Clinical Efficacy of 1% Alendronate Gel as a Local Drug Delivery System in the Treatment of Chronic Periodontitis: A Randomized, Controlled Clinical Trial

Background: Alendronate (ALN), an aminobisphosphonate, is known to inhibit osteoclastic bone resorption and was proposed to have osteostimulative properties in vivo and in vitro as shown by an increase in matrix formation. The present study aims to explore the efficacy of a 1% ALN gel compared to a placebo 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. Methods: A total of 66 intrabony defects were treated with a 1% ALN or placebo gel. The ALN gel was prepared by adding ALN to a polyacrylic acid-distilled water mixture. Clinical parameters (modified sulcus bleeding index, plaque index, probing depth [PD], and clinical attachment level [CAL]) were recorded at baseline and 2 and 6 months, and radiographic parameters at baseline and 6 months. The defect fill at baseline and 6 months was calculated on standardized radiographs by using image-analysis software. Results: The mean PD reduction and CAL gain were greater in the ALN group than in the placebo group at 2 and 6 months. Furthermore, a significantly greater mean percentage of bone fill was found in the ALN group (40.4% +/- 11.71%) than in the placebo group (2.5% +/- 1.02%). Conclusions: Results of the present study shows that the local delivery of 1% ALN into the periodontal pocket stimulated a significant increase in PD reduction, CAL gain, and improved bone fill compared to a placebo gel as an adjunct to SRP. These results can provide a new direction in the field of periodontal healing. J Periodontol 2012;83:11-18.