ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Teriparatide Treatment Can Result in Improved Clinical Outcomes Compared to Placebo in the Treatment of Chronic Periodontitis
Clinical Question In periodontally compromised patients, can use of teriparatide help in the regeneration of periodontal tissues?
Clinical Bottom Line For the treatment of chronic periodontitis, surgical intervention accompanied by teriparatide therapy can result in improved probing depth, clinical attachment levels, and radiographic bone levels compared to surgery alone. These results were shown over a one-year follow-up period in which all but one of the 40 patients completed the study. While this study is a promising step in the treatment of chronic periodontitis, further research with larger sample sizes is still required.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 20950166Bashutski/201040 patients with severe chronic periodontitisRandomized Controlled Trial
Key resultsTeriparatide resulted in 29% gain in bone at six months, compared to 3% gain for placebo (p<0.001). Clinically, probing depths and attachment levels also showed greater improvement at one year (33% and 22% respectively) than the placebo group (20% and 7% respectively). These results were also statistically significant (p=0.02). No adverse events were reported, possibly due to the small sample size.
Evidence Search ("periodontitis"[MeSH Terms] OR "periodontitis"[All Fields]) AND ("teriparatide"[MeSH Terms] OR "teriparatide"[All Fields]) AND ("regeneration"[MeSH Terms] OR "regeneration"[All Fields])
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The Evidence
This randomized, placebo-controlled, double-blind, parallel-design clinical trial followed 40 surgical patients with severe chronic periodontitis and included a six-week treatment regimen with teriparatide along with a placebo group. These patients were followed for one year after surgery. The specified inclusion criteria helped maintain homogeneity between the groups. All patients completed the treatment phase of the study, with one patient in the treatment group being lost to follow-up. Measurement of bone-specific alkaline phosphatase levels ensured adherence to the treatment regimen.
Applicability Patients in the treatment group showed significant improvement in probing depth, radiographic bone level, and clinical attachment level at one year compared to placebo, suggesting that the short dosing regimen used in this study could potentially have long lasting effects on patients with periodontitis. Due to the small study sample, further research is needed in order to make stronger conclusions regarding this treatment.
Specialty/Discipline (Periodontics)
Keywords periodontitis, teriparatide, regeneration
ID# 2780
Date of submission: 11/18/2014spacer
E-mail neitzke@uthscsa.edu
Author Rebecca Neitzke, DDS
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Stephen Harris, PhD
Faculty mentor/Co-author e-mail harris@uthscsa.edu
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