Effect of Adjuvant Use of NSAID in Reducing Probing Pocket Depth in the Context of Conventional Periodontal Therapy: A Systematic Review of Randomized Trials

Abstract

This systematic review aimed to assess the literature on the benefit of adjuvant nonsteroidal anti-inflammatory drugs (NSAIDs) during conventional periodontal therapy in terms of probing pocket depth (PD). A literature search according to PRISMA guidelines in Medline (PubMed), Embase (Ovid), and Cochrane library identified seven studies to be included in this review. In terms of the main outcome, PD, three studies found a larger reduction after NSAID administration compared to non-NSAID control patients. In two studies, no difference in PD reduction between NSAID and placebo was found. Overall, the NSAID patients showed no significant difference with an estimated 0.11 mm larger reduction in PD than the control [95% CI: −0.22 mm, 0.44 mm]. The secondary outcomes, bleeding on probing (BOP) and clinical attachment gain, also showed comparable results in all studies between patients receiving NSAID and those that did not. The estimated additional PD reduction of 0.11 mm in the NSAID group is very small and not statistically significant. It is unlikely that PD can be improved by adjuvant NSAID treatment after root surface debridement, yet the evidence to date is limited and warrants further investigation.

Keywords

• periodontitis
• non-surgical periodontal therapy
• systematic review
• nonsteroidal anti-inflammatory drugs