Influence of indomethacin on the regeneration of cortical bone within titanium implants in rabbits

Osseointegration Pharmacology: A Systematic Mapping Using Artificial Intelligence

Clinical performance of osseointegrated implants could be compromised by the medications taken by patients. The effect of a specific medication on osseointegration can be easily investigated using traditional systematic reviews. However, assessment of all known medications requires the use of evidence mapping methods. These methods allow assessment of complex questions, but they are very resource intensive when done manually. The objective of this study was to develop a machine learning algorithm to automatically map the literature assessing the effect of medications on osseointegration. Datasets of articles classified manually were used to train a machine-learning algorithm based on Support Vector Machines. The algorithm was then validated and used to screen 599,604 articles identified with an extremely sensitive search strategy. The algorithm included 281 relevant articles that described the effect of 31 different drugs on osseointegration. This approach achieved an accuracy of 95%, and compared to manual screening, it reduced the workload by 93%. The systematic mapping revealed that the treatment outcomes of osseointegrated medical devices could be influenced by drugs affecting homeostasis, inflammation, cell proliferation and bone remodeling. The effect of all known medications on the performance of osseointegrated medical devices can be assessed using evidence mappings executed with highly accurate machine learning algorithms.

Effects of Nonsteroidal Anti-inflammatory Drugs on Osseointegration: A Review

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.

Investigation of the effect of ibuprofen on the healing of osseointegrated oral implants

OBJECTIVE

To investigate the effect of a 1-week postoperative course of 600 mg of ibuprofen taken four times a day on marginal bone level around oral implants.

MATERIALS AND METHODS

Twenty-eight patients were allocated to the ibuprofen group (14 patients) or no-ibuprofen group (14 patients). Overall, 57 implants were inserted, 31 implants in the ibuprofen group and 26 in the no-ibuprofen group. The primary outcome measure was the change in marginal bone level around oral implants from baseline (2 weeks postplacement) to the 3- and 6-month radiographic examinations. The paralleling technique and a film holder coupled to a beam-aiming device were used to take the periapical radiographs. Measurement of changes in bone level was made using a viewing box and ×8 magnifier.

RESULTS

Three subjects were withdrawn from the therapy early as they did not complete the dose of ibuprofen (e.g. because of self-reported stomach upset). The mean marginal mesial bone loss from the baseline was 0.37 mm at the 3-month and 0.27 mm at the 6-month follow up for the ibuprofen group, while the corresponding values for the no-ibuprofen group were 0.15 mm and 0.08 mm. The mean marginal distal bone loss from the baseline was 0.42 mm at the 3-month and 0.2 mm at the 6-month follow up for the ibuprofen group, while the corresponding values for the no-ibuprofen group were 0.08 mm and 0.15 mm. There were no significant differences between the ibuprofen and no-ibuprofen groups when comparing the bone changes.

CONCLUSION

Administration of a short course of systemic ibuprofen for postoperative pain management following implant insertion may not have a significant effect on the marginal bone loss around oral implants in the early healing phase.

Effects of dissolucytotic gold ions on recovering brain lesions

Recent experimental research has shown that metallic gold releases charged gold atoms when placed intracerebrally and that the liberated gold ions affect inflammation in the brain. The observations suggest that metallic gold can be used as a safe suppressor of inflammation in the central nervous system.

Effect of meloxicam and diclofenac sodium on peri-implant bone healing in rats

BACKGROUND

This study evaluated the effects of diclofenac sodium and meloxicam on peri-implant bone healing.

METHODS

Thirty male rats were divided into three groups: the control group (CG) received no drug; the diclofenac sodium group (DSG) received 1.07 mg/kg twice a day for 5 days; and the meloxicam group (MG) received 0.2 mg/kg daily for 5 days. A screw-shaped titanium implant was placed in the tibia. Fluorochromes, oxytetracycline (OxT), calcein (CA), and alizarin (AL), were injected at 7, 14, and 21 days, respectively, after implantation, and the animals were sacrificed 28 days after implant placement. The percentages of OxT-, CA-, and AL-labeled bone as well as the percentages of bone-to-implant contact (BIC), cortical bone area (CBA), and trabecular bone area (TBA) within the implant threads were evaluated.

RESULTS

Bone healing was delayed in the DSG during the first 14 days after implant placement (OxT-labeled bone: DSG: 5.3% +/- 7.3% versus CG: 13.2% +/- 9.8%, P = 0.002, and versus MG:14.4% +/- 13.1%, P = 0.05). The percentages of BIC (DSG: 49.6% +/- 21.9%; MG: 67.1% +/- 22.8%; and CG: 68.1% +/- 22.8%) and CBA (DSG: 63.7% +/- 21.2%; MG: 82.7% +/- 12.4%; CG: 84.9% +/- 10.6%) were lower in the DSG compared to the MG and CG (P <0.001). The percentage of TBA was significantly greater in the DSG compared to the MG and CG (DSG: 36.3% +/- 21.2% versus MG: 17.3% +/- 12.7% and versus CG: 15.1% +/- 10.6%; P <0.001).

CONCLUSION

Diclofenac sodium seemed to delay peri-implant bone healing and to decrease BIC, whereas meloxicam had no negative effect on peri-implant bone healing.