The Influence of NSAIDS on Osseointegration of Dental Implants A Systematic Review
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2018, Vol 6, Issue 2
Abstract
Objective:To determine whether there is enough data to support prescribing NSAID is likelyhas negative effect on osseointergration or not. Materials and Methods:The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement was used in this study. The clinical question in “PICO” format was: Do NSAIDs Inhibit the osseointegration of the dental implant? PubMed, MEDLINE, ScienceDirect and Cochrane Library was searched for articles published up until march 4, 2018. Results: The search resulted in 371 articles. After selection according to the eligibility criteria, four studies fulfilled were included (Three RCT doubled blind and one retrospective cohort study) with a total of 217 patients analyzed, and 610 implants placed. Administration of a short course of systemic ibuprofen for post-operative pain management subsequent to implant placement may not have a significant effect on the marginal bone around dental implants in the early healing period. Conclusion: The survival rate of implants in patients using NSAIDs in short term does not differ from the survival rate in healthy patients not using NSAIDs or using placebo. However, a greater number of prospective studies and clinical trials in the future is essential to support more solid conclusions. During the last decade, dental implants are the first option to replace missing teeth. Developments in dental implant material, structural design, surface features, and surgical procedures made dental implants a secure and highly predictable procedure with a mean survival rate of 94.6 % and a mean success rate of 89.7 % after more than 10 years [1]. Highly survival rate of dental implant always depends on successful osseointergration after the placement; treatment outcome will deteriorate if there is any change of this biological process. Eventually, when an implant is restored by prosthetic and placed into function, bone remodeling becomes a serious aspect in responding to the functional requirements that placed on the implant restoration and supporting bone [2]. Osseointegration is a histologically characterize the intimate contact between the living bone and the surface of dental implant made of titanium at the light microscopic level of magnification [3,4]. This is the main target that can achieve a desired stability and strength to withstand and transfer the occlusal load during function without harming soft tissue [5,6]. After dental implant insertion bone will demonstrate sequence of initial healing contain inflammatory reaction, resorption of the bone at the site of insertion, growth factors releasing and attract the osteoprogenitor cells to the prepared site which is later on differentiate into osteoblast during the continuous process of bone remodeling [7]. Mild inflammatory response will promote healing of bone at the site [8]. Stability of dental implant must be achieved to enhance differentiation of osteoblasts and avoid fibrous tissue formation between implant surface and bone which may lead to nonintegration and implant failure [9]. Nonsteroidal anti-inflammatory drugs (NSAIDs) are used mostly in the dental clinics for management of acute and chronic inflammation and pain [10]. The main biologic effect of these anti-inflammatory drugs is the suppression of cyclooxygenase enzymes that is responsible to make Prostaglandins products [11]. There are three isoforms of cyclooxygenase: COX-1, COX- 2, and COX-3 [12]. COX-1 is constitutive that regulates normal cellular processes, and COX-2 is inducible and it induced by Inflammatory mediators and cytokines that produces by tissue injury, also it plays important physiological role on cardiovascular system. COX-3 is an alternative to COX-1 which is limited only in the central nervous system [13- 15]. COX-2 is an imperative for differentiation of mesenchymal stem cells into osteoblasts and also work as a main source of PGE2 that stimulate osteoblast to increase bone formation, bone mass, and strength. NSAIDs and COX-2 inhibitors directly affect the bone healing process via suppression of the COX-2 enzyme, which will decrease the amount of Prostaglandins, differentiation and activation of osteoblast in the early phases of bone healing [16]. This Review aim to determine if there is enough data to support that NSAIDs will have a positive effect on osseointergration of dental implant. Our rational is to support osseointergration of dental implant in patient by prescribing NSAIDs.
Authors and Affiliations
Maryam Alhindi, Hasan Muaddi, Mohammed Almosairy, Abdullah Alshebany, Malik Alabdulkader
Keywords
Related Articles
- EP ID EP585644
- DOI 10.26717/BJSTR.2018.06.001315
- Views 168
- Downloads 0
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