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Table 8 In vivo studies using animalĀ models that investigated the effect of NSAIDs on osseointegration

From: The effect of non-steroidal anti-inflammatory drugs on the osteogenic activity in osseointegration: a systematic review

Study (year)

Sample (size)

Treatment group (size)

Methodology

Parameter

Outcome

Cai et al. (2015) [22]

New Zealand white rabbits (nā€‰=ā€‰18).

Implant inserted into calvaria (nā€‰=ā€‰18).

Control (nā€‰=ā€‰6)

Diclofenac (nā€‰=ā€‰6)

Parecoxib (nā€‰=ā€‰6)

Treatments were administered for 7Ā days:

Diclofenac, 2Ā mg/kg/day orally

Parecoxib, 1.5Ā mg/kg/day subcutaneous injection

Parameters observed at week 4 and 12 after implantation:

Micro-CT: bone volume ratio, mean trabecular thickness, and mean trabecular separation.

Histomorphometric: bone-to-implant contact.

No statistically significant differences between the three separate groups, nor between the different time points.

Chikazu et al. (2007) [30]

9-week old male mice (nā€‰=ā€‰72).

Implant inserted in femur (nā€‰=ā€‰72).

Mice with the original C57BL6/129S7 hybrid background were generated and maintained: Wild-type (nā€‰=ā€‰36)

COX-2-knockout (nā€‰=ā€‰36)

No drug was administered

mRNA levels were observed at days 0, 1, 2, 4, 7, and 56 after implant insertion: expression of COX-2 and osteocalcin mRNA.

Histomorphometric analysis at weeks 4 and 8: bone-to-implant contact.

Expression of COX-2 and osteocalcin mRNA was induced in bone surrounding implants in wild-type mice, but not in knockout mice.

Bone-to-implant contact was minimal in knockout mice.

Goodman et al. (2002) [29]

New Zealand white rabbits (nā€‰=ā€‰8).

Titanium bone harvest chamber inserted in tibia (nā€‰=ā€‰8).

Control

Naproxen

Rofecoxib

Treatments administered:

Control: weeks 0ā€“4 and 9ā€“12.

Naproxen, 110Ā mg/kg: weeks 5ā€“8 orally.

Rofecoxib, 12.5Ā mg/kg: week 13ā€“16 orally.

Immunohistochemistry observed: total tissue area, total bone area, ratio of bone area, and total number of osteoblasts and osteoclast-like cells per section area

Naproxen and rofecoxib decreased bone ingrowth significantly.

Rofecoxib decreased the area of osteoblasts per area compared with controls, and naproxen sodium did not reach statistical significance.

Goodman et al. (2005) [26]

New Zealand white rabbits (nā€‰=Ā 8).

Titanium bone harvest chamber implanted bilaterally in tibia (nā€‰=ā€‰16).

Control

Rofecoxib

Treatments were administered for 6Ā weeks each: control-no drug; rofecoxib (12.5Ā mg/day) for the first 2Ā weeks of a 6-week trial, or the last 2Ā weeks or given continuously for all 6Ā weeks washout periods

Immunohistochemistry observed: total tissue area, total bone area, ratio of bone area, and the total number of osteoblasts and osteoclast-like cells per section area.

Rofecoxib given continuously for 6Ā weeks had less bone ingrowth, osteoclast-like cells and osteoblasts per area compared to the control treatment.

Rofecoxib given for 2 of a 6-weeks cycle did not interfere with the parameters.

Pablos et al. (2008) [31]

Male Sprague-Dawley rats, 3-month-old, weighing 250-300Ā g (nā€‰=ā€‰30).

Implant inserted in tibia (nā€‰=ā€‰30).

Control (nā€‰=ā€‰10)

Diclofenac (nā€‰=ā€‰10)

Meloxicam (nā€‰=ā€‰10)

Diclofenac, 1.07Ā mg/kg b.i.d. for 5Ā days.

Meloxicam, 0.2Ā mg/kg daily for 5Ā days.

Histomorphometric analysis at 28Ā days after implant insertion: bone-to-implant contact, cortical bone area, and trabecular bone area within the implant threads

The bone-to-implant contact was lower in diclofenac compared with the meloxicam and control.

The trabecular bone area was greater in diclofenac compared with meloxicam and control.

Ribeiro et al. (2006) [27]

Male Wistar rats, aged 10Ā weeks (nā€‰=ā€‰31).

Implant inserted in tibia (nā€‰=Ā 31).

Control (nā€‰=ā€‰14)

Meloxicam (nā€‰=ā€‰17)

Daily subcutaneous injections for 60Ā days: control, 1Ā mL/kg of saline Meloxicam, 3Ā mg/kg

Histomorphometric analysis at 60Ā days after implant insertion: bone-to-implant contact, bone area, and bone density in the cortical and cancellous bone areas

Meloxicam reduced bone-to-implant contact, bone area, and bone density in both the cortical and cancellous bone areas.

Ribeiro et al. (2009) [28]

Male Wistar rats, aged 10Ā weeks (nā€‰=ā€‰30).

Implant inserted in tibia (nā€‰=ā€‰30).

Control (nā€‰=ā€‰14)

Meloxicam (nā€‰=ā€‰16)

Daily subcutaneous injections for 60Ā days: control, 1Ā mL/kg of saline Meloxicam, 3Ā mg/kg

Histomorphometric analysis at 60Ā days after implant insertion: bone-to-implant contact, bone area, and bone density in the cortical and cancellous bone areas

Blasting implant surface with aluminium oxide can increase bone-to-implant contact; however, it does not reverse the negative effects caused by a selective COX-2 inhibitor on bone healing around implants.

Salduz et al. (2017) [32]

New Zealand white rabbits, skeletally mature weighing 3.5ā€“4Ā kg (nā€‰=ā€‰40).

Titanium rods implanted bilaterally in femur (nā€‰=ā€‰80).

Control

Diclofenac

Celecoxib

Treatments were administered for 8Ā weeks: control, regular food Diclofenac, 5Ā mg/kg/day intramuscularly Celecoxib, 3Ā mg/kg/day orally

Biomechanical and histomorphometric analysis at 8Ā weeks after implant insertion: interface failure load, bone quality, bone implant interface, host reaction, total bone area, and bone-to-implant contact rate

No significant difference in the biomechanical and histological results between the groups.