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Clinical and Radiographic Assessment of Single or Combined Treatment with Lepidium sativum and Alendronate of Non-Surgically Treated Chronic Periodontitis in Postmenopausal Osteoporotic Women.

AIM OF THE STUDY
The aim of the study was to compare the clinical outcomes, radiometric indices (antigonial index and mental index) before and after nonsurgical treatment of chronic periodontitis in postmenopausal osteoporotic women receiving alendronate (ALN) and Lepidium sativum either singly or combined.


MATERIALS AND METHODS
The study was conducted on 45 postmenopausal osteoporotic women with chronic periodontitis. The study population was divided randomly and equally into three groups: A, B and C (15 patients each). Group A: local debridement was performed for these patients. They received ALN at a dose of (70 mg/ once/ week) for six months as regular treatment of osteoporosis. Group B: patients were given finely powdered dried seeds of Lepidium sativum (LS; 1 gm tid) for six weeks plus local debridement. Group C: patients received combined treatment of LS at a dose of 1 gm/tid (for six weeks) and ALN at a dose of 70 mg once weekly for six months plus local debridement. Gingival index (GI), pocket depth (PI) and clinical attachment level (CAL) were measured together with ADAM8 level in the GSF of the study group at baseline, three and six months.


RESULTS
By comparing the means of GI at baseline, three months and six months within the three groups, Group C showed the highest signifi cant decrease in the mean GI (p = 0.01). Comparing the pocket depth and the clinical attachment level, Group B and C showed comparable pocket depth reduction and Group C reported the highest clinical attachment gain at p=0.001. By comparing the mean of radiometric indices of the three groups through the whole study period, Group C showed the greatest increase in the MI index from baseline to six months at p=0.0001. By comparing the mean percentage of change (%) in GI among the three groups, Group C showed the statistically signifi cant highest mean percent decrease in GI. By comparing the mean percentage of change of pocket depth before and after treatment, both Groups B and C showed significantly higher percentage of PD reduction than Group A after three months and six months at p = 0.002 and p = 0.001, respectively, while no signifi cant difference was detected between groups B and C through the whole study period. By comparing mean percentage of changes of CAL, Group C showed the highest percentage of CAL change.


CONCLUSIONS
Within the limits of the study, it is concluded that Lepidium sativum can be used in the treatment of osteoporotic postmenopausal women with chronic periodontitis who refuse treatment with ALN. The combined use of LS and ALN may have a synergistic effect resulting in a more favorable clinical response, increased bone mass than using ALN alone when combined with conventional therapy in treatment of chronic periodontitis in postmenopausal osteoporotic women.