Effect of bisphosphonates on periodontal diseases in menopausal and postmenopausal women: A systematic review and meta-analysis.

PURPOSE: To systematically evaluate the effect of bisphosphonates on periodontal diseases in menopausal and postmenopausal women. METHODS: Databases (PubMed, Embase, Web of Science, Cochrane Library databases, Chinese Scientific and Technological Journal database, Wan Fang Data, China Biomedical Literature Database, and Chinese National Knowledge Infrastructure) were searched from inception to July 2024, languages are Chinese and English. Randomized controlled trials (RCTs) reporting the effect of bisphosphonates in menopausal and postmenopausal women with periodontitis were included. The risk of bias was performed using the Cochrane collaboration tool. The primary outcome was clinical attachment loss (CAL), and the secondary outcomes were probing depth (PD) and gingival index (GI). The analysis of the data was performed using Rev Man 5.3 and Stata 16.0. RESULTS: The meta-analysis incorporated four studies that fulfilled the inclusion criteria. In evaluating the efficacy of bisphosphonates against control treatments, there was high heterogeneity observed in CAL (P = 0.0002; I(2) = 85%) and PD (P< 0.00001; I(2) = 93%) within the study groups. Meta-analysis showed a significant improvement in CAL gain (MD = - 0.57 mm; 95% CI = -1.04 to -0.11 mm; P< 0.05), PD reduction (MD = - 0.50 mm; 95% CI = -0.96 to -0.05 mm; P< 0.05), and GI reduction (MD = -1.11; 95% CI = -1.22 to -1.01; P< 0.00001) for bisphosphonate treatment vs. bisphosphonate-naive therapy. CLINICAL SIGNIFICANCE: Bisphosphonate treatment seems to be beneficial for managing periodontitis in menopausal and postmenopausal women.