Zoledronic acid improves periodontal health, reduces serum inflammation, and enhances bone metabolism in postmenopausal osteoporosis complicated by periodontitis.

OBJECTIVE

To investigate the effects of zoledronic acid (ZA) on periodontal indices, serum inflammatory markers, and bone metabolism in postmenopausal osteoporosis (PMO) patients with periodontitis (PD).

METHODS

A total of 113 PMO+PD cases were recruited between May 2021 and February 2024. Fifty-two cases in the control group received standard therapy, while 61 cases in the observation group were treated with ZA. Therapeutic efficacy, periodontal indices (attachment loss [AL], probing depth [PD], and gingival bleeding index [GBI]), serum inflammatory markers (interleukin-1β [IL-1β], tumor necrosis factor-α [TNF-α], and C-reactive protein [CRP]), bone metabolism markers (N-terminal midfragment of osteocalcin [N-MID], beta-CrossLaps [β-CTx], and human calcitonin [hCT]), safety (fever, constipation, muscle soreness), and bone mineral density (BMD) at the lumbar spine and proximal femur were analyzed. A multivariable binary logistic regression model was used to determine factors influencing therapeutic efficacy.

RESULTS

The observation group demonstrated significantly better therapeutic outcomes than the control group. Treatment type was identified as an independent factor influencing efficacy. In the observation group, AL, PD, GBI, IL-1β, TNF-α, CRP, N-MID, and β-CTX levels were significantly reduced post-intervention compared to pre-intervention levels and the control group (all P<0.05), with no significant inter-group differences in hCT levels or adverse event rates (both P>0.05). BMD in the lumbar spine and proximal femur improved significantly in the observation group compared to the control group (both P<0.05).

CONCLUSIONS

ZA positively impacts periodontal health, reduces serum inflammation, and enhances bone metabolism in PMO patients with PD.