Kumchai Hattanas, Taub Daniel I, Tomlinson Ryan E
Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Department of Oral and Maxillofacial Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Clin Exp Dent Res. 2025 Feb;11(1):e70065. doi: 10.1002/cre2.70065.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are often prescribed following the placement of dental implants, but the effects of these drugs on the osseointegration process are poorly understood. We designed a randomized, placebo-controlled pilot study to quantitatively assess the effect of NSAIDs during early implant osseointegration.
Subjects receiving a maxillary dental implant were randomized to take naproxen or placebo for 7 days after the surgery. Implant osseointegration was quantified using Resonance Frequency Analysis device. Implant-Stability-Quotient (ISQ) measurement was performed at the time of surgery and at follow-up visits 1, 4, and 16 weeks after surgery. Periapical radiographs were taken to measure the marginal bone level. Separately, a questionnaire of NSAIDs usage was provided to subjects presenting with early implant failure.
After 4 weeks, ISQ values increased modestly ( + 1%) in subjects receiving naproxen whereas subjects receiving placebo had a much larger increase in ISQ value (+41%). We observed 55% more marginal bone loss at 4 weeks, and 52% at 16 weeks in the naproxen group compared to the placebo group. These results were not found to have statistically significant between groups (p ≥ 0.05). These effect sizes and variance were used to conduct a power analysis to determine the necessary sample size for future studies. Furthermore, our separate questionnaire study revealed that 68% of our patients with early failed dental implants reported a history of NSAIDs usage after the surgery.
In conclusion, this pilot study provides effect sizes and sample size estimates for future studies to definitively determine recommendations regarding NSAID usage following dental implant surgery. Nonetheless, our study did not observe any statistically significant differences in ISQ value or marginal bone loss after up to 16 weeks of follow-up between subjects from naproxen and placebo groups.
非甾体抗炎药（NSAIDs）常在牙种植体植入后开具处方，但这些药物对骨结合过程的影响尚不清楚。我们设计了一项随机、安慰剂对照的试点研究，以定量评估NSAIDs在种植体早期骨结合过程中的作用。
接受上颌牙种植体植入的受试者在术后随机服用萘普生或安慰剂7天。使用共振频率分析装置对种植体骨结合进行定量分析。在手术时以及术后1、4和16周的随访时进行种植体稳定性商数（ISQ）测量。拍摄根尖片以测量边缘骨水平。另外，向出现早期种植体失败的受试者提供一份NSAIDs使用情况问卷。
4周后，服用萘普生的受试者的ISQ值适度增加（+1%），而服用安慰剂的受试者的ISQ值增加幅度更大（+41%）。与安慰剂组相比，萘普生组在4周时边缘骨吸收多55%，在16周时多52%。未发现这些结果在组间具有统计学意义（p≥0.05）。这些效应大小和方差用于进行功效分析，以确定未来研究所需的样本量。此外，我们单独的问卷调查显示,68%的早期牙种植体失败患者报告术后有使用NSAIDs的病史。
总之，这项试点研究为未来的研究提供了效应大小和样本量估计，以最终确定关于牙种植体手术后NSAIDs使用的建议。尽管如此，我们的研究在随访长达16周后，未观察到萘普生组和安慰剂组受试者之间在ISQ值或边缘骨吸收方面存在任何统计学上的显著差异。
