A systematic review to determine the impact of non‐steroidal anti‐inflammatory drugs on dental implant osseointegration

摘要

Abstract Introduction Non‐steroidal anti‐inflammatory drugs (NSAIDs) are commonly used over the counter analgesics for the management of post‐operative pain following dental surgery, including dental implant placement. NSAIDs work through inhibition of the cyclo‐oxygenase (COX) enzyme, in particular the isoform COX‐2. COX‐2 has been shown to induce new bone formation with upregulation of COX‐2 demonstrated following bony fractures. The aim of this systematic review was to determine if NSAID use affects bone healing and osseointegration following dental implant placement. Methods Electronic databases (Medline and Embase) were searched in addition to hand searches from reference lists of selected papers. Only randomised control trials were included in this review. Results Three studies were included and data provided on bone healing and osseointegration following dental implant surgery (with and without NSAID use) were analysed. The Cochrane risk of bias tool (2.0) were used to assess risk of bias. Two randomised control trials were conducted on animal subjects and one on human participants. One animal study reported significantly reduced bone healing around dental implants following the use of prolonged subcutaneous NSAIDs. No other studies reported any significant findings. There was considerable heterogeneity between included studies. Conclusion There is limited evidence exploring the relationship of NSAIDs and dental implant osseointegration and bone healing to draw definitive conclusions. Further research is required in this area.