Journal Article

Meloxicam medication reduces orthodontically induced dental root resorption and tooth movement velocity: a combined in vivo and in vitro study of dental-periodontal cells and tissue

Proff, Peter, Fanghänel, Jochen, Kirschneck, Christian, Meier, Matthias, Bauer, Kathrin

2017

Overview

Non-steroidal anti-inflammatory drugs (NSAID) are used to alleviate pain sensations during orthodontic therapy but are also assumed to interfere with associated pseudo-inflammatory reactions. In particular, the effects of partially selective COX-2 inhibition over the constitutively expressed COX-1 (11:1) on periodontal cells and tissue, as induced by the NSAID meloxicam, remain unclear. We investigate possible adverse side-effects and potentially useful beneficial effects during orthodontic therapy and examine underlying cellular and tissue reactions. We randomly assigned 63 male Fischer344 rats to three consecutive experiments of 21 animals each (cone-beam computed tomography; histology/serology; reverse-transcription quantitative real-time polymerase chain reaction) in three experimental groups ( n  = 7; control; orthodontic tooth movement [OTM] of the first/second upper left molars [NiTi coil spring, 0.25 N]; OTM with a daily oral meloxicam dose of 3 mg/kg). In vitro, we stimulated human periodontal ligament fibroblasts (hPDL) with orthodontic pressure (2 g/cm 2 ) with/without meloxicam (10 μM). In vivo, meloxicam significantly reduced serum C-reactive protein concentration, tooth movement velocity, orthodontically induced dentine root resorption (OIRR), osteoclast activity and the relative expression of inflammatory/osteoclast marker genes within the dental-periodontal tissue, while presenting good gastric tolerance. In vitro, we observed a corresponding significant decrease of prostaglandin E 2 /interleukin-6/RANKL(−OPG) expression and of hPDL-mediated osteoclastogenesis. By inhibiting prostaglandin synthesis, meloxicam seems to downregulate hPDL-mediated inflammation, RANKL-induced osteoclastogenesis and, consequently, tooth movement velocity by about 50%, thus limiting its suitability for analgesia during orthodontic therapy. However, its protective effects regarding OIRR and good tolerance profile suggest future prophylactic application, which merits its further investigation.

• Publisher: Springer Berlin Heidelberg,Springer,Springer Nature B.V
• Subject: Adolescent / adverse effects / analgesia / Animal experimentation / Animals / Biomarkers - metabolism / Biomedical and Life Sciences / Biomedicine / blood serum / C-reactive protein / C-Reactive Protein - metabolism / Cells, Cultured / Complications and side effects / computed tomography / COX-2 inhibitors / drug therapy / Evidence-based medicine / Female / fibroblasts / gene expression / Gene Expression Regulation - drug effects / genetic markers / histology / Human Genetics / Humans / in vitro studies / inflammation / Inflammation - genetics / Inflammation - pathology / Interleukin-6 - genetics / Interleukin-6 - metabolism / Ligaments / Male / males / Meloxicam / Molecular Medicine / Movement / nonsteroidal anti-inflammatory agents / Nonsteroidal anti-inflammatory drugs / Orthodontics / osteoclasts / Osteoclasts - drug effects / Osteoclasts - pathology / Osteogenesis - drug effects / Osteogenesis - genetics / Osteoprotegerin - genetics / Osteoprotegerin - metabolism / pain / Periodontal Ligament - drug effects / Periodontal Ligament - pathology / prostaglandins / protective effect / Proteomics / quantitative polymerase chain reaction / RANK Ligand - genetics / RANK Ligand - metabolism / rats / Rats, Inbred F344 / Regular Article / Reproducibility of Results / resorption / reverse transcription / Rodents / Root Resorption - drug therapy / serology / Steroidal anti-inflammatory agents / Stomach - drug effects / Teeth / Thiazines - pharmacology / Thiazines - therapeutic use / Thiazoles - pharmacology / Thiazoles - therapeutic use / Tooth Movement Techniques / Tooth Root - drug effects / Tooth Root - pathology / Young Adult