{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:00:41Z","timestamp":1760234441378,"version":"build-2065373602"},"reference-count":43,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2021,5,4]],"date-time":"2021-05-04T00:00:00Z","timestamp":1620086400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: The aim of this study was to evaluate and compare the effects of two different anti-inflammatory drugs (ketoprofen and prednisone) combined with an antibiotic (amoxicillin + clavulanic acid) and periodontal surgery on dental and periodontal parameters in patients with severe chronic periodontitis. In addition, salivary stress expressed by cortisol levels was assessed. Materials and Methods: An interventional study was performed on 22 periodontal subjects and 19 clinical healthy controls. The patients were divided in four groups, depending on treatment planning, as follows: eight patients received prednisone and antibiotherapy, associated with surgical periodontal therapy; seven patients received ketoprofen and antibiotherapy, associated with surgical periodontal therapy (group II); seven patients received only prednisone. Periodontal healthy patients underwent routine scaling and polishing. Bleeding on probing (BOP), dental mobility and salivary cortisol (ng\/mL) were assessed before and after treatment. The means and standard deviations for the salivary cortisol levels (SCLs), dental and periodontal parameters were calculated for all groups using each patient as a unit of analysis. Results: Data analyses showed that the two different anti-inflammatory drugs associated with or without surgical therapy were efficient on inflammation periodontal parameters (BOP, dental mobility). Prednisone treatment alone was associated with a significant decrease of SCLs between pretreatment and post-treatment. Conclusions: In the present study, the effects of either of the anti-inflammatory drugs on inflammation evolution and salivary stress were comparable in patients undergoing antibiotherapy and surgical periodontal therapy.<\/jats:p>","DOI":"10.3390\/medicina57050447","type":"journal-article","created":{"date-parts":[[2021,5,5]],"date-time":"2021-05-05T22:51:42Z","timestamp":1620255102000},"page":"447","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Effects of Prednisone\/Ketoprofen Administration in Association with Amoxicillin Clavulanate Following Periodontal Surgical Therapy in Patients with Severe Chronic Periodontitis"],"prefix":"10.3390","volume":"57","author":[{"given":"Lidia","family":"Sfetcu","sequence":"first","affiliation":[{"name":"Department of Microbiology, Faculty of Dental Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020032 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2915-5124","authenticated-orcid":false,"given":"Andreea Cristiana","family":"Didilescu","sequence":"additional","affiliation":[{"name":"Department of Embryology, Faculty of Dental Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8737-0973","authenticated-orcid":false,"given":"Cristian","family":"Vl\u0103dan","sequence":"additional","affiliation":[{"name":"Faculty of Dental Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 010221 Bucharest, Romania"},{"name":"Department of Oral and Maxillofacial Surgery, \u201cDan Theodorescu\u201d University Hospital of Oral and Maxillofacial Surgery, 010221 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Octavian","family":"Dinc\u0103","sequence":"additional","affiliation":[{"name":"Faculty of Dental Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 010221 Bucharest, Romania"},{"name":"Department of Oral and Maxillofacial Surgery, \u201cDan Theodorescu\u201d University Hospital of Oral and Maxillofacial Surgery, 010221 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Miricescu","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Faculty of Dental Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriela","family":"B\u0103ncescu","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Faculty of Dental Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020032 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandru","family":"Bucur","sequence":"additional","affiliation":[{"name":"Faculty of Dental Medicine, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 010221 Bucharest, Romania"},{"name":"Department of Oral and Maxillofacial Surgery, \u201cDan Theodorescu\u201d University Hospital of Oral and Maxillofacial Surgery, 010221 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura Carina","family":"Tribus","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Bucharest Emergency University Hospital, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020032 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,5,4]]},"reference":[{"key":"ref_1","first-page":"65","article-title":"Occupational stress, salivary cortisol, and periodontal disease: A clinical and laboratory study","volume":"7","author":"Atri","year":"2015","journal-title":"J. Int. Oral Health"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1111\/j.1600-0757.2012.00454.x","article-title":"Systemic medication and the inflammatory cascade","volume":"64","author":"Alani","year":"2014","journal-title":"Periodontol 2000"},{"key":"ref_3","first-page":"411","article-title":"Drugs, medications and periodontal disease","volume":"217","author":"Heasman","year":"2014","journal-title":"Nat. Publ. Gr."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1111\/j.1600-0765.1981.tb00953.x","article-title":"The periodontal status of subjects receiving non-steroidal anti-inflammatory drugs","volume":"16","author":"Waite","year":"1981","journal-title":"J. Periodontal Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1902\/jop.1978.49.6.307","article-title":"A clinical study of gingival inflammation in renal transplant recipients taking immunosuppressive drugs","volume":"49","author":"Kardachi","year":"1978","journal-title":"J. Periodontol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1902\/jop.1982.53.4.245","article-title":"The effects of immunosuppressive drugs on periodontal inflammation in human renal allograft patients","volume":"53","author":"Been","year":"1982","journal-title":"J. Periodontol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1111\/j.1600-051X.1991.tb02300.x","article-title":"Periodontal conditions in Europe","volume":"18","author":"Pilot","year":"1991","journal-title":"J. Clin. Periodontol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1379","DOI":"10.1902\/jop.2010.100044","article-title":"Sex differences in destructive periodontal disease: A systematic review","volume":"81","author":"Shiau","year":"2010","journal-title":"J. Periodontol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"S44","DOI":"10.1111\/j.1834-7819.2009.01142.x","article-title":"Smoking and periodontal disease","volume":"54","author":"Zee","year":"2009","journal-title":"Aust. Dent. J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1111\/j.1741-2358.2010.00448.x","article-title":"Oral hygiene and periodontal disease in Victorian nursing homes","volume":"29","author":"Hopcraft","year":"2012","journal-title":"Gerodontology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1902\/jop.2003.74.5.610","article-title":"Obesity and Periodontal Disease in Young, Middle-Aged, and Older Adults","volume":"74","author":"Bissada","year":"2003","journal-title":"J. Periodontol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1111\/j.1600-0765.2007.01063.x","article-title":"Relationship between body mass index and periodontitis in young Japanese adults","volume":"43","author":"Ekuni","year":"2008","journal-title":"J. Periodontal Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1111\/j.1600-051X.2005.00742.x","article-title":"The relationship between selected measures of periodontal status and demographic and behavioural risk factors","volume":"32","author":"Dye","year":"2005","journal-title":"J. Clin. Periodontol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1111\/j.1600-0757.2011.00416.x","article-title":"Socioeconomic position indicators and periodontitis: Examining the evidence","volume":"58","author":"Borrell","year":"2012","journal-title":"Periodontol 2000"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"S299","DOI":"10.4103\/ccd.ccd_289_18","article-title":"Association of stress, salivary cortisol, and chronic periodontitis: A clinico-biochemical study","volume":"9","author":"Obulareddy","year":"2018","journal-title":"Contemp. Clin. Dent."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"421","DOI":"10.4103\/1735-3327.270786","article-title":"Comparative evaluation of the cortisol level of unstimulated saliva in patients with and without chronic periodontitis","volume":"16","author":"Naghsh","year":"2019","journal-title":"Dent. Res. J."},{"key":"ref_17","first-page":"47","article-title":"Periodontics salivary and serum cortisol in patients with periodontal disease and lichen planus","volume":"1","author":"Miricescu","year":"2015","journal-title":"Stoma. Edu. J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"7954291","DOI":"10.1155\/2019\/7954291","article-title":"Comparison of early effectiveness of three different intervention methods in patients with chronic orofacial pain: A randomized, controlled clinical trial","volume":"2019","author":"Dalewski","year":"2019","journal-title":"Pain Res. Manag."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1111\/j.1600-0528.1984.tb01408.x","article-title":"Measurement of dental caries experience--modification of the DMFT index","volume":"12","author":"Anaise","year":"1984","journal-title":"Community Dent. Oral Epidemiol."},{"key":"ref_20","unstructured":"Carranza, F. (2015). Carranza\u2019s Clinical Periodontology, Elsevier Saunders. [12th ed.]."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1111\/j.1600-051X.1980.tb02156.x","article-title":"Tooth mobility and periodontal therapy","volume":"7","author":"Fleszar","year":"1980","journal-title":"J. Clin. Periodontol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1387","DOI":"10.1902\/jop.2007.060264","article-title":"Case definitions for use in population-based surveillance of periodontitis","volume":"78","author":"Page","year":"2007","journal-title":"J. Periodontol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1111\/j.1749-6632.1993.tb18343.x","article-title":"Methods for collecting saliva","volume":"694","author":"Navazesh","year":"1993","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1590\/S1806-83242008000100013","article-title":"Periodontal condition in patients with rheumatoid arthritis","volume":"22","author":"Ishi","year":"2008","journal-title":"Braz. Oral Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"255","DOI":"10.4103\/0972-124X.85670","article-title":"The effect of ketoprofen in chronic periodontitis: A clinical double-blind study","volume":"15","author":"Srinivas","year":"2011","journal-title":"J. Indian Soc. Periodontol."},{"key":"ref_26","first-page":"215","article-title":"The use of topical subgingival gels of non-steroidal anti-inflammatory drugs (NSAIDs) as an adjunct to non-surgical management of chronic periodontitis","volume":"22","author":"Funosas","year":"2009","journal-title":"Acta Odontol. Latinoam"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1111\/j.1600-0765.1992.tb01829.x","article-title":"Flurbiprofen effect on gingival crevicular fluid prostaglandin and thromboxane levels in humans","volume":"27","author":"Abramson","year":"1992","journal-title":"J. Periodontal Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1307","DOI":"10.1902\/jop.1996.67.12.1307","article-title":"Effect of a non-steroidal anti-inflammatory drug on tissue levels of immunoreactive prostaglandin E2, immunoreactive leukotriene, and pain after periodontal surgery","volume":"67","author":"Roszkowski","year":"1996","journal-title":"J. Periodontol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1902\/jop.1998.69.7.777","article-title":"Effects of ketorolac tromethamine mouthrinse (0.1%) on crevicular fluid prostaglandin E2 concentrations in untreated chronic periodontitis","volume":"69","author":"Preshaw","year":"1998","journal-title":"J Periodontol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"658","DOI":"10.4103\/njcp.njcp_221_17","article-title":"Effects of a cyclic NSAID regimen on levels of gingival crevicular fluid prostaglandin E2and Interleukin-1\u03b2: A 6-month randomized controlled clinical trial","volume":"21","author":"Oduncuoglu","year":"2018","journal-title":"Niger. J. Clin. Pract."},{"key":"ref_31","first-page":"407","article-title":"Tooth mobility after periodontal surgery","volume":"59","author":"Feller","year":"2004","journal-title":"SADJ"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1016\/S1286-4579(00)01272-7","article-title":"The role of immune responses in bone loss during periodontal disease","volume":"2","author":"Baker","year":"2000","journal-title":"Microbes Infect."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1111\/j.1600-051X.1983.tb02201.x","article-title":"Non-steroidal anti-inflammatory drugs in the reduction of human alveolar bone loss","volume":"10","author":"Feldman","year":"1983","journal-title":"J. Clin. Periodontol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1902\/jop.1995.66.5.329","article-title":"A comparison of topical ketorolac, systemic flurbiprofen, and placebo for the inhibition of bone loss in adult periodontitis","volume":"66","author":"Jeffcoat","year":"1995","journal-title":"J. Periodontol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1902\/jop.2002.73.9.1030","article-title":"Effect of Selective Cyclooxygenase-2 Inhibition on the Development of Ligature-Induced Periodontitis in Rats","volume":"73","author":"Holzhausen","year":"2002","journal-title":"J. Periodontol."},{"key":"ref_36","first-page":"666","article-title":"Clinical and radiological assessment of effects of long-term corticosteroid therapy on oral health","volume":"10","author":"Beeraka","year":"2013","journal-title":"Dent. Res. J."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1177\/154405910608500408","article-title":"Stress, cortisol, and periodontitis in a population aged 50 years and over","volume":"85","author":"Hilgert","year":"2006","journal-title":"J. Dent. Res."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1038\/sj.bdj.4809882","article-title":"Oral diseases and socio-economic status (SES)","volume":"194","author":"Hobdell","year":"2003","journal-title":"Br. Dent. J."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1038\/sj.bdj.4811857","article-title":"Steroid cover for dental patients on long-term steroid medication: Proposed clinical guidelines based upon a critical review of the literature","volume":"197","author":"Gibson","year":"2004","journal-title":"Br. Dent. J."},{"key":"ref_40","first-page":"49","article-title":"Salivary cortisol-marker of stress response to different dental treatment","volume":"44","author":"Greabu","year":"2006","journal-title":"Rom. J. Intern. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1016\/S1079-2104(05)80123-4","article-title":"Salivary cortisol response to dental treatment of varying stress","volume":"79","author":"Miller","year":"1995","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endodontology"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Dubar, M., Clerc-Urm\u00e8s, I., Baumann, C., Cl\u00e9ment, C., Alauzet, C., and Bisson, C. (2020). Relations of Psychosocial Factors and Cortisol with Periodontal and Bacterial Parameters: A Prospective Clinical Study in 30 Patients with Periodontitis Before and After Non-Surgical Treatment. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17207651"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1469","DOI":"10.1210\/jc.2015-3694","article-title":"Salivary cortisone reflects cortisol exposure under physiological conditions and after hydrocortisone","volume":"101","author":"Debono","year":"2016","journal-title":"J. Clin. Endocrinol. Metab."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/57\/5\/447\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:57:09Z","timestamp":1760162229000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/57\/5\/447"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,4]]},"references-count":43,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,5]]}},"alternative-id":["medicina57050447"],"URL":"https:\/\/doi.org\/10.3390\/medicina57050447","relation":{},"ISSN":["1648-9144"],"issn-type":[{"type":"electronic","value":"1648-9144"}],"subject":[],"published":{"date-parts":[[2021,5,4]]}}}