Local Drug Delivery of Alendronate Gel for the Treatment of Patients With Chronic Periodontitis With Diabetes Mellitus: A Double-Masked Controlled Clinical Trial

Background: Alendronate (ALN) increases alveolar bone density with systemic use and, has been found to increase bone formation on local delivery into the periodontal pocket. The purpose of the present study is to explore the efficacy of 1% ALN gel as a local drug delivery system in adjunct to scaling and root planing (SRP) for the treatment of intrabony defects in patients with chronic periodontitis (CP) with type 2 diabetes (DM) compared to a placebo gel. Methods: Seventy intrabony defects were treated with either 1% ALN or placebo gel. Clinical parameters were recorded at baseline, 2 months, and 6 months. Radiographic parameters were recorded at baseline and 6 months. Defect fill at baseline and 6 months was calculated on standardized radiographs using image analysis software. Results: Mean probing depth (PD) reduction and mean clinical attachment level (CAL) gain was greater in the ALN group than the placebo group at both 2 and 6 months. Furthermore, significantly greater mean percentage of bone fill was found in the ALN group (44.2% +/- 11.78%) compared to the placebo group (2.8% +/- 1.61%). Conclusions: In patients with type 2 DM and CP, local delivery of 1% ALN into periodontal pockets resulted in a significant increase in the PD reduction, CAL gain, and improved bone fill compared to placebo gel as an adjunct to SRP. Thus, ALN can be used as an adjunct to SRP to provide a new dimension in the periodontal therapy in the near future. J Periodontol 2012;83: 1322-1328.