Effects of selective cyclooxygenase-2 inhibition on gingival tissue levels of prostaglandin E2 and prostaglandin F2alpha and clinical parameters of chronic periodontitis.
BACKGROUND
The purpose of the present study was to evaluate the effect of a relatively selective cyclooxygenase (COX)-2 inhibitor (nimesulide) and non-selective COX-1/COX-2 inhibitor (naproxen) used as an adjunct to non-surgical (scaling and root planing [SRP]) periodontal therapy in chronic periodontitis patients on the gingival tissue (GT) levels of prostaglandin (PG)E2 and PGF2alpha.


METHODS
Thirty patients with chronic periodontitis were divided into 3 groups of 10 each. One group received 100 mg of nimesulide; one received 275 mg of naproxen sodium; and the third group received placebo tablets in a 2 x 1 regimen for 10 days as an adjunct to SRP. GT samples were obtained before drug intake and on day 10. Plaque index (PI) and papillary bleeding index (PBI) scores were recorded at baseline, day 10, and at 3 months; probing depth (PD) and clinical attachment level (CAL) were recorded at baseline and at 3 months. The levels of PGE2 were detected using an enzyme immunoassay (EIA), and the levels of PGF2alpha were analyzed by radioimmunoassay (RIA). Differences among and within the groups were assessed using non-parametric statistical analysis. Ten periodontally healthy individuals served as controls.


RESULTS
All 3 groups showed statistically significant reductions in PBI and PI on day 10 and at 3 months (P < 0.02), and in PD and CAL at 3 months (P < 0.02, P < 0.05, respectively). In the naproxen group, GT PGE2 levels exhibited a significant decrease (P < 0.05). However, the decrease of GT PGE2 levels in the nimesulide group was insignificant (P > 0.05), while a significant increase was observed in the placebo group (P < 0.05) on day 10. Both the nimesulide and naproxen groups showed a significant decrease (P<0.05) in PGF2alpha level, while the placebo group showed a significant increase (P<0.05).


CONCLUSIONS
Nimesulides, relatively selective COX-2 inhibitors, may have additional inhibitory effects on GT PGF2alpha levels in the first week following non-surgical periodontal treatment. However, nimesulide has an insignificant effect on reducing PGE2 levels in gingival tissue. The determination of GT levels of COX-1 and COX-2 enzymes as well as PGE2 and PGF2alpha in long-term studies may provide further support for the adjunctive use of selective COX-2 inhibitors in treatment of chronic periodontitis.
Vardar
Saynur
S
Department of Periodontology, School of Dentistry, Ege University, Izmir, Turkey. saynurvardar@yahoo.com
Baylas
Haluk
H
Huseyinov
Afig
A
D000328:Adult; D002908:Chronic Disease; D051545:Cyclooxygenase 1; D016861:Cyclooxygenase Inhibitors / Q000627:therapeutic use*; D003774:Dental Plaque Index; D012534:Dental Scaling; D015237:Dinoprost / Q000032:analysis*; D015232:Dinoprostone / Q000032:analysis*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005881:Gingiva / Q000201:enzymology / Q000378:metabolism*; D006801:Humans; D007527:Isoenzymes / Q000037:antagonists & inhibitors*; D008297:Male; D016555:Matched-Pair Analysis; D008565:Membrane Proteins; D008875:Middle Aged; D009288:Naproxen / Q000627:therapeutic use; D017622:Periodontal Attachment Loss / Q000145:classification / Q000628:therapy; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000145:classification / Q000628:therapy; D010518:Periodontitis / Q000188:drug therapy*; D010919:Placebos; D011451:Prostaglandin-Endoperoxide Synthases; D016745:Root Planing; D013223:Statistics as Topic; D018709:Statistics, Nonparametric; D013449:Sulfonamides / Q000627:therapeutic use*
D016861:Cyclooxygenase Inhibitors; D007527:Isoenzymes; D008565:Membrane Proteins; D010919:Placebos; D013449:Sulfonamides; D009288:Naproxen; D015237:Dinoprost; D051545:Cyclooxygenase 1; C496511:PTGS1 protein, human; D011451:Prostaglandin-Endoperoxide Synthases; D015232:Dinoprostone; C012655:nimesulide