scholarly journals Anti-inflammatory systemic pharmacotherapy of periodontitis (a literature review)

2021 ◽  
Vol 2 (1) ◽  
pp. 17-24
Author(s):  
M.V. Khaitovich

A search was conducted in the databases Scopus, Web of Science, MedLine, The Cochrane Library. Periodontal disease is the main cause of tooth loss. Periodontitis is an inflammatory dise-ase caused by a specific microflora and leads to the progressive destruction of the ligaments of the tooth and alveolar bone. This is accompanied by the formation of the gums recession, the formation of periodontal pockets, both separately and mutually. Periodontitis is observed in 9–85 % of children, 70–90 % of adolescents, more than half of adults. Activation of inflammation in the periodontium is inextricably linked with systemic processes in the body, which are accompanied by an inflammatory response, and therefore perio-dontitis is a concomitant factor in coronary heart disease and cerebrovascular disease/ischemic stroke, adversely affects the digestive, cardiovascular, endocrine and other systems. Uncontrolled inflammatory response of the body in the conditions of microbial biofilm, which is tightly adjacent to the tooth surface, leads to the destruction of periodontal tissues, bone loss. If the acute inflammation subsides in time, preventing destruction without the complete return of tissues to homeostasis, it leads to damage caused by neutrophils and chronic inflammation. Systemic anti-inflammatory therapy with the use of non-selective nonsteroidal anti-inflammatory drugs is an important direction of periodontitis therapy, which reduces the intensity of inflammation, minimizes the destruction of periodontal tissues, limits the resource of nutrients for pathogenic microorganisms, prevents resorption of alveolar bone. For the prevention of gastropathy, it is advisable to use a synthetic analogue of prostaglandin E2 misoprostol in the complex therapy. The mana-gement of drug interaction should be used when prescribing nonsteroidal anti-inflammatory drugs to a patient taking sulfonylureas, warfarin, antihypertensive drugs, and the like.

2020 ◽  
Vol 17 (35) ◽  
pp. 381-390
Author(s):  
Andrei SEVBITOV ◽  
Alla DAVIDYANTS ◽  
Roman BALYKIN ◽  
Anton TIMOSHIN ◽  
Mariya KUZNETSOVA

Periodontal disease in the adult population is one of the most pressing problems of dentistry around the world. Thanks to the introduction of modern technologies in practice, it was possible to identify the main mechanisms of the development of this disease at the molecular and genetic level. The interaction of periodontal pathogens with immune factors of antimicrobial protection of the body is the basis of periodontal tissue inflammation and further leads to the destruction of the alveolar bone. Epithelial cells of the gum mucosa play a crucial role against periodontal pathogenic bacteria. Factors of innate immunity play a role not only in antimicrobial protection, but they also support the conditions necessary for the healing and regeneration of periodontal tissues. Therefore, various therapeutic approaches that affect the factors of innate immunity are considered as effective and promising. Clinical examination and determination of factors of innate immunity were performed in 115 patients. Healthy individuals made up a group of 30 people. Patients with chronic generalized periodontitis with varying degrees of severity were 85 people. Each patient underwent orthopantomography on the orthopantomograph Orthophosis XG DS/Ceph (SIRONA Dental System GmbH, Germany) in order to assess the state of the bone tissue of the jaws (the degree of destruction of the cortical layer, the degree of resorption of the interalveolar partitions). Targeted intraoral radiographs were used to assess the state of bone tissue and the quality of surgical treatment. Immunological methods of research were carried out in several stages. The findings of this article make the claim that the use of autologous complex immunopeptides in the surgical treatment of periodontitis reduces the time of achieving a therapeutic effect 2 times, resulting in the rapid relief of the symptoms of inflammation and acceleration of reparative processes.


2021 ◽  
Vol 6 (5) ◽  
pp. 38-44
Author(s):  
O. D. Saliuk ◽  
◽  
P. H. Gerasimchuk ◽  
L. O. Zaitsev ◽  
I. I. Samoilenko ◽  
...  

In this article the review of foreign and domestic literary sources, which are devoted to the actual problem of modern dentistry – the treatment of inflammatory diseases of periodontal tissues: gingivitis and periodontitis are presented. The complex approach to their treatment involves the appointment of a significant amount of pharmacotherapeutic drugs. Therapeutic failures and iatrogenic complications have led to the fact that today the interests of doctors and population to medicinal products significantly increased. The purpose of the study is to analyze the data of scientific literature on the use of plant-based medicinal products for the treatment of periodontal inflammatory diseases over the past 10 years. Materials and methods. Comprehensive and systematic analysis of literature. Review and discussion. The analysis of information sources on the use of plant-based medicinal products in dentistry both independently and in the composition of medical and prophylactic means has established that the modern assortment of plant-based preparations in the pharmaceutical market of Ukraine to a certain extent is limited. The emergence of new plant-based species that have been tested in conditions of experimental pathology and require an evidence-based clinical base is noted. The composition of plant-based preparations used for the treatment of inflammatory periodontal diseases include vitamins, biologically active substances, glycosides, alkaloids, in connection with a wide range of action: antiseptic, anti-inflammatory, regenerating, hemostatic, antioxidative. The data on plant-based preparations that are most often used such as chamomile extracts, calendula, hypericum, plantain, kalanchoe, aloe, eucalyptus, milfoil, nettle, calamus and plant-based species are summarized. The medicinal agents considered are mainly recommended for local treatment of periodontal diseases in the form of dental care means, mouth rinse, gel, chewing gum, herbal liquer. It is known that the complex treatment of periodontal diseases includes a general influence on the body. The properties of green tea with its wide range of actions are investigated. With antioxidant properties, it can be a healthy alternative for controlling destructive changes in periodontal diseases. Attention is drawn to the proposed unique natural complex “Resverazin” due to a wide range of pharmacological action, low toxicity and relative safety. The drug produces antioxidant, anti-inflammatory, immune stimulating, vasodilative, neuroprotective action. Conclusion. Based on the literature analysis, it can be concluded that the accumulated experimental and clinical data on the therapeutic properties of plants prove perspective of their use in the complex treatment of inflammatory periodontal diseases. Future studies are mandatory for further confirmation of the effectiveness of these medicinal plants


2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Mirghani HO

Background: Post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) is a serious disease. The role of nonsteroidal anti-inflammatory drugs (NSAIDs) in the prevention of PEP is conflicting. Objectives: This review aimed to assess the preventive role of NSAIDs in PEP with special emphasis on the dose and route of administration. Methods: We searched PubMed and Google Scholar for relevant observational studies published in English during the period from January 2010 to January 2020. The terms post-ERCP pancreatitis, diclofenac sodium, indomethacin, NSAIDs, dose, route of administration were used. Results: Of the 179 identified, 19 full texts were screened and included in the review. Ten studies were from Europe, seven from Asia and two were published in the USA, the studies showed that NSAIDs were effective in preventing PEP when used rectally or intramuscularly, higher doses are more efficacious and the combination with stents was not superior, careful patients selection is needed in particular regarding the body mass index. Conclusion: NSAIDs were effective in PEP prevention; however, the evidence is weak due to the observational nature and the different methods used in the included studies. Randomized controlled studies are needed to solve the issue.


2020 ◽  
pp. 019459982094701
Author(s):  
John D. Cramer ◽  
Michael L. Barnett ◽  
Samantha Anne ◽  
Brian T. Bateman ◽  
Richard M. Rosenfeld ◽  
...  

Objective To offer pragmatic, evidence-informed advice on nonsteroidal anti-inflammatory drugs (NSAIDs) as first-line therapy after surgery. This companion to the American Academy of Otolaryngology–Head & Neck Surgery (AAO-HNS) clinical practice guideline (CPG), “Opioid Prescribing for Analgesia After Common Otolaryngology Operations,” presents data on potency, bleeding risk, and adverse effects for ibuprofen, naproxen, ketorolac, meloxicam, and celecoxib. Data Sources National Guidelines Clearinghouse, CMA Infobase, National Library of Guidelines, NICE, SIGN, New Zealand Guidelines Group, Australian National Health and Medical, Research Council, TRIP database, PubMed, Guidelines International Network, Cochrane Library, EMBASE, CINAHL, BIOSIS Previews, ISI Web of Science, AHRQ, and HSTAT. Review Methods AAO-HNS opioid CPG literature search strategy, supplemented by PubMed/MEDLINE searches on NSAIDs, emphasizing systematic reviews and randomized controlled trials. Conclusion NSAIDs provide highly effective analgesia for postoperative pain, particularly when combined with acetaminophen. Inconsistent use of nonopioid regimens arises from common misconceptions that NSAIDs are less potent analgesics than opioids and have an unacceptable risk of bleeding. To the contrary, multimodal analgesia (combining 500 mg acetaminophen and 200 mg ibuprofen) is significantly more effective analgesia than opioid regimens (15 mg oxycodone with acetaminophen). Furthermore, selective cyclooxygenase-2 inhibition reliably circumvents antiplatelet effects. Implications for Practice The combination of NSAIDs and acetaminophen provides more effective postoperative pain control with greater safety than opioid-based regimens. The AAO-HNS opioid prescribing CPG therefore prioritizes multimodal, nonopioid analgesia as first-line therapy, recommending that opioids be reserved for severe or refractory pain. This state-of-the-art review provides strategies for safely incorporating NSAIDs into acute postoperative pain regimens.


ChemistryOpen ◽  
2020 ◽  
Vol 9 (8) ◽  
pp. 822-834
Author(s):  
Kenneth K. Laali ◽  
Angela T. Zwarycz ◽  
Nicholas Beck ◽  
Gabriela L. Borosky ◽  
Manabu Nukaya ◽  
...  

2019 ◽  
Vol 89 (4) ◽  
pp. 651-660 ◽  
Author(s):  
Renata Travassos da Rosa Moreira Bastos ◽  
Marco Nassar Blagitz ◽  
Mônica Lídia Santos de Castro Aragón ◽  
Lucianne Cople Maia ◽  
David Normando

ABSTRACT Objectives: To identify the scientific evidence that demonstrates which of the transverse maxillary treatments has the least effect on periodontal tissues. Materials and Methods: PubMed (MEDLINE), Cochrane Library, Scopus, Web of Science, Virtual Health Library, Google Scholar, and OpenGrey were searched without restrictions. A hand search was also carried out in the reference lists of the articles selected. The related articles tool in the PubMed database was checked for each article included. Risk of bias assessment was performed using Cochrane Collaboration's Risk of Bias tool for randomized clinical trials and the ROBINS-I tool for nonrandomized studies of interventions. The GRADE tool was used to assess the quality of the evidence. Results: After examination of the full texts, three studies were finally included. Two studies used a Haas expander with different protocols, and one study used a Haas expander compared with a quad-helix appliance. These studies evaluated periodontal parameters and periodontal indices by clinical examination with a millimeter probe, and one study examined computed tomography images. After quality assessment, two studies were considered as having a “low” risk of bias. One study was scored as having a moderate risk of bias. The evidence was graded as moderate quality for alveolar bone level, tooth displacement, and inclination and very low for all other outcomes. Conclusions: There were no significant differences to enable a sound conclusion about which type of maxillary expansion has the least periodontal side effects.


2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Zheling Feng ◽  
Jun Cao ◽  
Qingwen Zhang ◽  
Ligen Lin

AbstractInflammation is an active defense response of the body against external stimuli. Long term low-grade inflammation has been considered as a deteriorated factor for aging, cancer, neurodegeneration and metabolic disorders. The clinically used glucocorticoids and non-steroidal anti-inflammatory drugs are not suitable for chronic inflammation. Therefore, it’s urgent to discover and develop new effective and safe drugs to attenuate inflammation. Clerodane diterpenoids, a class of bicyclic diterpenoids, are widely distributed in plants of the Labiatae, Euphorbiaceae and Verbenaceae families, as well as fungi, bacteria, and marine sponges. Dozens of anti-inflammatory clerodane diterpenoids have been identified on different assays, both in vitro and in vivo. In the current review, the up-to-date research progresses of anti-inflammatory clerodane diterpenoids were summarized, and their druglikeness was analyzed, which provided the possibility for further development of anti-inflammatory drugs.


2018 ◽  
Vol 2018 ◽  
pp. 1-13 ◽  
Author(s):  
Pajaree Sriuttha ◽  
Buntitabhon Sirichanchuen ◽  
Unchalee Permsuwan

Background. Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most widely used medication in several countries, including Thailand. NSAIDs have been associated with hepatic side effects; however, the frequency of these side effects is uncertain. Aim of the Review. To systematically review published literature on randomized, controlled trials that assessed the risk of clinically significant hepatotoxicity associated with NSAIDs. Methods. Searches of bibliographic databases EMBASE, PubMed, and the Cochrane Library were conducted up to July 30, 2016, to identify randomized controlled trials of ibuprofen, naproxen, diclofenac, piroxicam, meloxicam, mefenamic acid, indomethacin, celecoxib, and etoricoxib in adults with any disease that provide information on hepatotoxicity outcomes. Results. Among the 698 studies, 18 studies met the selection criteria. However, only 8 studies regarding three NSAIDs (celecoxib, etoricoxib, and diclofenac) demonstrated clinically significant hepatotoxic evidence based on hepatotoxicity justification criteria. Of all the hepatotoxicity events found from the above-mentioned three NSAIDs, diclofenac had the highest proportion, which ranged from 0.015 to 4.3 (×10−2), followed by celecoxib, which ranged from 0.13 to 0.38 (×10−2), and etoricoxib, which ranged from 0.005 to 0.930 (×10−2). Conclusion. Diclofenac had higher rates of hepatotoxic evidence compared to other NSAIDs. Hepatotoxic evidence is mostly demonstrated as aminotransferase elevation, while liver-related hospitalization or discontinuation was very low.


2016 ◽  
Vol 31 (1) ◽  
pp. 26-34 ◽  
Author(s):  
Jan Gaertner ◽  
Ulrike M Stamer ◽  
Constanze Remi ◽  
Raymond Voltz ◽  
Claudia Bausewein ◽  
...  

Background: Dipyrone (metamizole) is one of the most widely used non-opioid analgesics for the treatment of cancer pain. Aim: Because evidence-based recommendations are not yet available, a systematic review was conducted for the German Guideline Program in Oncology to provide recommendations for the use of dipyrone in cancer pain. Design: First, a systematic review for clinical trials assessing dipyrone in adult patients with cancer pain was conducted. Endpoints were pain intensity, opioid-sparing effects, safety, and quality of life. Data sources: The search was performed in MedLine, Embase (via Ovid), and the Cochrane Library (1948–2013) and additional hand search was conducted. Finally, recommendations were developed and agreed in a formal structured consensus process by 53 representatives of scientific medical societies and 49 experts. Results: Of 177 retrieved studies, 4 could be included (3 randomized controlled trials and 1 cohort study, n = 252 patients): dipyrone significantly decreased pain intensity compared to placebo, even if low doses (1.5–2 g/day) were used. Higher doses (3 × 2 g/day) were more effective than low doses (3 × 1 g/day), but equally effective as 60 mg oral morphine/day. Pain reduction of dipyrone and non-steroidal anti-inflammatory drugs did not differ significantly. Compared to placebo, non-steroidal anti-inflammatory drugs, and morphine, the incidence of adverse effects was not increased. Conclusion: Dipyrone can be recommended for the treatment of cancer pain as an alternative to other non-opioids either alone or in combination with opioids. It can be preferred over non-steroidal anti-inflammatory drugs due to the presumably favorable side effect profile in long-term use, but comparative studies are not available for long-term use.


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