Effects of host modulation by nonsteroidal anti-inflammatory drugs on periodontal disease: a systematic review and meta-analysis

Abstract

Purpose: Nonsteroidal anti-inflammatory drugs that prohibit biosynthesis of arachidonic acid metabolites have been considered potent host modulation agents. The aim of this review was to determine the effect of nonsteroidal anti-inflammatory drugs adjunctive with nonsurgical periodontal treatment in patients with periodontal disease. Materials and Methods: Three electronic databases were searched to identify relevant studies. The methodological quality and mean differences of the change in clinical attachment level and probing depth were analyzed according to Cochrane review methods. Results: Twelve studies were included in the methodological assessment and nine studies were suitable for inclusion in the meta-analysis. The mean difference in the clinical attachment level gain did not differ significantly between the nonsteroidal anti-inflammatory drugs and control groups at any observation time. The highest mean difference in clinical attachment level gain was 0.30 mm at 4 weeks (95% confidence interval = -0.37 to 0.97). There was a significant mean difference in the probing depth reduction, of 0.34 mm (95% confidence interval = 0.29 to 0.40) at 6 weeks. Conclusion: Therefore, nonsteroidal anti-inflammatory drugs have additional therapeutic effect when administrated with nonsurgical periodontal treatment.

Melatonin as a Topical/Systemic Formulation for the Management of Periodontitis: A Systematic Review

“…It is also pivotal to perform debridement and instill plaque control measures around dental restorations and their interface with periodontal hard and soft tissues in order to prevent the initiation and progression of periodontitis. Additionally, therapeutic strategies include the administration of antimicrobials [ 2 ], anti-inflammatory agents [ 4 ], and antioxidants [ 3 ] systemically and topically for the management of periodontitis. It is in this connection that melatonin has been tried in periodontitis management.…”

“…Complete dental plaque and calculus removal form the basis of periodontal therapy as pathogens from plaque are initiators of periodontal disease [ 1 ]. However, in addition to scaling and root planing (SRP) and periodontal surgery, other adjunctive measures have been employed, such as the use of antimicrobials [ 2 ], antioxidants [ 3 ], anti-inflammatory agents [ 4 ], and antiseptics [ 5 ]. These measures have shown promising periodontal benefits [ 5 ].…”