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SPECIALITY                                                                                                             My dental surgery patients



        AI helps predict treatment                                                                                             need pain relief that                        1
                                                                                                                               acts fast…and lasts…

        outcomes for patients with


        diseased dental implants                                                                                               …  I prescribe once-daily                      2,3

                                                                                                                                 ARCOXIA /EXINEF
                                                                                                                                                       ®
                                                                                                                                                                           ®
        The algorithm FARDEEP offers a personalized approach to identify patients
        who better respond to regenerative therapies.
                                                                                                                               ONCE-DAILY
              lthough dental implant-                                            bacterial burdens across all
                                                                                                                                                                 ®
                                                                                                                                                ®
              supported crowns offer                                             patients. Nonetheless, only the               ARCOXIA /EXINEF  90 mg OFFERS…
        Aaesthetic, functional and                                               patients with more immune cell
        natural-feeling tooth replacements,                                      subtypes for bacterial control can
        and the market is estimated to                                           suppress the recolonization of
        reach $6.8 billion by 2024, the                                          pathogenic bacteria and show
        emerging endemic of peri-implantitis                                     better regenerative outcomes.
        has severely compromised the long-                                                                                                                     …FAST ONSET
        term success of implant dentistry.                                       “Regenerative therapy for
                                                                                 peri-implantitis is expensive                                                      OF ACTION                1
        Roughly one-quarter of dental                                            and treatment outcomes are                                                                                                          28 min
        implant patients are threatened                                          unpredictable,” said first author
        by peri-implantitis, a destructive                                       Jeff Wang, a U-M clinical assistant
        inflammatory process that infects                                        professor and principal investigator
        the tissue and bone around dental    with peri-implantitis, who were     for the regenerative treatment of
        implants. It can lead to progressive   receiving reconstructive therapy.   peri-implantitis clinical trial. “It would
        bone loss, bleeding, pus and         They quantified the abundance       be very helpful if we could use the
        eventual loss of the dental implants   of harmful bacteria and certain   information to determine the best
        and associated crowns or dentures    infection fighting immune cells in   course of treatment, or maybe
        that they support. Replacement of a   each sample.                       we’d decide that the more sensible                                                                     ®                                              ®
        new dental implant at the previously                                     option would be to replace an old
        damaged site is often challenging    According to senior author and      implant with a new one, despite the
        because of poor bone quality and     assistant professor of dentistry Yu   challenge to rebuild the bone.”
        delayed healing.                     Leo Lei, D.D.S., Ph.D., patients
                                             who were at low risk for periodontal   According to Wang, in the future, it
        Unfortunately, there is currently no   disease showed more immune cells   may be possible to predict the risk
        reliable way to assess how patients   that were highly adept at controlling   of peri-implantitis before a dental      Indicated for the treatment of moderate to severe acute                      RECOMMENDED DOSE
        will respond to treatment of this    bacterial infections. Lei, who has   implant is placed. More human
        condition.                           an appointment at the University    clinical trials are required before           post-operative pain associated with dental surgery               2,3            90 mg ONCE DAILY
                                             of Michigan Health Rogel Cancer     FARDEEP is ready to be used
        To that end, a team led by the       Center, also added that the team    widely by clinicians.
        University of Michigan School of     was surprised that the types of cells                                             REFERENCES: 1. Daniels SE, Bandy DP, Christensen SE, et al., Evaluation of the Dose Range of Etoricoxib in an Acute Pain Setting Using the Postoperative Dental Pain Model. Clin J Pain. 2011;27(1).
        Dentistry developed a machine        associated with better outcomes     “However, this proof-of-concept               2. Approved ARCOXIA® package insert, March 2020.  3. Approved EXINEF® package insert, May 2020.
        learning algorithm — a form          for implant patients challenge      study offers a personalized                   INDICATIONS: ARCOXIA®/EXINEF® is indicated for: symptomatic relief of osteoarthritis (OA) and rheumatoid arthritis (RA); treatment of ankylosing spondylitis (AS); treatment of acute gouty arthritis; short term
                                                                                                                               relief of acute pain, treatment limited to a maximum period of 8 days; treatment of primary dysmenorrhoea; treatment of moderate to severe acute post-operative pain associated with dental surgery.
        of artificial intelligence — to      conventional thinking.              approach to identify the types                SELECTED SAFETY INFORMATION: CONTRAINDICATIONS: Known hypersensitivity to etoricoxib or to any of the excipients of ARCOXIA®/EXINEF®, patients who have developed signs of asthma, acute rhinitis, nasal polyps, angioedema or urticaria following the
        assess an individual patient’s                                           of patients that better respond               administration of aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs) including ARCOXIA®/EXINEF®. Active peptic ulceration or active gastrointestinal (GI) bleeding, severe hepatic dysfunction (Child-Pugh score greater than 9 or serum albumin less than
                                                                                                                               25 g/L), severe renal impairment (eCrCl less than 30 mL/min), uncontrolled hypertension, pregnancy and lactation, children and adolescents under 16 years of age, inflammatory bowel disease, congestive heart failure (NYHA II – IV), established ischaemic heart disease,
        risk of regenerative outcomes        “Much emphasis has been placed      to regenerative therapies,” said              peripheral arterial disease and/or cerebrovascular disease, perioperative analgesia in the setting of coronary artery bypass surgery (CABG), concomitant administration with ARCOXIA®/EXINEF® may lead to toxic blood concentrations of lithium and digoxin (approximate
                                                                                                                               increase of 33 % in digoxin C max in healthy volunteers). WARNINGS AND SPECIAL PRECAUTIONS: ARCOXIA®/EXINEF® may predispose patients to cardiovascular events, gastrointestinal events or cutaneous reactions which may be fatal. Long-term administration
        after surgical treatments of peri-   on the immune cell types that are   co-author William Giannobile, a               of NSAIDs such as ARCOXIA®/EXINEF®, has resulted in renal papillary necrosis and other renal injury. Selective COX-2 inhibitor class of medicines, such as ARCOXIA®/EXINEF®, are associated with an increased risk of arterial thrombotic events (especially myocardial
                                                                                                                               infarction (MI) and stroke). As the cardiovascular risks may increase with dose and duration of exposure, the shortest duration possible and the lowest effective daily dose should be used. Caution should be used when initiating treatment with ARCOXIA®/EXINEF® in patients
        implantitis.                         more adept at wound healing and     professor of oral medicine, infection         with dehydration. It is advisable to rehydrate patients prior to starting therapy with ARCOXIA®/EXINEF®. Caution should be exercised in patients with history of cardiac failure, left ventricular dysfunction or hypertension, and in patients with pre-existing oedema from any
                                                                                                                               other reason. ARCOXIA®/EXINEF® is not a substitute for aspirin for cardiovascular prophylaxis because of its lack of effect on platelets. Because ARCOXIA®/EXINEF® does not inhibit platelet aggregation, antiplatelet therapies should not be discontinued. Concomitant
                                             tissue repair,” he said. “However,   and immunity, and dean of the                administration of low-dose aspirin with ARCOXIA®/EXINEF® increases the rate of gastrointestinal adverse effects. Serious skin reactions, some of them fatal, including exfoliative dermatitis, Stevens-Johnson syndrome and toxic epidermal necrolysis have been reported in
        The algorithm is called FARDEEP,     here we show that immune cell       Harvard School of Dental Medicine,            association with the use of selective COX-2 inhibitors such as ARCOXIA®/EXINEF®. When using ARCOXIA®/EXINEF® in the elderly and in patients with renal, hepatic or cardiac dysfunction, medically appropriate supervision should be intensified. Upper gastrointestinal
                                                                                                                               complications: perforations, ulcers or bleedings (PUBs), some of them resulting in a fatal outcome, have occurred in patients treated with ARCOXIA®/EXINEF® Elevations of alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) have been reported in
        which stands for Fast and Robust     types that are central to microbial   who was previously at the U-M               approximately 1% of patients in clinical trials treated for up to 1 year with ARCOXIA®/EXINEF® 60 mg and 90 mg daily. Contains lactose. Patients with the rare hereditary conditions of galactose intolerance e.g. galactosaemia, Lapp lactase deficiency, glucose-galactose
                                                                                                                               malabsorption or fructose intolerance should not take ARCOXIA®/EXINEF®. SIDE EFFECTS: Very common (≥ 1/10) and common (≥ 1/100, < 1/10) side effects: Post-dental extraction alveolar osteitis (dry socket), oedema/fluid retention, dizziness, headache, palpitations,
        Deconvolution of Expression          control are strongly correlated with   School of Dentistry.                       hypertension, gastrointestinal disorders (e.g. abdominal pain, flatulence, heartburn), diarrhoea, dyspepsia, epigastric discomfort, nausea, ecchymosis, asthenia/fatigue, flu-like disease, increased ALT and AST.
        Profiles. In the study, researchers   superior clinical outcomes.”                                                     For full prescribing information refer to the package insert approved by the Medicines Regulatory Authority.
        used FARDEEP to analyze tissue                                           Source: University of Michigan                           MSD (Pty) Ltd (Reg. No. 1996/003791/07),                            Co-marketed by: Organon South Africa (Pty) Ltd
        samples from a group of patients     Surgical management can reduce      Health System                                            Private Bag 3, Halfway House 1685 I Tel: 011 655 3000  I  www.msd.co.za  Email: dpoc.zaf@organon.com
                                                                                                                               S3  ARCOXIA® – Reg. No’s: 30 mg – 44/3.1/0063, 60 mg – 37/3.1/0399, 90 mg – 37/3.1/0400, 120 mg – 37/3.1/0401. Each ARCOXIA tablet contains 30 mg, 60 mg, 90 mg or 120 mg of etoricoxib.
                                                                                                                               S3  EXINEF® – Reg. No’s: 30 mg – 44/3.1/0898, 60 mg – 44/3.1/0899, 90 mg – 44/3.1/0900, 120 mg – 44/3.1/0901. Each EXINEF tablet contains 30 mg, 60 mg, 90 mg or 120 mg of etoricoxib.
          4   DENTAL NEWS                                                                                                      Copyright © 2021 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA. All rights reserved.         ZA-CXB-110004 11/23
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