Bisphosphonate Effects on Gingival-crevicular-fluid at Baseline and After Periodontal Treatment

Objectives: Do bisphosphonates have an effect on gingival-crevicular-fluid (GCF) cytokines and bone-turnover marker concentrations at baseline and when SCRP outcomes are evaluated?
Methods: 60 postmenopausal women (PMW) with chronic periodontitis participated in this IRB approved investigation. 30 had been using bisphosphonate for osteoporosis and 30 did not; within each group, 15 participants received scaling root-planing (SCRP) and 15 did not. GCF samples were taken at baseline and at re-evaluation, 6 weeks after SCRP, by inserting a paper point into the gingiva and stored in -80c. IL1-β, TNFα and RANKL concentrations were measured by enzyme-linked immunosorbent assay (ELISA). Concentrations were compared between bisphosphonate and control groups at baseline, and at re-evaluation. Significance level was set to P<0.05.
Results: Significant baseline difference in GCF IL1-β is identified between participants who used bisphosphonate and those who did not (167±46.7vs. 191±50.0, p=0.015), but not TNFα or RANKL. The bisphosphonate group had significant difference between baseline and re-evaluation in IL1-β (191±50.0 vs. 159±41.9; p=0.009) and TNFα (11.0±3.83 vs. 6.40±3.86;p<0.001) but not RANKL. The control group had no significant differences at baseline, but had significant difference between baseline and re-evaluation in all parameters respectively (167±46.7vs. 137±50.0;p=0.017; 7.92±3.36vs. 5.57±2.78;p=0.004;161±36.9 vs. 124±31.8;p<0.001). There are no significant baseline differences between participants who received SCRP and those who did not. There was a significant difference between baseline and re-evaluation in participants who received SCRP versus those who did not in all parameters respectively (176±42.5vs. 124±32.8,p<0.001; 9.06±3.18vs.2.78±1.63,p<0.001;172±26.9vs.125±34.4 p<0.001). Participants who received bisphosphonate therapy and SCRP compared to those having SCRP alone had significantly different changes at re-evaluation in all parameters, respectively, (19.4±5.6vs.39.4±2.12, p=0.005; 10.94±2.7vs.8.46±1.01, p<0.001; 19.8±9.9vs.42.0±5.1;p<0.001).
Conclusions: Bisphosphonates have an effect on GCF markers at baseline and when SCRP outcomes are evaluated. SCRP also has an effect on GCF in all participants. This supports the assertion that bisphosphonates modulate host-response in periodontal treatment.