DOI QR코드

DOI QR Code

Evaluation of the efficacy of salmon calcitonin nasal spray on bone healing following surgical removal of impacted third molar: a randomized controlled study

  • 투고 : 2025.11.03
  • 심사 : 2026.03.09
  • 발행 : 2026.04.30

초록

Objectives: To assess the efficacy of salmon calcitonin spray on postoperative pain, serum calcitonin levels, and bone healing after surgical removal of impacted mandibular third molar. Materials and Methods: This prospective study included 100 patients who required surgical removal of impacted mandibular third molars under local anesthesia. Group I included 50 patients who received intranasal serum calcitonin spray, and Group II included 50 patients who did not receive serum calcitonin spray. The postoperative pain was evaluated on the 1st, 3rd and 7th days. The serum osteocalcin levels were assessed at 1 month, and bone density was evaluated at the 3rd month postoperatively. Results: The severity of pain was less in Group I on days 3, and 7 postoperatively compared to Group II (P<0.05). The postoperative serum calcitonin level was higher in Group I compared to Group II (P<0.05), and the bone density was greater in Group I when compared to Group II evaluated at the 3rd month postoperatively (P<0.05). Conclusion: The results of our study delineate that Group I patients had better efficacy in controlling pain and improved bone healing with calcitonin nasal spray when compared to Group II patients.

키워드

참고문헌

  1. Yilmaz BE, Omezli MM, Torul D. Is it possible to predict the post-operative sequelae following third molar surgery using hematological biomarkers? J Oral Maxillofac Surg Med Pathol 2026;38:29-35. https://doi.org/10.1016/j.ajoms.2025.06.014
  2. Lapić I, Padoan A, Bozzato D, Plebani M. Erythrocyte sedimentation rate and C-reactive protein in acute inflammation. Am J Clin Pathol 2020;153:14-29. https://doi.org/10.1093/ajcp/aqz142
  3. Mirhadi S, Ashwood N, Karagkevrekis B. Factors influencing fracture healing. Trauma 2013;15:140-55. https://doi.org/10.1177/1460408613486571
  4. Jiao H, Xiao E, Graves DT. Diabetes and its effect on bone and fracture healing. Curr Osteoporos Rep 2015;13:327-35. https://doi.org/10.1007/s11914-015-0286-8
  5. Chen Y, Guo Q, Pan X, Qin L, Zhang P. Smoking and impaired bone healing: will activation of cholinergic anti-inflammatory pathway be the bridge? Int Orthop 2011;35:1267-70. https://doi.org/10.1007/s00264-011-1243-5
  6. Askew A, Chakkalakal D, Fang X, McGuire M. Delayed fracture healing in alcohol abusers—a preliminary retrospective study. Open Bone J 2011;3:1-5. https://doi.org/10.2174/1876525401103010001
  7. Gopalan A, Panneerselvam E, Doss GT, Ponvel K, Raja Vb K. Evaluation of efficacy of low intensity pulsed ultrasound in facilitating mandibular fracture healing-a blinded randomized controlled clinical trial. J Oral Maxillofac Surg 2020;78:997.e1-7. https://doi.org/10.1016/j.joms.2020.01.036
  8. Karayürek F, Kadiroğlu ET, Nergiz Y, Coşkun Akçay N, Tunik S, Ersöz Kanay B, et al. Combining platelet rich fibrin with different bone graft materials: an experimental study on the histopathological and immunohistochemical aspects of bone healing. J Craniomaxillofac Surg 2019;47:815-25. https://doi.org/10.1016/j.jcms.2019.01.023
  9. Tarantino U, Cerocchi I, Celi M, Scialdoni A, Saturnino L, Gasbarra E. Pharmacological agents and bone healing. Clin Cases Miner Bone Metab 2009;6:144-8.
  10. Jun SH, Ahn JS, Lee JI, Ahn KJ, Yun PY, Kim YK. A prospective study on the effectiveness of newly developed autogenous tooth bone graft material for sinus bone graft procedure. J Adv Prosthodont 2014;6:528-38. https://doi.org/10.4047/jap.2014.6.6.528
  11. Ubios AM, Jares Furno G, Guglielmotti MB. Effect of calcitonin on alveolar wound healing. J Oral Pathol Med 1991;20:322-4. https://doi.org/10.1111/j.1600-0714.1991.tb00938.x
  12. Hegde V, Jo JE, Andreopoulou P, Lane JM. Effect of osteoporosis medications on fracture healing. Osteoporos Int 2016;27:861-71. https://doi.org/10.1007/s00198-015-3331-7
  13. Wang Q, Qin H, Deng J, Xu H, Liu S, Weng J, et al. Research progress in calcitonin gene-related peptide and bone repair. Biomolecules 2023;13:838. https://doi.org/10.3390/biom13050838
  14. Lee SL, Yu LX, Cai B, Johnsons GR, Rosenberg AS, Cherney BW, et al. Scientific considerations for generic synthetic salmon calcitonin nasal spray products. AAPS J 2011;13:14-9. https://doi.org/10.1208/s12248-010-9242-9
  15. Gabopoulou Z, Vadalouca A, Velmachou K, Karanastasi C, Van Zundert A. Epidural calcitonin: does it provide better postoperative analgesia? An analysis of the haemodynamic, endocrine, and nociceptive responses of salmon calcitonin and opioids in epidural anesthesia for hip arthroplasty surgery. Pain Pract 2002;2:326-31. https://doi.org/10.1046/j.1533-2500.2002.02042.x
  16. Lucchesi L, Kwok J. Long term antibiotics and calcitonin in the treatment of chronic osteomyelitis of the mandible: case report. Br J Oral Maxillofac Surg 2008;46:400-2. https://doi.org/10.1016/j.bjoms.2007.09.007
  17. Zolhavarieh SM, Mousavi-Bahar SH, Mohseni M, Emam AH, Poorolajal J, Majzoubi F. [Effect of intravenous acetaminophen versus fentanyl on postoperative pain after transurethral lithotripsy]. Braz J Anesthesiol 2019;69:131-6. Portuguese. https://doi.org/10.1016/j.bjan.2018.06.009
  18. Coluzzi F, Taylor R, Pergolizzi JV, Mattia C, Raffa RB. Good clinical practice guide for opioids in pain management: the three Ts - titration (trial), tweaking (tailoring), transition (tapering). Braz J Anesthesiol 2016;66:310-7. https://doi.org/10.1016/j.bjane.2014.09.005
  19. Yazdani J, Khiavi RK, Ghavimi MA, Mortazavi A, Hagh EJ, Ahmadpour F. [Calcitonin as an analgesic agent: review of mechanisms of action and clinical applications]. Braz J Anesthesiol 2019;69:594-604. Portuguese. https://doi.org/10.1016/j.bjan.2019.08.004
  20. Zhou J, Li T, Li L, Xue Y. Clinical efficacy of calcitonin compared to diclofenac sodium in chronic nonspecific low back pain with type I Modic changes: a retrospective study. J Pain Res 2018;11:1335-42. https://doi.org/10.2147/JPR.S158718
  21. Schwartz G, Galonski M, Gordon A, Shandling M, Mock D, Tenenbaum HC. Effects of salmon calcitonin on patients with atypical (idiopathic) facial pain: a randomized controlled trial. J Orofac Pain 1996;10:306-15.
  22. Plosker GL, McTavish D. Intranasal salcatonin (salmon calcitonin). A review of its pharmacological properties and role in the management of postmenopausal osteoporosis. Drugs Aging 1996;8:378-400. https://doi.org/10.2165/00002512-199608050-00006
  23. Hamdy RC, Daley DN. Oral calcitonin. Int J Womens Health 2012;4:471-9. https://doi.org/10.2147/IJWH.S24776
  24. Pontiroli AE, Pajetta E, Calderara A, Alberetto M, Pozza G, Manganelli V, et al. Intranasal and intramuscular human calcitonin in female osteoporosis and in Paget's disease of bones: a pilot study. J Endocrinol Invest 1991;14:47-51. https://doi.org/10.1007/BF03350260
  25. Milanés MV, Vargas ML, Martín MI. Involvement of kappa-opioid receptor mechanisms in the calcitonin-induced potentiation of opioid effects at the hypothalamus-pituitary-adrenocortical axis. Eur J Pharmacol 1994;271:103-9. https://doi.org/10.1016/0014-2999(94)90270-4
  26. Yazdani J, Ahmadpour F. Effect of calcitonin on healing duration, function and pain relief in patients with maxillofacial fractures. A pilot study. Adv Biosci Clin Med 2019;7:1-4. https://doi.org/10.7575/aiac.abcmed.v.7n.4p.1
  27. Trovas GP, Lyritis GP, Galanos A, Raptou P, Constantelou E. A randomized trial of nasal spray salmon calcitonin in men with idiopathic osteoporosis: effects on bone mineral density and bone markers. J Bone Miner Res 2002;17:521-7. https://doi.org/10.1359/jbmr.2002.17.3.521
  28. Monier-Faugere MC, Geng Z, Qi Q, Arnala I, Malluche HH. Calcitonin prevents bone loss but decreases osteoblastic activity in ovariohysterectomized beagle dogs. J Bone Miner Res 1996;11:446-55. https://doi.org/10.1002/jbmr.5650110405
  29. Chesnut CH, Azria M, Silverman S, Engelhardt M, Olson M, Mindeholm L. Salmon calcitonin: a review of current and future therapeutic indications. Osteoporos Int 2008;19:479-91. https://doi.org/10.1007/s00198-007-0490-1
  30. Sun LM, Lin MC, Muo CH, Liang JA, Kao CH. Calcitonin nasal spray and increased cancer risk: a population-based nested case-control study. J Clin Endocrinol Metab 2014;99:4259-64. https://doi.org/10.1210/jc.2014-2239
  31. Sabbisetti VS, Chirugupati S, Thomas S, Vaidya KS, Reardon D, Chiriva-Internati M, et al. Calcitonin increases invasiveness of prostate cancer cells: role for cyclic AMP-dependent protein kinase A in calcitonin action. Int J Cancer 2005;117:551-60. https://doi.org/10.1002/ijc.21158
  32. Appelboom T. Calcitonin in reflex sympathetic dystrophy syndrome and other painful conditions. Bone 2002;30:84S-86S. https://doi.org/10.1016/s8756-3282(02)00702-0
  33. Blau LA, Hoehns JD. Analgesic efficacy of calcitonin for vertebral fracture pain. Ann Pharmacother 2003;37:564-70. https://doi.org/10.1345/aph.1C350
  34. Papadokostakis G, Damilakis J, Mantzouranis E, Katonis P, Hadjipavlou A. The effectiveness of calcitonin on chronic back pain and daily activities in postmenopausal women with osteoporosis. Eur Spine J 2006;15:356-62. https://doi.org/10.1007/s00586-005-0916-4
  35. Wells G, Chernoff J, Gilligan JP, Krause DS. Does salmon calcitonin cause cancer? A review and meta-analysis. Osteoporos Int 2016;27:13-9. https://doi.org/10.1007/s00198-015-3339-z
  36. Sahin F, Yilmaz F, Kotevoglu N, Kuran B. Efficacy of salmon calcitonin in complex regional pain syndrome (type 1) in addition to physical therapy. Clin Rheumatol 2006;25:143-8. https://doi.org/10.1007/s10067-005-1153-2