Fig. 1. PRISMA flow diagram of literature search
Fig. 1. PRISMA flow diagram of literature search
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Luo, J., Miller, C., Jirjis, T. et al. The effect of non-steroidal anti-inflammatory drugs on the osteogenic activity in osseointegration: a systematic review.
Int J Implant Dent 4, 30 (2018). https://doi.org/10.1186/s40729-018-0141-7
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Received: 22 May 2018
Accepted: 13 July 2018
Published: 09 October 2018
DOI: https://doi.org/10.1186/s40729-018-0141-7
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
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Jie Denny Luo, Catherine Miller, Tamara Jirjis, Masoud Nasir, and Dileep Sharma declare that they have no competing interests.
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College of Medicine & Dentistry, James Cook University, 14-88 McGregor Road, Smithfield, QLD, 4878, Australia
Jie Denny Luo, Tamara Jirjis, Masoud Nasir & Dileep Sharma
College of Public Health, Medical and Veterinary Sciences, James Cook University, 14-88 McGregor Road, Smithfield, QLD, 4878, Australia
Catherine Miller
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The authors acknowledge and are grateful for the help and preparation of manuscript by the supporting research supervisors: Dr. Ernest Jennings and Prof. Alan Nimmo.
The systematic review is funded by James Cook University College of Medicine and Dentistry as part of a Dentistry Honours Research Project.
A meta-analysis was not conducted for this systematic review. The critical analysis tables t...
Winnett B, Tenenbaum HC, Ganss B, Jokstad A. Perioperative use of non-steroidal anti-inflammatory drugs might impair dental implant osseointegration. Clin Oral Implants Res. 2016;27(2):E1–7.
Goodman SB, Ma T, Mitsunaga L, Miyanishi K, Genovese MC, Smith RL. Temporal effects of a COX-2-selective NSAID on bone ingrowth. J Biomed Mater Res A. 2005;72((3):279–87.
Ribeiro FV, Cesar-Neto JB, Nocit...
Marquez-Lara A, Hutchinson ID, Nuñez F, Smith TL, Miller AN. Nonsteroidal anti-inflammatory drugs and bone-healing: a systematic review of research quality. JBJS Rev. 2016;4(3). https://doi.org/10.2106/JBJS.RVW.O.00055.
Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JPA, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate...
Salari P, Abdollahi M. Controversial effects of non-steroidal anti-inflammatory drugs on bone: a review. Inflamm Allergy Drug Targets. 2009;8(3):169–75.
Boursinos LA, Karachalios T, Poultsides L, Malizos KN. Do steroids, conventional non-steroidal anti-inflammatory drugs and selective Cox-2 inhibitors adversely affect fracture healing? J Musculoskelet Neuronal Interact. 2009;9(1):44–52.
Kaly...
Cyclooxygenase
Non-steroidal anti-inflammatory drug/s
Prostaglandin
Prostaglandin E2
The analgesic and therapeutic effects of NSAIDs are achieved by COX-2 inhibition [4]. It is likely that COX inhibition by NSAIDs is detrimental to the bone healing process, given the favourable actions of PG on this process [4]. Osteoblasts have the capacity to produce PGs, where PGE2 is most abundant, through the COX pathway though the evidence asserting that PGs have a direct role in bone healin...
The majority of the included studies revealed a high risk of bias, and conclusions from studies that have a high risk of bias are sufficient to affect interpretation of data [16,17,18]. Publication and selection bias is apparent in several included studies, as the negative effects of NSAIDs on osseointegration can be expected in the studies that administered NSAID at a high concentration and/or fo...
The influence of NSAIDS on bone healing in animal models has been shown to be related to the duration of treatment and drug selectivity [5]. A total of seven studies were identified that investigated the effect of NSAIDs on the osseointegration of titanium implants in animals: mice, rabbits, and rats (Table 8).
The duration of treatment is a factor to consider when using NSAIDs, and a study cond...
The effects of NSAIDs on the osteogenic activity of osteoblasts have been extensively studied at the molecular pharmacological level [23]. However, only two studies have been identified that investigated the effect of NSAIDs on osteoblasts attached to titanium surfaces (Table 6). In the study conducted by Boyan et al., their results demonstrated that a non-selective COX inhibitor (indomethacin, 0...
The eligibility and study selection criteria as mentioned above were applied to the 79 full-text articles. A total of 66 studies were excluded after a full-text assessment for the following reasons:
The study did not explore the role of COX pathway in osseointegration (n = 26).
The effects of NSAIDs on osteoblasts were not investigated on titanium (n = 24).
The study was a systematic re...
The full-text manuscripts of included studies were catalogued into in vitro, clinical, and in vivo studies. The data from the included studies were independently extracted by the primary (JDL) and the second reviewer (TJ) according to the “Data items” section as listed below. Disagreements or uncertainties were discussed with the third reviewer (MN) until an agreement was reached.
The data co...
An electronic search into four databases: Ovid, Pubmed, Scopus, and Web of Science was performed to systematically identify the available literature. Articles published between January 1, 1999, and July 7, 2018, were considered.
The focus question, used to guide the search strategy, according to the PICO schema is “Will variables such as the dosage, duration of administration, and selectivity o...
Cyclooxygenases have an important role in the production of PGs where these enzymes in bone tissues show increased activity under the influence of hypoxia-inducible factors [6, 11]. Therefore, local activity of COX enzymes promotes bone formation and resorption through the production of PGs [12]. Non-selective NSAIDs are reported to inhibit the activity of COX-1 equally, if not more than COX-2 [2]...
Non-steroidal anti-inflammatory drugs (NSAIDs) are a group of drugs with anti-inflammatory, analgesic, and antipyretic effects. They are commonly used in dentistry for management of dental pain associated with inflammation. NSAIDs exert their effects through the inhibition of the cyclooxygenase (COX) enzyme, therefore interfering with the synthesis of prostaglandins (PG) and thromboxanes; PGs and ...
Non-steroidal anti-inflammatory drugs are commonly used in implant dentistry for management of post-operative pain. The objective of this systematic review was to analyse the effect of non-steroidal anti-inflammatory drugs on the osteogenic activity of osteoblasts with an emphasis on its effect on osseointegration. A systematic literature search for in vitro, animal models, and clinical trials was...