Ribeirão Preto Dental School, University of São Paulo, Ribeirão Preto, SP, Brazil.
J Appl Oral Sci. 2010 Dec;18(6):630-4. doi: 10.1590/s1678-77572010000600016.
Prostaglandins control osteoblastic and osteoclastic function under physiological or pathological conditions and are important modulators of the bone healing process. The non-steroidal anti-inflammatory drugs (NSAIDs) inhibit cyclooxygenase (COX) activity and consequently prostaglandins synthesis. Experimental and clinical evidence has indicated a risk for reparative bone formation related to the use of non-selective (COX-1 and COX-2) and COX-2 selective NSAIDs. Ketorolac is a non-selective NSAID which, at low doses, has a preferential COX-1 inhibitory effect and etoricoxib is a new selective COX-2 inhibitor. Although literature data have suggested that ketorolac can interfere negatively with long bone fracture healing, there seems to be no study associating etoricoxib with reparative bone formation. Paracetamol/acetaminophen, one of the first choices for pain control in clinical dentistry, has been considered a weak anti-inflammatory drug, although supposedly capable of inhibiting COX-2 activity in inflammatory sites.
The purpose of the present study was to investigate whether paracetamol, ketorolac and etoricoxib can hinder alveolar bone formation, taking the filling of rat extraction socket with newly formed bone as experimental model.
The degree of new bone formation inside the alveolar socket was estimated two weeks after tooth extraction by a differential point-counting method, using an optical microscopy with a digital camera for image capture and histometry software. Differences between groups were analyzed by ANOVA after confirming a normal distribution of sample data.
Histometric results confirmed that none of the tested drugs had a detrimental effect in the volume fraction of bone trabeculae formed inside the alveolar socket.
前列腺素在生理或病理条件下控制成骨细胞和破骨细胞的功能,是骨愈合过程的重要调节剂。非甾体抗炎药(NSAIDs)抑制环氧化酶(COX)活性,从而抑制前列腺素的合成。实验和临床证据表明,使用非选择性(COX-1 和 COX-2)和 COX-2 选择性 NSAIDs 与修复性骨形成的风险有关。酮咯酸是一种非选择性 NSAID,低剂量时具有优先抑制 COX-1 的作用,依托考昔是一种新型选择性 COX-2 抑制剂。尽管文献数据表明酮咯酸可能对长骨骨折愈合产生负面影响,但似乎没有研究将依托考昔与修复性骨形成联系起来。扑热息痛/对乙酰氨基酚是临床牙科疼痛控制的首选药物之一,尽管据称它能够抑制炎症部位的 COX-2 活性,但被认为是一种弱抗炎药。
本研究旨在探讨扑热息痛、酮咯酸和依托考昔是否会通过以大鼠拔牙窝内新形成的骨填充作为实验模型来阻碍牙槽骨的形成。
通过差分点计数法,在拔牙后两周,使用带有数字摄像头的光学显微镜采集图像并使用组织计量软件,评估牙槽窝内新骨形成的程度。在确认样本数据呈正态分布后,通过方差分析比较各组之间的差异。
组织学结果证实,测试的药物均未对牙槽窝内形成的骨小梁体积分数产生不利影响。