Revista de Odontologia da UNESP
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Revista de Odontologia da UNESP
Review Article

Effect of bisphosphonate on periodontal disease – narrative review of literature

Efeito dos bisfosfonatos na doença periodontal: revisão narrativa da literatura

Goes, Paula; Lima, Vilma de

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Abstract

This work evaluated the effect of Bisphosphonates (BPs) on periodontitis through a narrative review of literature. For this, it was searched articles in several computadorized database such as PubMed, Lilacs, Scielo, Medline and Central Register of Controlled Trials (COCHRANE/CCTR), using the keywords: Bisphosphonates and Periodontal disease. It was searched articles related to pre-clinical and clinical assays involving the systemic uses of BP on periodontitis, published in English or Portuguese, in the last 10 years. Initially, 144 references were found. From analysis of titles and abstracts, and considering inclusion and exclusion criterias, 17 full papers were included, being 11 studies in vivo preclinical and 6 clinical trials. Of these, 13 studies concluded that treatment with BFs prevented, significantly, the alveolar bone loss by changing the number and morphology of osteoclasts, 10 studies showed modulating inflammation, reducing recruitment of neutrophils, myeloperoxidase activity, inflammatory mediators, matrix metalloproteinases, and gingival bleeding index. Two studies also showed reduction on serum levels of N-terminal cross-linking telopeptide of type I collagen and one showed reduction on Bone-specific alkaline phosphatase, In summary, the treatment with BFs prevented alveolar bone resorption, modulated inflammation, and reduced serum levels of biochemical markers of bone metabolism, with improvement of clinical periodontal parameters, being therefore, an important pharmacological approach to be suggested as adjunct to basic periodontal therapy.

Keywords

Bisphosphonates, periodontitis, inflammation

Resumo

Este trabalho avaliou o efeito dos Bisfosfonatos (BFs) na periodontite por meio de uma revisão narrativa da literatura. Para tanto, buscaram-se artigos em diversas bases de dados computadorizadas, tais como PubMed, Lilacs, Scielo, Medline e o Centro de Registro de Ensaios Clínicos da Biblioteca Cochrane (COCHRANE/CCTR), utilizando-se as palavras- chave: “Bisphosphonates” e “Periodontal Disease”. Foram buscados artigos relacionados a ensaios pré-clínicos e clínicos envolvendo os usos sistêmicos de BFs na periodontite, publicados em língua inglesa ou portuguesa nos últimos dez anos. Inicialmente, foram encontradas 144 referências. A partir de análises de títulos e resumos, seguindo critérios de inclusão e exclusão, 17 artigos completos foram incluídos, sendo 11 estudos pré-clínicos in vivo e seis ensaios clínicos. Desses, 13 concluíram que o tratamento com BFs preveniu, de forma significante, a perda óssea alveolar por meio de alteração de número e morfologia de osteoclastos, dez estudos mostraram modulação da inflamação, redução do recrutamento de neutrófilos, da atividade de mieloperoxidase, de mediadores inflamatórios e metaloproteinases de matriz, bem como de índices de sangramento gengival. Dois estudos mostraram redução dos níveis séricos de Telopeptídeo N-terminal de colágeno tipo I, enquanto outro mostrou redução de Fosfatase Alcalina Óssea, marcadores do metabolismo ósseo. Em suma, o tratamento com BFs preveniu a reabsorção óssea alveolar, modulou a inflamação e reduziu o nível sérico de marcadores bioquímicos do metabolismo ósseo, com melhora dos parâmetros clínicos periodontais; esse tratamento é, portanto, uma importante abordagem farmacológica a ser sugerida como adjuvante à terapia periodontal básica.

Palavras-chave

Bisfosfonato, periodontite, inflamação

References

 


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