Evidence map›Paper›PMID 42175665›Full record

ArticleJournal of clinical periodontology2026

Nonsteroidal Anti-Inflammatory Drugs and the Risk of Periodontitis Among Adults With Osteoarthritis: A Target Trial Emulation.

Ignacio Leiva-Escobar, Aiswarya Puzhakkara Chennas, Zoheir Alayash, Stefan Lars Reckelkamm, Birte Holtfreter, Thomas Kocher, Sebastian-Edgar Baumeister, Michael Nolde

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In one paragraph

Article in Journal of clinical periodontology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Ignacio Leiva-EscobarInstitute of Health Services Research in Dentistry, University of Münster, Münster, Germany.ORCID https://orcid.org/0009-0008-9788-0118
Aiswarya Puzhakkara ChennasInstitute of Health Services Research in Dentistry, University of Münster, Münster, Germany.
Zoheir AlayashInstitute of Health Services Research in Dentistry, University of Münster, Münster, Germany.ORCID https://orcid.org/0000-0002-6850-5668
Stefan Lars ReckelkammInstitute of Health Services Research in Dentistry, University of Münster, Münster, Germany.ORCID https://orcid.org/0000-0002-5273-7288
Birte HoltfreterDepartment of Restorative Dentistry, Periodontology and Endodontology, University Medicine Greifswald, Greifswald, Germany.ORCID https://orcid.org/0000-0002-6541-3127
Thomas KocherDepartment of Restorative Dentistry, Periodontology and Endodontology, University Medicine Greifswald, Greifswald, Germany.ORCID https://orcid.org/0000-0001-9605-2822
Sebastian-Edgar BaumeisterInstitute of Health Services Research in Dentistry, University of Münster, Münster, Germany.ORCID https://orcid.org/0000-0002-9391-6602
Michael NoldeInstitute of Health Services Research in Dentistry, University of Münster, Münster, Germany.ORCID https://orcid.org/0000-0001-6893-7367

Funding

Deutsche Forschungsgemeinschaft 552087827
6 · The paper itself

Abstract

backgroundNonsteroidal anti-inflammatory drugs (NSAIDs) may mitigate periodontal tissue breakdown through cyclooxygenase (COX) inhibition; however, their long-term effects on the risk of periodontitis remain unclear.

methodsWe emulated target trials using US electronic health records (1995-2019) to compare the 5-year risk of incident periodontitis among adults with osteoarthritis-initiating NSAIDs versus acetaminophen. Eligible individuals had osteoarthritis, no prior periodontitis and no recent use of either medication. We estimated the risk of periodontitis using a pooled logistic regression model, adjusting for confounding via inverse probability weighting. Additionally, we conducted a subgroup analysis by NSAID COX selectivity, along with a negative control outcome analysis examining dental caries.

resultsThe 5-year risk difference (NSAIDs - acetaminophen) was 0.13% (95% CI: -0.32%, 0.58%). Similar findings were observed across subgroups compared with acetaminophen: non-selective NSAIDs, 0.11% (95% CI: -0.36%, 0.59%); preferential COX-2 NSAIDs, 0.10% (95% CI: -0.71%, 0.92%). The 5-year risk difference for dental caries was -0.27% (95% CI: -1.01%, 0.50%).

conclusionWe found no evidence that initiating NSAIDs, compared with acetaminophen, influenced the 5-year risk of periodontitis, and no differences by COX selectivity. Our findings align with inconclusive evidence from smaller studies on NSAIDs as adjuncts in periodontitis treatment.

Indexed as

Anti-Inflammatory Agents, Non-SteroidalOsteoarthritisPeriodontitisAcetaminophenAgedFemaleHumansMaleMiddle AgedRisk FactorsAcetaminophenAnti-Inflammatory Agents, Non-Steroidalanti‐inflammatory agentscausalitynonsteroidalobservational studies as topicperiodontitistherapeutic use

Identifiers

PMID42175665
PMCPMC13371416

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.