| Objective: The pathogenic mechanism of periodontal disease is very complex and is still not well known. Studies have shown that COX-2(cyclooxygenase-2) and prostaglandin play important roles in the pathogenic mechanism of periodontitis, and they may lead to periodontal inflammation and alveolar bone absorption, and the level of prostaglandin in periodontal tissue is directly related to the severity of periodontitis. Recently nimesulide, which is one kind of COX-2 selective inhibitors, is clinically used for the treatment of rheumatoid arthritis and osteoarthritis. However there is no report about using nimesulide for the treatment of periodontitis .The animal experiment and clinical observation was designed in our study to observe the effect of the nimesulide on periodontitis.Methods: Part of one—animal experiment: (1) 120 Sprague-Dawly rats were randomly devided into four groups:(1) control group;(2) periodontitis group(P): periodontitis was induced in rats by placing a piece of 3/0 braided silk around the cervix of the lower incisors, and then the rats were subjected to intraperitoneal injection of normal saline(NS) after operation daily;(3) nimesulide for prevention (NIMP) group: the rats were subjected to intraperitoneal injection of NIM (15mg/kg)daily after the rats receiving the operation of periodontitis model;(4) nimesulide for treatment (NIMT) group: the rats were subjected to intraperitoneal injection of NIM daily after receiving the same operation four weeks later. The gingival index(GI) was measured before the rats were sacrificed at end of 4,5and 8 weeks. For histopathological examination, the mandibular incisors and the periodontal tissues were removed at 4,5 and 8 weeks after the ligature induction of periodontitis. The tissues were fixed in 10% neutral-buffered of formaldhyde for more than 48 hours, decalcified, embedded in paraffin and sectioned. The sections were stained with hematoxylin and eosin. Histological changes were observed by microscope. The periodontal attachment loss(AL) was measured by Tiger cell image analyzer. Part of two—clinical observation: 136 patients with chronic periodontitis(CP) werechosed for the comparative study. Following the scaling and root planning, nimesulide and metronidazole were respectively used in two groups. After 2 weeks of observation, the effect of clinical treatment was assessed. Results:(1) Experimental periodontitis was successfully induced in rats by placing a piece of 3/0 braided silk around the cervix of the lower incisors at week 4.(2) In ligature-induced periodontitis group, at week 4,the GI and AL were higher significantly than those in control group ( p<0.0\ ) .The histopathologic changes of periodontium in periodontitis group showed obviously inflammatory ,and the severity of destruction for periodontium was increased as time passed.(3) In the nimesulide prevention group, the GI and AL were significantly lower than those in periodontitis group (/K0.01 ) .The histopathologic examination showed less inflammatory responses, and no obvious alveolar bone resorption was observed.(4) In the nimesulide treatment group, the GI and AL were significantly lower than those in periodontitis group at the end of week 5 and 8 (/K0.01) especially at week 8.(5) In clinical observation, our results showed that both nimesulide and metronidazole could decreased the severity of periodontal inflammation. However, nimesulide was more effective in reducing the probing depth (PD) than metronidazole group (p<0.05 ) . Nimesulide also showed a higher efficient in treatment for chronic periodontitis than metronidazole.(p<0.05 ) . Conclusions:(1) In ligature-induced periodontitis, nimesulide could effectively inhibit itsprogress.(2) In the developing periodontitis, a significant improvement was observed in GI and AL following the treatment with nimesulide.(3) Nimesulide showed a significant effect on chronic periodontitis thanmetronidazole. A significant improvement was observed in PD following treatment with nimesulide.
|
PDF Full Text Request