A COMPARISON OF TOPICAL KETOROLAC, SYSTEMIC FLURBIPROFEN, AND PLACEBOFOR THE INHIBITION OF BONE LOSS IN ADULT PERIODONTITIS

SYSTEMIC NON-STEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDs) have been show n to reduce alveolar bone loss in periodontitis. This study assesses t he efficacy of a topical NSAID rinse, containing ketorolac tromethamin e as the active agent. Adult periodontitis patients (n = 55) were stud ied in this 6-month randomized, double blind, parallel, placebo and po sitive-controlled study. Each patient had a least 3 sites at high risk for bone loss as assessed by low dose bone scan. Groups, balanced for gender, were assigned to one of three regimens: bid ketorolac rinse ( 0.1%) with placebo capsule; 50 mg bid flurbiprofen caps;le (positive c ontrol) with placebo rinse; or bid placebo rinse and capsule. Prophyla xes were provided every 3 months. Monthly examinations assessed safety , gingival condition, and gingival crevicular fluid PGE(2). Standardiz ed radiographs were taken at baseline and at 3 and 6 months for digita l subtraction radiography. A significant loss in bone height was obser ved during the study period in the placebo group (-0.63+/-0.11; P <0.0 01), but not in the flurbiprofen (-0.10+/-0.12; P = 0.40) or ketorolac rinse (+0.20+/-0.11 mm; P = 0.07) groups. Nested ANOVA revealed that ketorolac and flurbiprofen groups had less bone loss (P <0.01) and red uced gingival crevicular fluid PGE(2) levels (P <0.03) compared to pla cebo. ANOVA suggests (P = 0.06) that ketorolac rinse preserved more al veolar bone than systemic flurbiprofen at the dose regimens utilized. These data indicate that ketorolac rinse may be beneficial in the trea tment of adult periodontitis.