Altering the Progression of Human Alveolar Bone Loss With the Non‐Steroidal Anti‐Inflammatory Drug Flurbiprofen

Abstract

The treatment of human periodontal diseases relies on mechanical and antimicrobial suppression of the etiologic bacteria. The ability to alter the progression of periodontitis by additionally blocking host pathways involved in the destructive process is an area of current research. Prostaglandins and other metabolites of arachidonic acid are believed to be important host mediators of the bone resorption of diseases such as periodontitis. We have previously examined the effect of inhibitors of prostaglandin production, non-steroidal anti-inflammatory drugs (NSAIDs), on inhibiting alveolar bone loss in beagles. The present study was designed to examine the effect of the NSAID, flurbiprofen, on slowing the radiographic loss of alveolar bone in the human. Fifty-six individuals with radiographic evidence of alveolar bone loss were recruited for study. Forty-four patients remained in the study for the data analysis of loss of alveolar bone. Following a 6 month baseline pretreatment period to measure the radiographic progression of bone loss, half of the patients were administered flurbiprofen, 50 mg. b.i.d., while half were administered a placebo. All patients received a subgingival scaling and pumice by a hygienist every 6 months. The rate of alveolar bone loss in a 2 year treatment period was compared to the baseline 6 month pretreatment period within and between patient groups. Throughout the study, teeth exhibiting obvious loss of bone were exited from study and treated with conventional mechanical therapy. At the end of the pretreatment period both patient groups had a similar mean rate of alveolar bone loss.(ABSTRACT TRUNCATED AT 250 WORDS)

Blockade of RAGE suppresses periodontitis-associated bone loss in diabetic mice

“…Previous studies have identified non-antimicrobial mechanisms by which agents such as nonsteroidal antiinflammatory drugs, low-dose doxycycline and chemically modified tetracyclines (CMTs), antagonists of proinflammatory cytokines, and inhibitors of cyclooxygenase-2 may exert beneficial effects in periodontal disease (49)(50)(51)(52). Specifically, doxycycline and CMTs have demonstrated promise in enhancing collagen production and suppressing MMP synthesis/activation in cellbased systems and diabetic organisms (28,53,54).…”

Short-Term effect of COX-2 selective inhibitor as an adjunct for the treatment of periodontal disease: a clinical double-blind study in humans

“…The effects of NSAIDs on PGE 2 levels (2,13), gingival inflammation (17) and alveolar bone loss (16,18,19) have been widely examined in human, animal and in vitro experiments (6,20). In general, the results have shown beneficial effect the early phase of periodontal treatment, gingivitis and prevention of bone loss.…”

The effect of inflammatory response modulator agents on gingivitis and periodontitis

“…These results have not considered the type of medication and therapeutic procedure used in each patient, however, when only the patients under indomethacin therapy (n=9) were considered, statistically significant differences were found only for Gingival Index 17 . Similarly, Heasman & Seymour 20 also performed a retrospective study, evaluating the periodontal parameters of patients under NSAIDs treatment of at least 2 years (mean of 9 years) and compared to a control group. It was not found statistically significant differences in the following parameters: Plaque Index 18 , Gingival Index 19 , probing depth, clinical attachment loss, and gingival recession.…”

“…Williams et al 20 evaluated the effect of 50mg Flurbiprofen, twice daily, in the rate of radiographic alveolar bone loss and Gingival Index 19 , during 2.5 years, and compared to a placebo group. It was shown that both groups presented a decrease in the bone loss.…”