoking exposure. RESULTS: Thirteen studies were included. It was showed MD of 1.52 mm (95%CI: 0.97-2.07) and 1.44 mm (95%CI: 1.08-1.79) for PPD reduction and CAL gain, respectively, for locally delivered BP. BP was not able to provide significant improvements in smokers (subgroup analysis) when considering CAL (MD: 1.37; 95%CI: -0.17-2.91) and PPD (MD: 1.35; 95%CI: -0.13-2.83). Locally delivered BP also improved significantly the RADIO assessments (SMD: 4.34; 95%CI: 2.94-5.74). MD for systemically administered BP was 0.40 mm (95%CI: 0.21-0.60), 0.51 mm (95%CI: 0.19-0.83) and 1.05 (95%CI: 0.80-1.31) for PPD, CAL and RADIO, respectively. CONCLUSION: The administration of BP in adjunct to SRP may result in additional clinical effects.
BACKGROUND: Previous systematic reviews showed additional benefit of adjuvant bisphosphonates (BP) in the treatment of periodontitis. In contrast, it is unclear the effect of BP in patients with diabetes and smokers, its pooled effect when administered locally or systemically is also unknown. OBJECTIVES: This study aimed to systematically review the literature about the use of BP as adjuvant to nonsurgical scaling and root planning (SRP). METHODOLOGY: This study followed the PRISMA guideline. This study included randomized clinical trials that administered locally or systemically BPs as adjuvant for periodontal treatment. Five databases were used. Meta-analyses were performed, using the pooled mean differences (MD) for clinical attachment level (CAL) and probing pocket depth (PPD). Standard mean difference (SMD) was used for radiographic assessment (RADIO). Subgroup analyses were performed for locally delivered meta-analyses, considering diabetes and smoking exposure. RESULTS: Thirteen studies were included. It was showed MD of 1.52 mm (95%CI: 0.97-2.07) and 1.44 mm (95%CI: 1.08-1.79) for PPD reduction and CAL gain, respectively, for locally delivered BP. BP was not able to provide significant improvements in smokers (subgroup analysis) when considering CAL (MD: 1.37; 95%CI: -0.17-2.91) and PPD (MD: 1.35; 95%CI: -0.13-2.83). Locally delivered BP also improved significantly the RADIO assessments (SMD: 4.34; 95%CI: 2.94-5.74). MD for systemically administered BP was 0.40 mm (95%CI: 0.21-0.60), 0.51 mm (95%CI: 0.19-0.83) and 1.05 (95%CI: 0.80-1.31) for PPD, CAL and RADIO, respectively. CONCLUSION: The administration of BP in adjunct to SRP may result in additional clinical effects.
Authors: Aleksandra Ciesielska; Aida Kusiak; Agata Ossowska; Magdalena Emilia Grzybowska Journal: Int J Environ Res Public Health Date: 2021-12-27 Impact factor: 3.390
Authors: Angelica Leticia Reis Pavanelli; Bruna Silva de Menezes; Erica Bianca Barbosa Pereira; Fabio Assuncao de Souza Morais; Joni Augusto Cirelli; Rafael Scaf de Molon Journal: Biomed Res Int Date: 2022-05-02 Impact factor: 3.246