Selective COX-2 inhibitor reduces bone healing in bone defects

Abstract

Anti-inflammatory agents have been reported to regulate bone healing. The aim of this study was to investigate the effect of a selective cyclooxygenase-2 inhibitor (meloxicam) on bone healing in calvarial defects in rats. Thirty-six adult male Wistar rats were included. After anesthesia, a linear incision was made through the skin of the scalp, a full-thickness flap was reflected and a 4 mm round defect was made with a trephine drill. The animals were randomly assigned to one of the following 4 treatment groups (9 animals each), including daily subcutaneous injections: A: saline solution for 15 days; B: saline solution for 45 days; C: 3 mg/kg of meloxicam for 15 days and D: 3 mg/kg of meloxicam for 45 days. The animals were sacrificed and the specimens, routinely processed. The bone filling was histometrically measured and statistical analysis, performed. Intergroup comparisons demonstrated that the meloxicam groups presented a significant reduction in bone healing when compared to their respective controls (group A, 44.5 +/- 5.75%, against group C, 57.5 +/- 7.25%, p < 0.05; group B, 40.25 +/- 13.75%, against group D, 52.25 +/- 17.25%). Within the limits of the present study, it can be concluded that selective cyclooxygenase-2 inhibitors may reduce bone healing in calvarial defects in rats after continuous administration.

Short-term administration of non-selective and selective cox-2 nsaids do not interfere with bone repair in rats

“…However, despite their benefits when compared to non-selective drugs, evidences of undesirable effects similar to COX-1 drugs have been postulated, specifically related to bone repair process, marked by the drastic reduction in PGs levels that are directly involved in bone formation (Kawaguchi et al 1995;Altman et al 1995;Simon et al 2002;Gerstenfeld et al 2003;Harder and An 2003;Gurgel et al 2005). Such data has guided several researchers to confirm the diverse effects of the available selective and non-selective NSAIDs.…”

Selective Cyclooxygenase‐2 Inhibitor May Impair Bone Healing Around Titanium Implants in Rats

“…Although bone metabolism alterations and impaired bone repair have been observed following the administration of selective COX‐2 inhibitors in many studies, 12,16,23,24 there is no information regarding the effects of selective COX‐2 inhibitors on the bone healing around titanium implants. Furthermore, limited information is available regarding the effect of non‐selective NSAIDs on the implants 8,17 .…”

“…Selective cyclooxygenase‐2 (COX‐2) inhibitors have emerged with the objective of reducing these side effects and have been used in chronic administration to alleviate the chronic pain and discomfort associated with rheumatoid and osteoarthritis 9 . Their use can also promote negative effects on bone healing 10‐13 . The mechanisms by which selective COX‐2 inhibitors affect the bone during the healing process are not fully understood, but there is evidence to show that the COX‐2 enzyme is a critical regulator of mesenchymal cell differentiation into osteoblasts and that it participates in osteogenesis 14,15 …”

“…These effects of selective COX‐2 inhibitors on bone metabolism may have a profound impact on the prognosis of titanium implants, particularly when the drug is used on a daily basis for extended periods. Although impaired bone repair and bone formation have been reported as a consequence of NSAID therapy, 12,16 there is limited information regarding the effects of non‐selective NSAIDs on the bone healing around titanium implants, 8,17 and there are no data regarding the action of selective COX‐2 inhibitors on the osseointegration process. Based on these considerations, it seems relevant to evaluate the role of selective COX‐2 inhibitors on bone repair around implants.…”

Impact of Local and Systemic Alendronate on Simvastatin‐Induced New Bone Around Periodontal Defects

“…Pharmacological therapy toward this end may include systemic antibiotics or topical antimicrobials with variable results 3 . Pain medications also are used in postoperative management, some (non‐steroidal anti‐inflammatory drugs) with adverse effects on bone growth in animal models 4,5 . Pharmaco‐manipulation of bone turnover during the postoperative period has received little attention in periodontics, but recent recognition of the impact certain drugs have on bone turnover prompts additional investigation.…”