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A Comparison of Topical Ketorolac, Systemic Flurbiprofen, and Placebo for the Inhibition of Bone Loss in Adult Periodontitis
Author(s) -
Jeffcoat M.K.,
Reddy M.S.,
Haigh S.,
Buchanan W.,
Doyle M.J.,
Meredith M.P.,
Nelson S.L.,
Goodale M.B.,
Wehmeyer K.R.
Publication year - 1995
Publication title -
journal of periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.036
H-Index - 156
eISSN - 1943-3670
pISSN - 0022-3492
DOI - 10.1902/jop.1995.66.5.329
Subject(s) - ketorolac , ketorolac tromethamine , placebo , medicine , dental alveolus , flurbiprofen , periodontitis , analysis of variance , anesthesia , dentistry , analgesic , pathology , alternative medicine
S ystemic non‐steroidal anti‐inflammatory drugs (NSAIDs) have been shown to reduce alveolar bone loss in periodontitis. This study assesses the efficacy of a topical NSAID rinse, containing ketorolac tromethamine as the active agent. Adult periodontitis patients (n = 55) were studied in this 6‐month randomized, double blind, parallel, placebo and positive‐controlled study. Each patient had a least 3 sites at high risk for bone loss as assessed by low dose bone scan. Groups, balanced for gender, were assigned to one of three regimens: bid ketorolac rinse (0.1%) with placebo capsule; 50 mg bid flurbiprofen capsule (positive control) with placebo rinse; or bid placebo rinse and capsule. Prophylaxes were provided every 3 months. Monthly examinations assessed safety, gingival condition, and gingival crevicular fluid PGE2. Standardized radiographs were taken at baseline and at 3 and 6 months for digital subtraction radiography. A significant loss in bone height was observed during the study period in the placebo group (‐0.63±0.11; P <0.001), but not in the flurbiprofen (‐0.10±0.12; P = 0.40) or ketorolac rinse (+0.20±0.11 mm; P = 0.07) groups. Nested ANOVA revealed that ketorolac and flurbiprofen groups had less bone loss ( P <0.01) and reduced gingival crevicular fluid PGE 2 levels ( P <0.03) compared to placebo. ANOVA suggests ( P = 0.06) that ketorolac rinse preserved more alveolar bone than systemic flurbiprofen at the dose regimens utilized. These data indicate that ketorolac rinse may be beneficial in the treatment of adult periodontitis. J Periodontol 1995; 66:329–338 .