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

Abstract

Adjunctive therapeutic strategies that modulate the inflammatory mediators can play a significant role in periodontal therapy. In this double-blind, placebo-controlled study, 60 subjects diagnosed as periodontitis patients were evaluated for 28 days after periodontal treatment combined with selective cyclooxygenase-2 (COX-2) inhibitor. The experimental group received scaling and root planning (SRP) combined with the Loxoprofen antiinflammatory drug (SRP+Loxoprofen). The control group received SRP combined with placebo (SRP+placebo). Plaque index (PI), probing pocket depth (PD) and bleeding on probing (BOP) were monitored with an electronic probe at baseline and after 14 and 28 days. Both groups displayed clinical improvement in PD, PI and BOP. They also showed statistically similar values (p>0.05) of PD reduction on day 14 (0.4 mm) and on day 28 (0.6 mm). At the baseline, few deeper sites (7 mm) from SRP+Loxoprofen group were responsible and most PD reduction was observed after 14 days (p<0.05). The percentage of remaining deep pockets 7 mm) after 14 days in the SRP+Loxoprofen group was significantly lower (p<0.05) than in the SRP+placebo group. Loxoprofen presents potential effect as an adjunct of periodontal disease treatment, but long-term clinical trials are necessary to confirm its efficacy.

Dental and periodontal health status of subjects with sickle cell disease

“…51,52 Adjunctive anti-inflammatory therapy may lead to a faster and greater reduction in probing pocket depth than conventional periodontal therapy. 53 So, the regular use of NSAIDs by SCD patients may result in prevention of periodontal destruction in those patients.…”

Epigenetic biomarkers: a step forward for understanding periodontitis

“…It has been reported that COX-2 inhibitors were able to reduce the symptoms of periodontitis patients [97]. Nevertheless, COX-2 expression in inflamed gingival tissues from chronic periodontitis patients was lower and its promoter was hypermethylated [98], which was confirmed by an independent study [99].…”

Auxiliary chemical therapies in the treatment of aggressive periodontitis: current aspects

“…Metronidazole affects specifically the anaerobic oral flora, including P. gingivalis, T. forsythia and T. denticola, microorganisms attached to the red Socransky's complex 50 , while A. actinomycetemcomitans, an optional anaerobic bacterium, appears to be widely opposed by the amoxicillin 38-39,41. The anti-inflammatory effect in the AP treatment was not observed. In addition, the studies with these drugs have inconsistent data and, therefore, do not allow any indication [46][47] .…”

“…Another study has demonstrated clinical benefit (PD reduction in deep pockets) when loxoprofen was associated with SRP in patients with periodontal disease, not being specified the subtype disease 47 .…”