A commonly prescribed medication after implant surgery are one of the non-steroidal anti-inflammatory drugs (NSAIDs). In addition to pain control, many of our patients are taking low dose aspirin for prevention of cardiovascular disease and cancer. When the mechanism of action of these drugs are evaluated, it is obvious they have an impact on the metabolic pathways responsible for bone formation and resorption. This discussion will outline the pharmacology of the NSAIDs and what we know about how they affect implant integration and bone regeneration. This discussion is an excerpt from the live online course “Bone Biology” presented periodically by SteinerBio.
NSAIDs’ Effect on Boneand Implant Integration
Non-Steroidal Anti-Inflammatory Drugs
There are many NSAIDs on the market and while they have differences in pain control and reduction of inflammation, they all work via inhibition of cyclooxygenase (COX) enzymes. The cox enzymes are responsible for the production of the prostaglandins. There are four principal bioactive prostaglandins generated in vivo:
- prostaglandin (PG) E2 (PGE2)
- prostacyclin (PGI2)
- prostaglandin D2 (PGD2)
- prostaglandin F2α (PGF2α)