title: Effects of nonsteroidal anti-inflammatory drugs on osseointegration: a review.
abstract: The purpose of this study was to review the effects of nonsteroidal anti-inflammatory drugs on osseointegration and determine whether they cause failures in dental implants and whether patients who use them chronically can receive dental implants safely. A bibliographic electronic search was performed using the Cochrane Library, PubMed, and Medline databases, selecting articles published between January 1982 and December 2012. The search included the following keywords, either alone or combined: "nonsteroidal anti-inflammatory drugs," "dental implants," "bone healing," and "osteoprogenitor cells." The inclusion criteria were the following: randomized, double-blind, placebo-controlled clinical studies, in vivo animal model studies of osseointegration, and in vitro studies of the effects of these agents on osteoprogenitor cells. The literature search revealed 360 references. A total of 31 articles met the inclusion criteria, including 2 clinical trials, 20 animal studies, and 9 osteoprogenitor cell studies. The clinical trials revealed that cyclooxygenase-1 (COX-1) inhibitors did not impair osseointegration. The animal studies showed that any drug that is capable of inhibiting COX-2 may impair the osseointegration process. The in vitro studies showed that COX-2 inhibitors are the most potent depressors of osseointegration at the cellular level. Caution must be taken when selecting COX-2 nonsteroidal anti-inflammatory drugs during the postoperative period.
authors: 1  Faculty of Dentistry, Federal University of Ceara, Sobral Campus, Sobral, Ceará, Brazil.
authors: Francisco Isaac Fernandes
authors: FI
authors: Gomes
authors: Maria Gerusa Brito
authors: MG
authors: Aragão
authors: Vicente
authors: V
authors: de Paulo Teixeira Pinto
authors: Delane Viana
authors: DV
authors: Gondim
authors: Francisco Cesar
authors: FC
authors: Barroso
authors: Antonio Alfredo Rodrigues E
authors: AA
authors: Silva
authors: Mirna Marques
authors: MM
authors: Bezerra
authors: Hellíada Vasconcelos
authors: HV
authors: Chaves
mesh_terms: D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000494:pharmacology; D051546:Cyclooxygenase 2; D015921:Dental Implants; D004311:Double-Blind Method; D006801:Humans; D016348:Osseointegration; D016032:Randomized Controlled Trials as Topic
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D015921:Dental Implants; D051546:Cyclooxygenase 2
keywords: dental implants; nonsteroidal anti-inflammatory drugs; osseointegration