Avaliação do efeito do alendronato de sódio sistêmico na periodontite: uma revisão sistemática com meta-análise

Abstract

Periodontitis is a chronic inflammatory disease with a multifactorial nature, directly linked to the presence of a dysbiotic biofilm. It is a condition responsible for the destruction of the supporting periodontium, including the root cementum, periodontal ligament, and alveolar bone. Sodium alendronate (ALN) is a bisphosphonate drug belonging to the itrogencontaining class, whose main mechanism is the inhibition of bone resorption through the suppression of osteoclastic activity, thus providing protection to bone tissue. Therefore, the aim of this study was to conduct a systematic review with meta-analysis on the effect of orally administered ALN in periodontitis. The search for studies was carried out in the following databases: MEDLINE, LILACS, PubMed, Scopus, LIVIVO, Cochrane, Web of Science, and Google Scholar. The exclusion criteria consisted of: studies other than randomized clinical trials; studies without a comparative control group; studies that did not present a clear definition of periodontitis; and studies in which ALN was administered via a route other than oral. The final sample of the review included 4 clinical trial studies, published between 2001 and 2020. Three studies compared a treatment group using ALN with a group without ALN treatment, while one study compared ALN with Hormone Replacement Therapy (HRT) and the combination of both treatments (HRT + ALN). Three studies used a dosage of 10 mg/day, and one study used 70 mg/day. The parameters analyzed were probing depth (PD), bone mineral density (BMD), clinical attachment level (CAL), gingival bleeding (GB), number of teeth with periodontal pockets (NPP), and presence of MMP-8 in the crevicular fluid. In the analysis of the primary studies, the parameters GB, BMD, PD, and CAL showed significant improvement with the use of ALN; however, an increase in MMP-8 levels in periodontal pockets was observed. After the meta-analysis, the parameters PD and CAL showed significantly better results with the use of ALN, while BMD and NPP did not present significantly different results. Thus, this review suggests that oral administration of ALN in periodontitis may lead to satisfactory outcomes regarding the improvement of clinical parameters of the disease