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Evidence on pharmacological agents for treating bony defects in chronic periodontitis: A network meta-analysis

Koli SS, Rathod SR, Bawankar P, Singh V, Savitha S

Dental research journal, 2025

Abstract

Background: Chronic periodontitis is an infectious disease of the oral cavity that causes progressive destruction of periodontal tissues, leading to structural changes like attachment loss, bone resorption, resulting in bony defects, and potential tooth loss if left untreated. Effective drugs, such as alendronate, rosuvastatin (RSV), atorvastatin, melatonin, and metformin (MF), have been used as adjuncts to scaling and root planning and require evaluation for their comparative effectiveness in treating bony defects in patients with chronic periodontitis. This study aims to compare the effectiveness of these drugs for treating such defects.

Materials and methods: This network meta-analysis (NMA) was conducted following Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines and registered in PROSPERO (CRD42024600432). A comprehensive search of PubMed, Scopus, and Cochrane Library identified 11 eligible randomized clinical trials reporting changes in clinical attachment level (CAL) and bone fill (BF) at 6 months posttreatment. The NMA systematically compared treatment outcomes across different intervention groups.

Results: MF was the most effective treatment for CAL and BF at 6 months. Ranking probabilities indicated that MF and RSV had the highest likelihood of being the most effective treatments.

Conclusion: These findings from the NMA suggest that MF may be an effective option for CAL improvement and BF. Further research is needed to validate these…

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