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Rothe R, Schulze S, Neuber C, Hauser S, Rammelt S, Pietzsch J. Adjuvant drug-assisted bone healing: Part I – Modulation of inflammation. Clin Hemorheol Microcirc 2020; 73:381-408. [DOI: 10.3233/ch-199102] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Rebecca Rothe
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Department of Radiopharmaceutical and Chemical Biology, Dresden, Germany
| | - Sabine Schulze
- University Center of Orthopaedics & Traumatology (OUC), University Hospital Carl Gustav Carus, Dresden, Germany
- Center for Translational Bone, Joint and Soft Tissue Research, University Hospital Carl Gustav Carus and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Christin Neuber
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Department of Radiopharmaceutical and Chemical Biology, Dresden, Germany
| | - Sandra Hauser
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Department of Radiopharmaceutical and Chemical Biology, Dresden, Germany
| | - Stefan Rammelt
- University Center of Orthopaedics & Traumatology (OUC), University Hospital Carl Gustav Carus, Dresden, Germany
- Center for Translational Bone, Joint and Soft Tissue Research, University Hospital Carl Gustav Carus and Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Center for Regenerative Therapies Dresden (CRTD), Dresden, Germany
| | - Jens Pietzsch
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Department of Radiopharmaceutical and Chemical Biology, Dresden, Germany
- Technische Universität Dresden, School of Science, Faculty of Chemistry and Food Chemistry, Dresden, Germany
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Huss MK, Felt SA, Pacharinsak C. Influence of Pain and Analgesia on Orthopedic and Wound-healing Models in Rats and Mice. Comp Med 2019; 69:535-545. [PMID: 31561753 DOI: 10.30802/aalas-cm-19-000013] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The surgical stress response and resulting physiologic changes can lead to postoperative complications and negatively impact animal welfare. Although appropriate pain management is crucial to reduce the pain and stress response to surgery, analgesic choice can significantly affect bone and wound healing. This review aims to summarize data from rat and mouse studies and to provide recommendations for integrating analgesia into orthopedic and wound healing models in these species. Data from other species, such as humans, rabbits and other rodents, is included, where available. From these data, we conclude that for orthopedic surgical models, opioids, local anesthetics and dissociative agents have minimal impact on fracture healing; cyclooxygenase 2 (COX2) selective nonsteroidal antiinflammatory drugs (NSAID) may be used in the shortterm; and steroids should be avoided. For wound healing models, short-term systemic or topical opioids have negligible impact on wound healing; NSAID or local anesthetics may be used short-term; and systemic steroids should be avoided. Alternative analgesics such as tramadol, gabapentin, ketamine, and acetaminophen warrant consideration and further evaluation for both orthopedic and wound healing models. In all cases, researchers and veterinarians should work together to determine the appropriate analgesic plan to minimize pain, as well as to minimize unwanted effects on the orthopedic and wound healing models themselves.
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Affiliation(s)
- Monika K Huss
- Department of Comparative Medicine, Stanford University, Stanford, California;,
| | - Stephen A Felt
- Department of Comparative Medicine, Stanford University, Stanford, California
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Hatipoglu MG, Inal S, Kabay S, Cayci MK, Deger A, Kuru HI, Altikat S, Akkas G. The Influence of Different Nonsteroidal Anti-Inflammatory Drugs on Alveolar Bone in Rats: An Experimental Study. Acta Stomatol Croat 2016; 49:325-30. [PMID: 27688417 DOI: 10.15644/asc49/4/8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
THE AIM The aim of this study was to investigate the effect of dexketoprofen trometamol, meloxicam, diclofenac sodium on any untreated alveolar bone when they are used as drugs for another indication. MATERIALS AND METHODS Twenty eight male Spraque-Dawley rats were randomized into four groups as dexketoprofen trometamol (Group I), meloxicam (Group II), diclofenac sodium (Group III) and control group. Nonsteroidal anti-inflammatory drugs (NSAID) were administered after a fibula fracture for 10 days. Untreated alveolar bone was histopathologically examined for spongious bone density, osteoclastic density and osteoblastic density. RESULTS Spongious bone density was lower in study groups (Group I, group II and group III) than the control group (p<0.05). In contrast, the increase in osteoclastic density was observed in other groups apart from the control group (p<0.05). Osteoblastic density was evaluated and it was determined that group II and group III had lower results than the control group (p<0.05) but group I was equal to the control group. CONCLUSION This study showed that systemically administrated NSAIDs have the potential to affect untreated alveolar bone. This should also be considered in long term use of NSAIDs.
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Affiliation(s)
- Mujgan Gungor Hatipoglu
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Dumlupinar University, Kutahya, Turkey
| | - Sermet Inal
- Department of Orthopaedic and Traumatology, Faculty of Medicine, Dumlupinar University, Kutahya. Turkey
| | - Sahin Kabay
- Department of Urology, Medical Faculty, Faculty of Medicine, Dumlupinar University, Kutahya, Turkey
| | - Muhammet Kasim Cayci
- Department of Biology, Faculty of Arts and Science, Dumlupinar University, Kutahya,Turkey
| | - Ayşenur Deger
- Department of Pathology, Faculty of Medicine, Dumlupinar University, Kutahya, Turkey
| | - Halil Isa Kuru
- Department of Medical Laboratory Techniques, Simav Vocational High School, Dumlupinar University, Kutahya, Turkey
| | - Sayit Altikat
- Department of Department of Biochemistry, Faculty of Medicine, Dumlupinar University, Kutahya, Turkey
| | - Gizem Akkas
- Department of Pathology, Ministry of Health, Dumlupinar University, Kutahya Evliya Celebi Education and Research Hospital, Kutahya, Turkey
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Gomes FIF, Aragão MGB, de Paulo Teixeira Pinto V, Gondim DV, Barroso FC, Silva AARE, Bezerra MM, Chaves HV. Effects of Nonsteroidal Anti-inflammatory Drugs on Osseointegration: A Review. J ORAL IMPLANTOL 2015; 41:219-30. [DOI: 10.1563/aaid-joi-d-13-00125] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The purpose of this study was to review the effects of nonsteroidal anti-inflammatory drugs on osseointegration and determine whether they cause failures in dental implants and whether patients who use them chronically can receive dental implants safely. A bibliographic electronic search was performed using the Cochrane Library, PubMed, and Medline databases, selecting articles published between January 1982 and December 2012. The search included the following keywords, either alone or combined: “nonsteroidal anti-inflammatory drugs,” “dental implants,” “bone healing,” and “osteoprogenitor cells.” The inclusion criteria were the following: randomized, double-blind, placebo-controlled clinical studies, in vivo animal model studies of osseointegration, and in vitro studies of the effects of these agents on osteoprogenitor cells. The literature search revealed 360 references. A total of 31 articles met the inclusion criteria, including 2 clinical trials, 20 animal studies, and 9 osteoprogenitor cell studies. The clinical trials revealed that cyclooxygenase-1 (COX-1) inhibitors did not impair osseointegration. The animal studies showed that any drug that is capable of inhibiting COX-2 may impair the osseointegration process. The in vitro studies showed that COX-2 inhibitors are the most potent depressors of osseointegration at the cellular level. Caution must be taken when selecting COX-2 nonsteroidal anti-inflammatory drugs during the postoperative period.
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Affiliation(s)
| | | | | | - Delane Viana Gondim
- Faculty of Medicine, Federal University of Ceara, Fortaleza Campus, Fortaleza, Ceará, Brazil
| | | | | | - Mirna Marques Bezerra
- Faculty of Dentistry, Federal University of Ceara, Sobral Campus, Sobral, Ceará, Brazil
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Inal S, Kabay S, Cayci MK, Kuru HI, Altikat S, Akkas G, Deger A. Comparison of the effects of dexketoprofen trometamol, meloxicam and diclofenac sodium on fibular fracture healing, kidney and liver: an experimental rat model. Injury 2014; 45:494-500. [PMID: 24246878 DOI: 10.1016/j.injury.2013.10.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Revised: 08/08/2013] [Accepted: 10/04/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Nonsteroidal anti-inflammatory drugs (NSAIDs) are particularly used in patients with bone fractures, but there are limited studies on whether one NSAID is superior to another. In this study, we used histopathological and biochemical parameters to determine whether there are differences between the effects of the administration of clinical doses of dexketoprofen trometamol (DEXT), meloxicam (MEL) and diclofenac sodium (DIC) on the healing of closed fibular fractures and the toxicity of both the liver and kidney. METHODS Twenty-eight male Sprague-Dawley rats were randomly divided into four groups of seven each. Closed diaphyseal fractures were formed in the left fibulas of all of the rats. The NSAIDs dexketoprofen trometamol (DEXT) (Arveles(®)), meloxicam (MEL) (Melox(®)) and diclofenac sodium (DIC) (Voltaren(®)) were intramuscularly administered to Groups I, II, and III, respectively, for a period of 10 days after the fibular fractures were performed. No pharmacological agents were administered to Group IV (Control group). Blood samples were collected from all of the rats after the fractures were performed, and the rats were sacrificed on day 28. The histopathological findings were compared, and the blood samples were evaluated to determine any differences between the levels of superoxide dismutase (SOD), catalase (CAT), and malondialdehyde (MDA). RESULTS Our results suggest that DEXT and MEL impair the healing of bone fractures and that DIC does not histopathologically affect the healing process of bone fractures. We also found that DEXT, MEL, and DIC impaired the renal histopathology compared with the control group. However, the liver histopathological analysis showed that DEXT and MEL caused a higher degree of parenchymal necrosis compared with DIC. CONCLUSION Based on our results, DIC can be considered a relatively safe medication in patients with fractures.
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Affiliation(s)
- Sermet Inal
- Department of Orthopaedics and Traumatology, Faculty of Medicine, Dumlupinar University, Kutahya, Turkey.
| | - Sahin Kabay
- Department of Urology, Faculty of Medicine, Dumlupinar University, Kutahya, Turkey.
| | - M Kasim Cayci
- Department of Biology, Faculty of Arts and Science, Dumlupinar University, Kutahya, Turkey.
| | - H Isa Kuru
- Department of Medical Laboratory Techniques, Simav Vocational High School, Dumlupinar University, Turkey.
| | - Sayit Altikat
- Department of Biochemistry, Faculty of Medicine, Dumlupinar University, Kutahya, Turkey.
| | - Gizem Akkas
- Department of Pathology, Faculty of Medicine, Dumlupinar University, Kutahya, Turkey.
| | - Aysenur Deger
- Department of Pathology, Faculty of Medicine, Dumlupinar University, Kutahya, Turkey.
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Xu T, Yan M, Wang Y, Wang Z, Xie L, Tang C, Zhang G, Yu J. Estrogen deficiency reduces the dentinogenic capacity of rat lower incisors. J Mol Histol 2013; 45:11-9. [PMID: 23974864 PMCID: PMC4544579 DOI: 10.1007/s10735-013-9533-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2013] [Accepted: 08/12/2013] [Indexed: 01/23/2023]
Abstract
Endogenous estrogen deficiency usually causes the systemic osteoporosis including the jaw bones. However, it remains unclear whether estrogen deficiency can affect the tooth mineralization. In this study, the classical osteoporotic rat model was established via the ovariectomy, which was subsequently confirmed by the detection of serum estradiol levels and body weights. The mineralization-related assays were performed to observe the potential changes in mineralized tissues of rat lower incisors. The clinical crown length, compressive strength, radiodensity, and calcium content in the ovariectomy group (OVX) were significantly downregulated (P < 0.01), as compared with the sham operation group (Sham). Histological results revealed that OVX incisors presented the thinner predentin structures than Sham incisors. Immunohistochemical staining and western blot assay further demonstrated that the odonto/osteoblast specific proteins (e.g., dentin sialoprotein, runt-related transcription factor 2, osterix, and osteocalcin) in the dentin–pulp complex of OVX incisors were significantly decreased in comparison with Sham counterparts. Together, estrogen deficiency reduces the dentinogenic capacity and calcium deposition in rat incisors, indicating that estrogen plays an important role in the dentinogenesis.
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Affiliation(s)
- Tao Xu
- Institute of Stomatology, Nanjing Medical University, 140 Hanzhong Road, Nanjing, 210029, Jiangsu, China
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Barbosa D, de Souza RA, Xavier M, da Silva FF, Arisawa EÂL, Villaverde AGJB. Effects of low-level laser therapy (LLLT) on bone repair in rats: optical densitometry analysis. Lasers Med Sci 2012; 28:651-6. [DOI: 10.1007/s10103-012-1125-0] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Accepted: 05/07/2012] [Indexed: 11/29/2022]
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Pountos I, Georgouli T, Calori GM, Giannoudis PV. Do nonsteroidal anti-inflammatory drugs affect bone healing? A critical analysis. ScientificWorldJournal 2012; 2012:606404. [PMID: 22272177 PMCID: PMC3259713 DOI: 10.1100/2012/606404] [Citation(s) in RCA: 164] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2011] [Accepted: 10/18/2011] [Indexed: 12/21/2022] Open
Abstract
Nonsteroidal anti-inflammatory drugs (NSAIDs) play an essential part in our approach to control pain in the posttraumatic setting. Over the last decades, several studies suggested that NSAIDs interfere with bone healing while others contradict these findings. Although their analgesic potency is well proven, clinicians remain puzzled over the potential safety issues. We have systematically reviewed the available literature, analyzing and presenting the available in vitro animal and clinical studies on this field. Our comprehensive review reveals the great diversity of the presented data in all groups of studies. Animal and in vitro studies present so conflicting data that even studies with identical parameters have opposing results. Basic science research defining the exact mechanism with which NSAIDs could interfere with bone cells and also the conduction of well-randomized prospective clinical trials are warranted. In the absence of robust clinical or scientific evidence, clinicians should treat NSAIDs as a risk factor for bone healing impairment, and their administration should be avoided in high-risk patients.
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Affiliation(s)
- Ippokratis Pountos
- Academic Department of Trauma & Orthopaedics, School of Medicine, University of Leeds, Leeds LS1 3EX, UK
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de Souza RA, Xavier M, da Silva FF, de Souza MT, Tosato MG, Martin AA, Castilho JCDM, Ribeiro W, Silveira L. Influence of creatine supplementation on bone quality in the ovariectomized rat model: an FT-Raman spectroscopy study. Lasers Med Sci 2011; 27:487-95. [PMID: 21837504 DOI: 10.1007/s10103-011-0976-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2011] [Accepted: 07/15/2011] [Indexed: 11/25/2022]
Abstract
The influence of creatine (Cr) supplementation on cortical and trabecular bone from ovariectomized rats was studied using FT-Raman spectroscopy. The intensity of organic-phase Raman bands was compared to mineral phase ones. Twenty-one female Wistar rats aged 3 months were divided into three groups (n = 7 per group): ovariectomized (OVX), ovariectomized treated with creatine (CRE) and sham-operated (SHAM) groups. Creatine supplementation (300 mg kg(-1) day(-1)) was provided for 8 weeks, starting 12 weeks after ovariectomy. FT-Raman spectroscopy was performed on the right medial femoral mid-shaft (cortical bone) and third lumbar vertebral body (trabecular bone). The integrated intensities of mineral phase (phosphate and carbonate bands at 959 and 1,071 cm(-1), respectively) and organic phase (amide I band at 1,665 cm(-1)) Raman bands were analyzed. The mineral-to-matrix (phosphate/amide I), carbonate-to-phosphate, and carbonate-to-amide I ratios were analyzed to assess bone quality. The phosphate content on trabecular bone was higher in the CRE group than the OVX group (p < 0.05). No significant changes in mineral or organic phases on cortical bone were observed. A radiographic assessment of bone density was encouraging as the same findings were showed by Raman intensity of phosphate from cortical (r(2) = 0.8037) and trabecular bones (r(2) = 0.915). Severe ovariectomy-induced bone loss was confirmed by FT-Raman spectroscopy. The results suggest that the chemical composition of trabecular bone tissue may be positively influenced by Cr supplementation after ovariectomy.
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Affiliation(s)
- Renato Aparecido de Souza
- Grupo de Estudos e Pesquisa em Ciências da Saúde, Instituto Federal de Educação, Ciência e Tecnologia do Sul de Minas Gerais, Muzambinho, MG, Brazil.
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da Silva FF, de Souza RA, Pacheco MTT, Ribeiro W, da Silva MASR, Miranda H, Salgado MAC, de Melo Castilho JC, Silveira L. Effects of different swimming exercise intensities on bone tissue composition in mice: a Raman spectroscopy study. Photomed Laser Surg 2010; 29:217-25. [PMID: 21182452 DOI: 10.1089/pho.2010.2784] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Raman spectroscopy was employed to evaluate the effect of different swimming intensities on femoral bone composition in an animal model. BACKGROUND DATA Intense swimming exercise may affect bone mineralization, and Raman technique has been shown to be effective in evaluating tissue composition (phosphate minerals and carbonate apatites - bands at 960 and 1170 cm(-1), as well as collagen matrix - amide I band at 1660 cm(-1)). MATERIALS AND METHODS Eighteen female Swiss Webster mice were separated into three groups (n = 6 per group) of sedentary (SED), and swimming with an intensity of 40% (PT-40) and 80% (PT-80) of the maximum load, with 6 weeks of training. Near-infrared Raman spectra (830 nm wavelength and 80 mW laser power) were obtained with a dispersive Raman spectrometer using a CCD camera and imaging spectrograph with 30-s integration time. Spectra were collected in the medial and lateral diaphysis of the femur and principal components analysis (PCA) was employed to extract features of the Raman bands of bone and to perform quantitative analysis. RESULTS PC1 vector resembles Raman spectra and carries information about apatite minerals and some contribution from organic matrix. A statistically significant difference was found in the PC1 scores (ANOVA, p < 0.05), indicating lower mineral concentrations in the femur in both the PT-40 and PT-80 groups compared to the SED group. These results corroborated with the radiographic assessment of bone density. CONCLUSION Raman technique associated with PCA statistics showed that intense swimming exercise may affect bone mineralization and remodeling in a mouse model of training.
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Affiliation(s)
- Fabiano Fernandes da Silva
- Grupo de Estudo e Pesquisa em Ciência da Saúde, Instituto Federal de Educação, Ciência e Tecnologia do Sul de Minas-Campus Muzambinho, Bairro Morro Preto, Muzambinho, MG, Brazil
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Matsumoto MA, De Oliveira A, Ribeiro Junior PD, Nary Filho H, Ribeiro DA. Short-term administration of non-selective and selective cox-2 nsaids do not interfere with bone repair in rats. J Mol Histol 2008; 39:381-7. [DOI: 10.1007/s10735-008-9176-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2008] [Accepted: 06/11/2008] [Indexed: 11/30/2022]
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