Nonsteroidal anti-inflammatory drugs in orthodontic tooth movement: Metalloproteinase activity and collagen synthesis by endothelial cells

Orthodontic treatment is based on the biologic principle that prolonged pre ssure on teeth results in remodeling of periodontal structures, allowing fo r tooth movement. Periodontal remodeling is a complex process regulated in part by prostaglandins and adversely affected by the use of nonsteroidal an ti-inflammatory drugs. We investigated the effects of indomethacin on colla genase activity and procollagen synthesis in rat endothelial cell cultures. Cyclooxygenase inhibition resulted in exacerbation of IL-1 beta-mediated c ollagenase B (MMP-9) production and activity, as well as attenuation of typ e IV procollagen synthesis levels by endothelial cells in vitro. Hence, the use of over-the-counter nonsteroidal anti-inflammatory drugs during tooth movement may result in aberrant remodeling of periodontal vasculature and o ther structures, ultimately affecting orthodontic treatment efficacy. Furth er studies are needed to establish novel pain relievers that do not interfe re with orthodontic processes.