The effect of systemic administration of ibuprofen in the experimental gingivitis model.
BACKGROUND
Studies in humans have indicated that systemically administered flurbiprofen and ibuprofen may reduce gingivitis. De novo plaque formation is enhanced at tooth surfaces adjacent to inflamed gingivae.


OBJECTIVE
The aim of the present clinical trial was to evaluate the effect of systemic administration of ibuprofen on gingivitis and plaque build-up.


METHODS
Eleven subjects were recruited for the study and were given oral hygiene instruction, scaling and professional mechanical tooth cleaning (PTC). At the end of a preparatory period (Day 0), the participants were told to abstain from all mechanical plaque control measures during a 2-week experimental period but to rinse with an assigned mouth rinse (positive control: 0.1% chlorhexidine digluconate; negative control: saline) or administer ibuprofen (tablets of 200 mg twice daily). Mouth rinsing was performed twice a day (after breakfast and in the evening), for 60 s with 10 ml. Re-examination was performed after 14 days of experiment. After a 2-week "wash-out" period, the participants received a new PTC and a second 14-day experimental period was initiated. The experimental and "wash-out" periods were repeated until all volunteers had been involved in all three regimens. Dental plaque was scored using the Quigley & Hein Plaque Index system and gingivitis according to the Gingival Index (GI) system. Supragingival plaque was collected and prepared for dark-field microscopy. One hundred bacterial cells were counted and classified into six different groups: coccoid cells, straight rods, filaments, fusiforms, spirochetes and motile rods. Gingival crevicular fluid (GCF) was collected from the same sites that were sampled for plaque. The volume of GCF collected in each strip was measured and analysed regarding content of lactoferrin and albumin.


RESULTS
During the period when the panelists rinsed with saline they accumulated large amounts of plaque and developed marked signs of gingivitis. When they rinsed with chlorhexidine digluconate, small amounts of plaque formed and few sites received GI score > or =2. After the 2 weeks of ibuprofen administration, the panelists presented with significantly fewer sites that scored GI > or =2 but had formed similar amounts of plaque as during the negative control period.


CONCLUSIONS
It is suggested that ibuprofen administered via the systemic route has an effect on gingivitis but not on de novo plaque formation.
Sekino
Satoshi
S
Department of Periodontology, Faculty of Odontology, The Sahlgrenska Academy at Göteborg University, SE-405 30 Göteborg, Sweden.
Ramberg
Per
P
Lindhe
Jan
J
D000284:Administration, Oral; D000328:Adult; D000704:Analysis of Variance; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D002710:Chlorhexidine / Q000008:administration & dosage; D018592:Cross-Over Studies; D003773:Dental Plaque / Q000188:drug therapy*; D005891:Gingivitis / Q000188:drug therapy*; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage*; D009067:Mouthwashes / Q000008:administration & dosage; D016037:Single-Blind Method; D012965:Sodium Chloride / Q000008:administration & dosage
D000891:Anti-Infective Agents, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D009067:Mouthwashes; D012965:Sodium Chloride; D002710:Chlorhexidine; D007052:Ibuprofen