Systematic Review on the effect of NSAIDs on Periodontal Condition

Objectives: Periodontal disease is caused by infectious microorganism but host are also involved inflammatory responses so nonsteroidal anti-inflammatory drugs(NSAIDs) which prohibit biosynthesis of prostaglandins is considered for host modulation. The aim of this review was to determine the effect of NSAIDs adjunctive with nonsurgical periodontal treatment(NSPT) on patients with periodontal disease.
Methods: Studies were searched from MEDLINE, EMBASE, Cochrane Central Register of Clinical Trials and KoreaMed databases. Searching strategy were developed for identifying randomized controlled trials comparing NSAIDs medication adjunctive NSPT compared with NSPT alone in point of clinical attachment level(CAL) and/or probing depth(PD) in patient with periodontal disease. Cochrane risk of bias assessment tool was used for assessment of methodological quality and RevMan(version 5.3) and STATA(version 13) were used for meta-analysis.
Results: 12 studies were included for methodological assessment. Most of studies has unclear risk in aspect of allocation concealments. 8 studies (6 studies evaluated CAL, 7 studies evaluated PD) were used for meta-analysis. Weighted mean difference was 0.18 (CI -0.13, 0.48) in CAL and 0.18 (CI 0.02, 0.35) in PD.
Conclusions: NSAIDs medication adjunctive to NSPT has benefit to more PD reduction than NSPT alone but no effect on CAL gain. The limitation is related to heterogeneity 1) potency of each NSAIDs, daily dose and duration 2) investigated sites/tooth, number of tooth, participant between studies.