Effects of NSAIDs/corticosteroids on PRP or PRF?

The goal of each surgeon is atraumacity (lack of swelling and post op discomfort/pain). However, all corticosteroid drugs rapidly suppress the release of inflammation factors by the granulocytes, thus blocking the hystamine/serotonine mediators. The lack of these factors reduces the vascularisation (since all new vessels need to "smell" these mediators so they will know where to grow to). Bottom line- the use of corticosteroids, reduces swelling but also slows down the healing (reduces the vascularisation of your possible graft sites, filled with PRP, or PRF). This might lead to non-integration of the graft. On the contrast- the use of NSAIDs (like B-piroxicam) takes more time to start working (1-2 days) , but blocks the synthesis of the enzymes which synthesize the infalmmation mediators (prostaglandines, tromboxane, etc.). The same enzymes (Prostaglandine E2, or PGe2) in the bone are responsible for the activation of the osteoclasts (which imminently induce initial post surgical periimplant bone resorption). So in short-both groups of drugs don`t go well with tissue engineering and implants. However I myself always prescribe (the lesser of two evils)-NSAID 12 hours prior implant placement and twice daily for the next 3-4 days for my patients. Stopped using Solu-medrol or similars for the reasons mentioned above. Hope this answered your question, be the "good doctor", causing "no swelling at all" to your implant patients, prescribe NSAIDs starting the night before surgery Hope this helps, Dr Dimitrov

What is your thoughts about naproxen? And diflunazeil?