Clinical and radiological improvement of peridontal disease in patients with type 2 diabetes mellitus treated with alendronate: A randomized, placebo-controlled trial

Background: Alendronate (ALN) is an aminobisphosphonate commonly used for o steoporosis in postmenopausal women. We studied the effect of ALN on bone l oss prevention in type 2 diabetes mellitus patients with periodontal diseas e. Methods: In a controlled double-blind, randomized study we evaluated prospe ctively diabetic patients paired by gender and years since diagnosis for 6 months. The study included 40 patients (20 men and 20 women), 50 to 60 year s old, with more than 5 years since diagnosis of diabetes and established p eriodontitis. They were randomly allocated to alendronate (10 mg/daily) or placebo treatment for 6 months. The endpoints of treatment were: the distan ce between the alveolar bone border and the cemento-enamel-junction (CEJ) e valuated by means of digital radiographic imaging, a biochemical marker of bone resorption (urine N-telopeptide) (Ntx), and periodontal parameters. Me tabolic control was assessed at baseline and after 6 months. Results: Baseline and 6-month glycated hemoglobin levels were similar in bo th groups. Alendronate induced a significant decrease in NTx at 6 months (P = 0.006). Periodontal parameters improved in both groups. However, they we re significantly better for the ALN treated group. Alveolar bone border-CEJ distance increased in the placebo, but decreased in the ALN group (P = 0.0 003). Conclusions: In type-2 diabetic patients, alendronate induced I more improv ement in alveolar bone crest height than control therapy. No differences in urinary N-telopeptide or glycated hemoglobin were observed in this short-t erm randomized controlled pilot trial.