Periodontal and Systemic Health Improvements with Alendronate Treatment in Postmenopausal Osteoporosis: A Clinical Perspective

Bisphosphonates are among the most frequently used antiresorptive drugs for the management of postmenopausal osteoporosis. Both periodontitis and osteoporosis are associated with osteoclast-related bone resorption. Postmenopausal osteoporosis (OP) is a prevalent condition often treated with bisphosphonates like Alendronate, which may influence periodontal health. Systemic factors of bone remodelling could modify local tissue response to periodontal infection. Accordingly, individuals with systemic bone loss who have periodontal disease may react differently concerning the production of inflammatory cytokines and bone remodelling mediators such as Tumor necrosis factor-alpha (TNF-α), Osteoprotegrin (OPG) and Receptor activator of nuclear factor kappa-B-Ligand (RANKL). In this study, we aim to identify the effect of alendronate as anti-inflammatory agent on periodontal tissue by measuring periodontal clinical parameters in addition to biochemical markers. This case-control study was carried out on (60) females aged from 55 to 65. All participants were divided into two groups equally, group A that included healthy postmenopausal females with healthy periodontium and group B included Osteoporosis patients. Patients where followed-up for one year through for three consecutive periods (0, 6, and 12 months) after receiving alendronate (ALN) treatment. OP and ALN groups were further subdivided equally into gingivitis and periodontitis patients. Blood sample were gathered for quantitative proportions of TNF-α through enzyme –linked immune sorbent assay (ELISA). The clinical periodontal parameters (PLI, GI, BOP) were reported for all teeth with the exception of third molars and kept in specifically designed case sheet documents following assortment of serum. There was a significant improvement in PLI, GI, and BOP were observed after 12 months of ALN treatment However, there was significant decrease in serum TNF at each consecutive recall follow up with response to control group. Additionally, our study revealed that there was a weak insignificant correlation were found between PLI, GI, BOP, and TNF- alpha, There was a significant improvement in Plaque index (PLI), Gingival Index (GI), Bleeding on Probing (BOP) in the context of alendronate therapy.