T. Howard Howell

Nonsteroidal Antiinflammatory Drugs as Inhibitors of Periodontal Disease Progression

Recent interest in the control and modulation of periodontal disease has focused on the potential benefits of blocking the host response mechanisms involved in the progression of the disease. In addition to recent advances in the identification and control of etiologic bacteria, investigators have indicated promising results using nonsteroidal antiinflammatory drugs (NSAIDs) as inhibitors of the inflammatory destruction in periodontal disease. This article examines research efforts over the last 20 years describing the role of prostaglandins in periodontal disease and the effect of NSAIDs on the progression of gingival inflammation and alveolar bone loss.

New technologies for the diagnosis of periodontal disease

Historically the initial onset of periodontal disease in an individual was considered slow but continuously progressive over time. It was inferred that an individual would experience progressive destruction of the attachment structures until edentulous. However, several studies in the early 1970s contested the traditional concept of continuous disease progression. These studies suggested that periodontal disease progressed by recurrent acute episodes. In specific individuals, the loss of attachment was faster than the concept of slowly progressing disease. There were also sites in patients that progressed slower (or not at all) than anticipated on the basis of radiographic and clinical history of previous disease progression. These findings clearly indicated the need to explore the nature of periodontal disease progression and to institute a major effort into innovative methods to diagnose periodontal diseases. Dentists and researchers could more effectively prevent and treat periodontal disease and relate pertinent research findings to specific disease initiation and progression.