RESUMO
Pulpitis, external root resorption, and pain may be experienced during orthodontic movement. The use of nonsteroidal anti-inflammatory drugs (NSAIDs) has been suggested to control these changes. The purpose of this study was to observe pulp-dentinal reactions, root resorption, tooth pain, and tooth movement after the application of a 4-ounce intrusive orthodontic force to human maxillary first premolars in patients given the NSAID nabumetone. Thirty-four maxillary first premolars were evaluated. A placebo was prescribed to 17 patients after an intrusive force was activated and reactivated for an 8-week period on the right side. The same procedure was repeated on the left side after patients were given nabumetone. Pulp-dentinal reactions and external root resorption were evaluated by histology. Pain and movement were also evaluated. Nabumetone was found to be useful in reducing pulpitis, external root resorption, and pain caused by intrusive orthodontic movement, without altering tooth movement in response to the application of orthodontic force.
Assuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Butanonas/uso terapêutico , Técnicas de Movimentação Dentária/efeitos adversos , Adolescente , Adulto , Dente Pré-Molar , Criança , Análise do Estresse Dentário , Método Duplo-Cego , Dor Facial/etiologia , Dor Facial/prevenção & controle , Feminino , Humanos , Masculino , Nabumetona , Pulpite/etiologia , Pulpite/prevenção & controle , Reabsorção da Raiz/etiologia , Reabsorção da Raiz/prevenção & controleRESUMO
OBJECTIVE AND DESIGN: This study examined whether serum levels of cytokines, IL-1beta and TNFalpha were elevated in rats with adjuvant arthritis in relation to disease progression, and if so, to verify the treatment effects of nabumetone (20 mg/kg, p. o.), a COX-2 inhibitor and pentoxifylline (20 mg/kg, p.o.), a type-4 phosphodiesterase (PDE4) inhibitor, alone or in combination. MATERIALS AND METHODS: Female Wistar rats were used. Freund's complete adjuvant (FCA) was used to induce arthritis. The increment in contralateral hind paw volume (the secondary lesion) was determined by plethysmometry and the serum cytokines were measured by ELISA. RESULTS: In control rats, the serum IL-1beta and TNFalpha levels were greatly elevated on the very first day i.e. 5 h after FCA, and thereupon a progressive decrease in IL-1beta but not TNFalpha was observed until day 30. The secondary arthritic lesion began to increase on day 14 (125+/-26 microl), and attained its peak (330+/-79 microl) on day 21 post-adjuvant injection. The peak arthritic lesion was significantly (p<0.001) less in rats that received nabumetone and pentoxifylline, alone or in combination (20+/-8, 41+/-15 and 65+/-10 microL, respectively). When serum cytokine levels were analysed on day 20 postadjuvant injection, rats treated with pentoxifylline or in association with nabumetone, but not nabumetone alone showed significantly lowered levels of serum TNFalpha. Unlike TNFalpha, serum IL-1beta did not vary significantly. CONCLUSIONS: The drugs nabumetone and pentoxifylline although appearing to produce differential effects on serum cytokine levels, seem to be equally efficacious in attentuating the progression of FCA-induced arthritis. Serum cytokine levels may not accurately reflect the treatment efficacy.
Assuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Artrite Experimental/tratamento farmacológico , Butanonas/uso terapêutico , Interleucina-1/sangue , Pentoxifilina/uso terapêutico , Fator de Necrose Tumoral alfa/análise , Animais , Artrite Experimental/sangue , Artrite Experimental/patologia , Ciclo-Oxigenase 2 , Inibidores de Ciclo-Oxigenase 2 , Inibidores de Ciclo-Oxigenase/uso terapêutico , Feminino , Isoenzimas/antagonistas & inibidores , Isoenzimas/farmacologia , Nabumetona , Inibidores de Fosfodiesterase/uso terapêutico , Prostaglandina-Endoperóxido Sintases/farmacologia , Ratos , Ratos Wistar , Membrana Sinovial/patologiaRESUMO
We assessed the effects of nabumetone, sulindac, and placebo on renal function and renal excretion of vasodilatory prostaglandins in older female patients (age >50 years) with osteoarthritis and normal renal function. Using a prospective, crossover design, we compared the effects of nabumetone 2000 mg/d and sulindac 400 mg/d with placebo on glomerular filtration rate (GFR), renal plasma flow (RPF), and urinary excretion of prostaglandin E2 and 6-keto-prostaglandin F1alpha in 12 patients. Urinary excretion of vasodilatory prostaglandins was not decreased after 14 days of treatment with either nabumetone or sulindac. Likewise, treatment with nabumetone or sulindac did not significantly alter renal function compared with placebo. There were no differences in mean changes in GFR or RPF from baseline after treatment with nabumetone or sulindac compared with placebo. The mean (+/- SD) changes in GFR from baseline were 0%+/-8% in patients receiving nabumetone, -8%+/-15% in patients receiving sulindac, and -7%+/-15% in patients receiving placebo. The results of this study demonstrate that treatment with nabumetone or sulindac caused no deterioration in renal function in older female patients with osteoarthritis and normal renal function.