Non-Cochrane · intervention · PM41607731
Evidence on pharmacological agents for treating bony defects in chronic periodontitis: A network meta-analysis.
Koli Shivani Sanjay, Rathod Surekha Ramrao, Bawankar Pranjali, et al. · Dental research journal · 2025 · PubMed · doi:10.4103/drj.drj_174_25
Findings
42 findings
| Population | ||||
|---|---|---|---|---|
| Patients with chronic periodontitis and intrabony or interradicular defects | Locally delivered alendronate (ALN) 1% gel adjunct to scaling and root planing | Placebo gel adjunct to scaling and root planing | Radiographic bone fill (BF) 6 months · Local drug delivery adjunct to scaling and root planing | MD 1.66 [0.97, 2.34] GRADE not reported 3 studies |
| Patients with chronic periodontitis and intrabony or interradicular defects | Locally delivered alendronate (ALN) 1% gel adjunct to scaling and root planing | Placebo gel adjunct to scaling and root planing | Clinical attachment level (CAL) gain 6 months · Local drug delivery adjunct to scaling and root planing | MD 1.25 [0.31, 2.19] GRADE not reported 3 studies |
| Patients with chronic periodontitis and intrabony or interradicular defects | Locally delivered rosuvastatin (RSV) 1.2% gel adjunct to scaling and root planing | Placebo gel adjunct to scaling and root planing | Clinical attachment level (CAL) gain 6 months · Local drug delivery adjunct to scaling and root planing | MD 1.67 [0.74, 2.59] GRADE not reported 3 studies |
| Patients with chronic periodontitis and intrabony or interradicular defects | Locally delivered rosuvastatin (RSV) 1.2% gel adjunct to scaling and root planing | Placebo gel adjunct to scaling and root planing | Radiographic bone fill (BF) 6 months · Local drug delivery adjunct to scaling and root planing | MD 1.67 [1.11, 2.24] GRADE not reported 3 studies |
| Patients with chronic periodontitis and intrabony or interradicular defects | Locally delivered atorvastatin (ATV) 1.2% gel adjunct to scaling and root planing | Placebo gel adjunct to scaling and root planing | Clinical attachment level (CAL) gain 6 months · Local drug delivery adjunct to scaling and root planing | MD 1.4 [0.43, 2.37] GRADE not reported 3 studies |
| Patients with chronic periodontitis and intrabony or interradicular defects | Locally delivered atorvastatin (ATV) 1.2% gel adjunct to scaling and root planing | Placebo gel adjunct to scaling and root planing | Radiographic bone fill (BF) 6 months · Local drug delivery adjunct to scaling and root planing | MD 1.45 [0.86, 2.05] GRADE not reported 3 studies |
| Patients with chronic periodontitis and intrabony or interradicular defects | Locally delivered melatonin (ML) 1% gel adjunct to scaling and root planing | Placebo gel adjunct to scaling and root planing | Radiographic bone fill (BF) 6 months · Local drug delivery adjunct to scaling and root planing | MD 0.96 [-0.21, 2.13] GRADE not reported 1 study |
| Patients with chronic periodontitis and intrabony or interradicular defects | Locally delivered melatonin (ML) 1% gel adjunct to scaling and root planing | Placebo gel adjunct to scaling and root planing | Clinical attachment level (CAL) gain 6 months · Local drug delivery adjunct to scaling and root planing | MD 0.45 [-1.49, 2.39] GRADE not reported 1 study |
| Patients with chronic periodontitis and intrabony or interradicular defects | Locally delivered metformin (MF) 1% gel adjunct to scaling and root planing | Placebo gel adjunct to scaling and root planing | Radiographic bone fill (BF) 6 months · Local drug delivery adjunct to scaling and root planing | MD 1.7 [0.95, 2.45] GRADE not reported 1 study |
| Patients with chronic periodontitis and intrabony or interradicular defects | Locally delivered metformin (MF) 1% gel adjunct to scaling and root planing | Placebo gel adjunct to scaling and root planing | Clinical attachment level (CAL) gain 6 months · Local drug delivery adjunct to scaling and root planing | MD 1.78 [0.65, 2.92] GRADE not reported 1 study |
| Patients with chronic periodontitis with intrabony or interradicular defects, treated with scaling and root planing | placebo gel (F) | 1% alendronate gel (A) | Clinical attachment level gain 6 months · Locally delivered adjunct to scaling and root planing · indirect evidence from side-splitting model (side AF); sign as reported | MD -1.72 GRADE not reported Studies not reported |
| Patients with chronic periodontitis with intrabony or interradicular defects, treated with scaling and root planing | placebo gel (F) | 1% alendronate gel (A) | Bone fill (radiographic) 6 months · Locally delivered adjunct to scaling and root planing · indirect evidence from side-splitting model (side AF); sign as reported | MD -1.05 GRADE not reported Studies not reported |
| Patients with chronic periodontitis with intrabony or interradicular defects, treated with scaling and root planing | placebo gel (F) | 1% alendronate gel (A) | Clinical attachment level gain 6 months · Locally delivered adjunct to scaling and root planing · direct evidence from side-splitting model (side AF); sign as reported | MD -1.03 GRADE not reported 3 studies |
| Patients with chronic periodontitis with intrabony or interradicular defects, treated with scaling and root planing | placebo gel (F) | 1% alendronate gel (A) | Bone fill (radiographic) 6 months · Locally delivered adjunct to scaling and root planing · direct evidence from side-splitting model (side AF); sign as reported | MD -1.96 GRADE not reported 3 studies |
| Patients with chronic periodontitis with intrabony or interradicular defects, treated with scaling and root planing | 1.2% atorvastatin gel (C) adjunct | 1% alendronate gel (A) | Bone fill (radiographic) 6 months · Locally delivered adjunct to scaling and root planing · indirect evidence from side-splitting model (side AC); sign as reported | MD 0.02 GRADE not reported Studies not reported |
| Patients with chronic periodontitis with intrabony or interradicular defects, treated with scaling and root planing | 1.2% atorvastatin gel (C) adjunct | 1% alendronate gel (A) | Clinical attachment level gain 6 months · Locally delivered adjunct to scaling and root planing · indirect evidence from side-splitting model (side AC); sign as reported | MD -0.25 GRADE not reported Studies not reported |
| Patients with chronic periodontitis with intrabony or interradicular defects, treated with scaling and root planing | 1.2% atorvastatin gel (C) adjunct | 1% alendronate gel (A) | Bone fill (radiographic) 6 months · Locally delivered adjunct to scaling and root planing · direct evidence from side-splitting model (side AC); sign as reported | MD -0.29 GRADE not reported 2 studies |
| Patients with chronic periodontitis with intrabony or interradicular defects, treated with scaling and root planing | 1.2% atorvastatin gel (C) adjunct | 1% alendronate gel (A) | Clinical attachment level gain 6 months · Locally delivered adjunct to scaling and root planing · direct evidence from side-splitting model (side AC); sign as reported | MD 0.4 GRADE not reported 2 studies |
| Patients with chronic periodontitis with intrabony or interradicular defects, treated with scaling and root planing | 1% metformin gel (E) adjunct | 1% alendronate gel (A) | Clinical attachment level gain 6 months · Locally delivered adjunct to scaling and root planing · direct evidence from side-splitting model (side AE); sign as reported | MD -0.23 GRADE not reported 1 study |
| Patients with chronic periodontitis with intrabony or interradicular defects, treated with scaling and root planing | 1% metformin gel (E) adjunct | 1% alendronate gel (A) | Bone fill (radiographic) 6 months · Locally delivered adjunct to scaling and root planing · indirect evidence from side-splitting model (side AE); sign as reported | MD -0.47 GRADE not reported Studies not reported |
| Patients with chronic periodontitis with intrabony or interradicular defects, treated with scaling and root planing | 1% metformin gel (E) adjunct | 1% alendronate gel (A) | Clinical attachment level gain 6 months · Locally delivered adjunct to scaling and root planing · indirect evidence from side-splitting model (side AE); sign as reported | MD 1.02 GRADE not reported Studies not reported |
| Patients with chronic periodontitis with intrabony or interradicular defects, treated with scaling and root planing | 1% metformin gel (E) adjunct | 1% alendronate gel (A) | Bone fill (radiographic) 6 months · Locally delivered adjunct to scaling and root planing · direct evidence from side-splitting model (side AE); sign as reported | MD 1.79 GRADE not reported 1 study |
| Patients with chronic periodontitis with intrabony or interradicular defects, treated with scaling and root planing | placebo gel (F) | 1% rosuvastatin gel (B) | Clinical attachment level gain 6 months · Locally delivered adjunct to scaling and root planing · direct evidence from side-splitting model (side BF); sign as reported | MD -1.46 GRADE not reported 3 studies |
| Patients with chronic periodontitis with intrabony or interradicular defects, treated with scaling and root planing | placebo gel (F) | 1% rosuvastatin gel (B) | Bone fill (radiographic) 6 months · Locally delivered adjunct to scaling and root planing · direct evidence from side-splitting model (side BF); sign as reported | MD -1.65 GRADE not reported 3 studies |
| Patients with chronic periodontitis with intrabony or interradicular defects, treated with scaling and root planing | placebo gel (F) | 1% rosuvastatin gel (B) | Clinical attachment level gain 6 months · Locally delivered adjunct to scaling and root planing · indirect evidence from side-splitting model (side BF); sign as reported | MD -3.71 GRADE not reported Studies not reported |
| Patients with chronic periodontitis with intrabony or interradicular defects, treated with scaling and root planing | placebo gel (F) | 1% rosuvastatin gel (B) | Bone fill (radiographic) 6 months · Locally delivered adjunct to scaling and root planing · indirect evidence from side-splitting model (side BF); sign as reported | MD -1.88 GRADE not reported Studies not reported |
| Patients with chronic periodontitis with intrabony or interradicular defects, treated with scaling and root planing | 1.2% atorvastatin gel (C) adjunct | 1% rosuvastatin gel (B) | Bone fill (radiographic) 6 months · Locally delivered adjunct to scaling and root planing · direct evidence from side-splitting model (side BC); sign as reported | MD -0.38 GRADE not reported 2 studies |
| Patients with chronic periodontitis with intrabony or interradicular defects, treated with scaling and root planing | 1.2% atorvastatin gel (C) adjunct | 1% rosuvastatin gel (B) | Clinical attachment level gain 6 months · Locally delivered adjunct to scaling and root planing · direct evidence from side-splitting model (side BC); sign as reported | MD -0.6 GRADE not reported 2 studies |
| Patients with chronic periodontitis with intrabony or interradicular defects, treated with scaling and root planing | 1.2% atorvastatin gel (C) adjunct | 1% rosuvastatin gel (B) | Clinical attachment level gain 6 months · Locally delivered adjunct to scaling and root planing · indirect evidence from side-splitting model (side BC); sign as reported | MD 0.36 GRADE not reported Studies not reported |
| Patients with chronic periodontitis with intrabony or interradicular defects, treated with scaling and root planing | 1.2% atorvastatin gel (C) adjunct | 1% rosuvastatin gel (B) | Bone fill (radiographic) 6 months · Locally delivered adjunct to scaling and root planing · indirect evidence from side-splitting model (side BC); sign as reported | MD 0.14 GRADE not reported Studies not reported |
| Patients with chronic periodontitis with intrabony or interradicular defects, treated with scaling and root planing | 1% metformin gel (E) adjunct | 1% rosuvastatin gel (B) | Clinical attachment level gain 6 months · Locally delivered adjunct to scaling and root planing · indirect evidence from side-splitting model (side BE); sign as reported | MD 0.97 GRADE not reported Studies not reported |
| Patients with chronic periodontitis with intrabony or interradicular defects, treated with scaling and root planing | 1% metformin gel (E) adjunct | 1% rosuvastatin gel (B) | Clinical attachment level gain 6 months · Locally delivered adjunct to scaling and root planing · direct evidence from side-splitting model (side BE); sign as reported | MD -0.9 GRADE not reported 1 study |
| Patients with chronic periodontitis with intrabony or interradicular defects, treated with scaling and root planing | 1% metformin gel (E) adjunct | 1% rosuvastatin gel (B) | Bone fill (radiographic) 6 months · Locally delivered adjunct to scaling and root planing · direct evidence from side-splitting model (side BE); sign as reported | MD 0.03 GRADE not reported 1 study |
| Patients with chronic periodontitis with intrabony or interradicular defects, treated with scaling and root planing | 1% metformin gel (E) adjunct | 1% rosuvastatin gel (B) | Bone fill (radiographic) 6 months · Locally delivered adjunct to scaling and root planing · indirect evidence from side-splitting model (side BE); sign as reported | MD 0.07 GRADE not reported Studies not reported |
| Patients with chronic periodontitis with intrabony or interradicular defects, treated with scaling and root planing | placebo gel (F) | 1.2% atorvastatin gel (C) | Clinical attachment level gain 6 months · Locally delivered adjunct to scaling and root planing · indirect evidence from side-splitting model (side CF); sign as reported | MD -0.9 GRADE not reported Studies not reported |
| Patients with chronic periodontitis with intrabony or interradicular defects, treated with scaling and root planing | placebo gel (F) | 1.2% atorvastatin gel (C) | Bone fill (radiographic) 6 months · Locally delivered adjunct to scaling and root planing · direct evidence from side-splitting model (side CF); sign as reported | MD -1.63 GRADE not reported 3 studies |
| Patients with chronic periodontitis with intrabony or interradicular defects, treated with scaling and root planing | placebo gel (F) | 1.2% atorvastatin gel (C) | Bone fill (radiographic) 6 months · Locally delivered adjunct to scaling and root planing · indirect evidence from side-splitting model (side CF); sign as reported | MD -0.78 GRADE not reported Studies not reported |
| Patients with chronic periodontitis with intrabony or interradicular defects, treated with scaling and root planing | placebo gel (F) | 1.2% atorvastatin gel (C) | Clinical attachment level gain 6 months · Locally delivered adjunct to scaling and root planing · direct evidence from side-splitting model (side CF); sign as reported | MD -1.57 GRADE not reported 3 studies |
| Patients with chronic periodontitis with intrabony or interradicular defects, treated with scaling and root planing | placebo gel (F) | 1% metformin gel (E) | Bone fill (radiographic) 6 months · Locally delivered adjunct to scaling and root planing · indirect evidence from side-splitting model (side EF); sign as reported | MD -2.93 GRADE not reported Studies not reported |
| Patients with chronic periodontitis with intrabony or interradicular defects, treated with scaling and root planing | placebo gel (F) | 1% metformin gel (E) | Bone fill (radiographic) 6 months · Locally delivered adjunct to scaling and root planing · direct evidence from side-splitting model (side EF); sign as reported | MD -1.37 GRADE not reported 1 study |
| Patients with chronic periodontitis with intrabony or interradicular defects, treated with scaling and root planing | placebo gel (F) | 1% metformin gel (E) | Clinical attachment level gain 6 months · Locally delivered adjunct to scaling and root planing · indirect evidence from side-splitting model (side EF); sign as reported | MD -0.4 GRADE not reported Studies not reported |
| Patients with chronic periodontitis with intrabony or interradicular defects, treated with scaling and root planing | placebo gel (F) | 1% metformin gel (E) | Clinical attachment level gain 6 months · Locally delivered adjunct to scaling and root planing · direct evidence from side-splitting model (side EF); sign as reported | MD -2.43 GRADE not reported 1 study |
Included primary studies 21
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Garg 2017 1.2% Rosuvastatin and 1.2% Atorvastatin Gel Local Drug Delivery and Redelivery in the Treatment of Class II Furcation Defects: A… PMID:27715376 | 2017 | 1 other review | not stated | not extracted yet |
| Gonde 2022 Comparative evaluation of 1% melatonin gel in the treatment of intrabony defect: A randomized controlled clinical trial DOI:10.1002/jper.21-0515 | 2022 | 1 other review | not stated | not extracted yet |
| Pankaj 2018 Comparative evaluation of subgingivally delivered 1.2% rosuvastatin and 1% metformin gel in treatment of intrabony defects in chronic… PMID:29802627 | 2018 | 1 other review | not stated | not extracted yet |
| Pradeep 2016 1.2% Rosuvastatin Versus 1.2% Atorvastatin Gel Local Drug Delivery and Redelivery in Treatment of Intrabony Defects in Chronic… PMID:26878748 | 2016 | 1 other review | not stated | not extracted yet |
| Pradeep 2017 Comparative evaluation of subgingivally delivered 1% alendronate versus 1.2% atorvastatin gel in treatment of chronic periodontitis: a… PMID:27091596 | 2017 | 1 other review | not stated | not extracted yet |
| Sharma 2022 matched by author and year (probable) | NR | 1 other review | not stated | not extracted yet |
| Sheokand 2019 The comparative evaluation of 1% alendronate gel as local drug delivery system in chronic periodontitis in smokers and non smokers:… PMID:31211036 | 2019 | 1 other review | not stated | not extracted yet |
| Chatterjee 2019 Efficacy of Locally Administered 1.2% Rosuvastatin Gel in Patients with Periodontitis: A Randomized Placebo Controlled Clinical Trial DOI:10.1055/s-0039-1688522 | 2019 | this review only | not stated | not extracted yet |
| Chatterjee 2019 Efficacy of Locally Administered 1.2% Rosuvastatin Gel in Patients with Periodontitis: A Randomized Placebo Controlled Clinical Trial. PMID:31170754 | 2019 | this review only | not stated | not extracted yet |
| Garg 2017 1.2% Rosuvastatin and 1.2% Atorvastatin Gel Local Drug Delivery and Redelivery in the Treatment of Class II Furcation Defects: A… DOI:10.1902/jop.2016.160399 | 2017 | this review only | not stated | not extracted yet |
| Gonde 2022 Comparative evaluation of 1% melatonin gel in the treatment of intrabony defect: A randomized controlled clinical trial. PMID:35238041 | 2022 | this review only | not stated | not extracted yet |
| Ipshita 2018 One percent alendronate and aloe vera gel local host modulating agents in chronic periodontitis patients with class II furcation defects:… DOI:10.1111/jicd.12334 | 2018 | this review only | not stated | not extracted yet |
| Ipshita 2018 One percent alendronate and aloe vera gel local host modulating agents in chronic periodontitis patients with class II furcation defects:… PMID:29722166 | 2018 | this review only | not stated | not extracted yet |
| Mitra 2023 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Pankaj 2018 Comparative evaluation of subgingivally delivered 1.2% rosuvastatin and 1% metformin gel in treatment of intrabony defects in chronic… DOI:10.1002/jper.17-0434 | 2018 | this review only | not stated | not extracted yet |
| Pradeep 2016 (RSV vs ATV) 1.2% Rosuvastatin Versus 1.2% Atorvastatin Gel Local Drug Delivery and Redelivery in Treatment of Intrabony Defects in Chronic… DOI:10.1902/jop.2016.150706 | 2016 | this review only | not stated | not extracted yet |
| Pradeep 2017 (ALN vs ATV) Comparative evaluation of subgingivally delivered 1% alendronate versus 1.2% atorvastatin gel in treatment of chronic periodontitis: a… DOI:10.1111/jicd.12215 | 2016 | this review only | not stated | not extracted yet |
| Pradeep 2017 (metformin) Efficacy of 1% Metformin Gel in Patients With Moderate and Severe Chronic Periodontitis: A Randomized Controlled Clinical Trial. PMID:28731373 | 2017 | this review only | not stated | not extracted yet |
| Pradeep 2017 (MF) Efficacy of 1% Metformin Gel in Patients With Moderate and Severe Chronic Periodontitis: A Randomized Controlled Clinical Trial DOI:10.1902/jop.2017.150096 | 2017 | this review only | not stated | not extracted yet |
| Sharma 2022 [Spontaneous remission of Kikuchi-Fujimoto disease (lymphadenopathy) with focal skin parakeratosis]. PMID:20229711 | 2009 | this review only | not stated | not extracted yet |
| Sheokand 2019 The comparative evaluation of 1% alendronate gel as local drug delivery system in chronic periodontitis in smokers and non smokers:… DOI:10.1016/j.jobcr.2018.05.006 | 2019 | this review only | not stated | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients with chronic periodontitis with Grade II furcation or intrabony defects | Chronic periodontitis patients with intrabony or interradicular (furcation) defects (11 RCTs) |
| Intervention | Locally delivered adjunctive 1% alendronate, 1.2% rosuvastatin, 1.2% atorvastatin, 1% melatonin, 1% metformin with SRP | Alendronate (n=6 trials), rosuvastatin (n=5), atorvastatin (n=5), melatonin (n=1), metformin (n=3) gels with SRP |
| Comparison | Each other and placebo gel | Placebo gel (n=11 arms vs placebo comparisons: ALN 3, RSV 3, ATV 3, ML 1, MF 1); head-to-head: ATV vs ALN 2, MF vs ALN 1, MF vs RSV 1 |
| Outcomes | Clinical attachment level gain and radiographic bone fill | CAL gain and bone fill (NMA, 6 months) |
| Study designs | RCTs | RCTs (n=11) |
| Timing | 6 months | 6 months |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | No | No | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | No | No | yes |
| 14Heterogeneity explained | No | Yes | no |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |