PERIO - Periodontal Practice Today 5 (2008), No. 4 4. June 2009
PERIO - Periodontal Practice Today 3 (2006), No. 2 (15.06.2006)
Clinical and Biochemical Evaluation of Short-Term Systemic Ibuprofen as an Adjunct to Non-Surgical Periodontal Therapy of Chronic Periodontitis
Basegmez Zeren, Cansu/Demirel, Korkud/Isik, Gulden/Yalcin, Funda/Tiryaki, Demir/Bektas, Muhammet/Onan, Utku
Both periodontopathogens and destructive host response play important roles in the pathogenesis of chronic periodontitis and ideal therapy must address both components. Therefore, management of the disease may require additional interventions that will modulate the host response, for example by the use of non-steroidal anti-inflammatory drugs (NSAIDs). The present study was designed to evaluate the efficacy of adjunctive ibuprofen clinically and also biochemically by detecting gingival crevicular fluid (GCF) matrix metalloproteinase-8 (MMP-8) and prostaglandin E2 (PGE2) levels, in the treatment of chronic periodontitis. Twenty chronic periodontitis patients were randomly placed in two groups. The control group received initial periodontal therapy, while the test group additionally received systemic ibuprofen for two weeks. Plaque index (PI), sulcus bleeding index (SBI), probing pocket depth (PPD) and relative attachment level (RAL) were recorded and GCF samples were obtained at the first, third and sixth months following therapy. GCF levels of MMP-8 and PGE2 were evaluated using enzyme immunoassay technique. Treatment outcomes were analysed by Mann-Whitney U test for treatment modalities and Wilcoxon signed rank test for changes within each group. Both groups showed significant improvements in all parameters following therapy (p < 0.05). The comparisons between the two groups revealed that neither mean PI scores, nor the improvements in SBI, PPD, RAL or GCF MMP-8 and PGE2 levels demonstrated statistical significance (p > 0.05). Adjunctive use of systemic ibuprofen demonstrated no beneficial effect on the clinical or biochemical outcome of periodontal treatment of chronic periodontitis. The lack of beneficial effect may be due to short period usage of ibuprofen.
Keywords: NSAID, gingival crevicular fluid (GCF), GCF MMP-8, GCF PGE2, chronic periodontitis