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Sun Y, Yin Y, Yang S, Ai D, Qin H, Xia X, Xu X, Song J. Lipotoxicity: The missing link between diabetes and periodontitis? J Periodontal Res 2024; 59:431-445. [PMID: 38419425 DOI: 10.1111/jre.13242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 01/10/2024] [Accepted: 01/14/2024] [Indexed: 03/02/2024]
Abstract
Lipotoxicity refers to the accumulation of lipids in tissues other than adipose tissue (body fat). It is one of the major pathophysiological mechanisms responsible for the progression of diabetes complications such as non-alcoholic fatty liver disease and diabetic nephropathy. Accumulating evidence indicates that lipotoxicity also contributes significantly to the toxic effects of diabetes on periodontitis. Therefore, we reviewed the current in vivo, in vitro, and clinical evidence of the detrimental effects of lipotoxicity on periodontitis, focusing on its molecular mechanisms, especially oxidative and endoplasmic reticulum stress, inflammation, ceramides, adipokines, and programmed cell death pathways. By elucidating potential therapeutic strategies targeting lipotoxicity and describing their associated mechanisms and clinical outcomes, including metformin, statins, liraglutide, adiponectin, and omega-3 PUFA, this review seeks to provide a more comprehensive and effective treatment framework against diabetes-associated periodontitis. Furthermore, the challenges and future research directions are proposed, aiming to contribute to a more profound understanding of the impact of lipotoxicity on periodontitis.
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Affiliation(s)
- Yu Sun
- College of Stomatology, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Yuanyuan Yin
- College of Stomatology, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Sihan Yang
- College of Stomatology, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Dongqing Ai
- College of Stomatology, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Han Qin
- College of Stomatology, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Xuyun Xia
- Department of Endocrinology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Xiaohui Xu
- College of Stomatology, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jinlin Song
- College of Stomatology, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
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Greethurst AR, Galletti C, Lo Giudice R, Nart J, Vallés C, Real-Voltas F, Gay-Escoda C, Marchetti E. The Use of Statins as an Adjunctive Periodontal Disease Treatment: Systematic Review and Meta-Analysis. Dent J (Basel) 2024; 12:150. [PMID: 38920851 PMCID: PMC11202911 DOI: 10.3390/dj12060150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 05/06/2024] [Accepted: 05/11/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND the purpose of this systematic review was to assess the clinical and radiographic effect of subgingival-administered statins as an adjunct periodontal treatment in patients with periodontitis. METHODS Electronic literature searches in Medline/PubMed and the Cochrane Library were conducted to identify all relevant articles. Eligibility was based on inclusion criteria which included Randomized Controlled Trials (RCTs) published after 2010, where the periodontal variables were assessed before and after periodontal treatment in combination with a statin administration. The risk of bias was assessed with the ROBINS-2 tool. The outcome variables were probing depth, clinical attachment level, bleeding on probing, and bone fill in systematically healthy patients, patients with type 2 diabetes, and smokers. RESULTS Out of 119 potentially eligible articles, 18 randomized controlled trials were included with a total of 1171 participants. The data retrieved from the meta-analysis showed the positive effect that statins have as an adjunctive periodontal disease treatment. When comparing the different types of statins, the PD reduction in the Simvastatin group was significantly higher than the Atorvastatin group at 6 months and at 9 months, while no differences between statins were found for the rest of the outcomes. Over 66% of the articles presented an overall risk of bias with some concerns, making this a limitation of this present RCT. CONCLUSIONS The adjunct administration of statins has proven to have a positive effect on the periodontium by improving both clinical and radiographic parameters by a considerable margin.
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Affiliation(s)
- Alice Rose Greethurst
- School of Dentistry, Department of Integrated Dentistry, International University of Catalonia, Sant Cugat del Vallès, 08022 Barcelona, Spain; (A.R.G.); (C.G.); (F.R.-V.)
| | - Cosimo Galletti
- School of Dentistry, Department of Integrated Dentistry, International University of Catalonia, Sant Cugat del Vallès, 08022 Barcelona, Spain; (A.R.G.); (C.G.); (F.R.-V.)
| | - Roberto Lo Giudice
- Department of Human Pathology of Adults and Developmental Age, Messina University, 98100 Messina, Italy
| | - José Nart
- Department of Periodontology, International University of Catalonia, Sant Cugat del Vallès, 08022 Barcelona, Spain; (J.N.); (C.V.)
| | - Cristina Vallés
- Department of Periodontology, International University of Catalonia, Sant Cugat del Vallès, 08022 Barcelona, Spain; (J.N.); (C.V.)
| | - Francisco Real-Voltas
- School of Dentistry, Department of Integrated Dentistry, International University of Catalonia, Sant Cugat del Vallès, 08022 Barcelona, Spain; (A.R.G.); (C.G.); (F.R.-V.)
| | - Cosme Gay-Escoda
- Oral and Maxillofacial Surgery Department, School of Dentistry, University of Barcelona, 08022 Barcelona, Spain;
- Department of Teknon Medical Center, IDIBELL Institute, 08022 Barcelona, Spain
| | - Enrico Marchetti
- Department of Life, Health and Environmental Sciences, University of l’Aquila, Piazzale Salvatore Tommasi 1, 67100 Coppito, Italy;
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Viglianisi G, Santonocito S, Lupi SM, Amato M, Spagnuolo G, Pesce P, Isola G. Impact of local drug delivery and natural agents as new target strategies against periodontitis: new challenges for personalized therapeutic approach. Ther Adv Chronic Dis 2023; 14:20406223231191043. [PMID: 37720593 PMCID: PMC10501082 DOI: 10.1177/20406223231191043] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 07/07/2023] [Indexed: 09/19/2023] Open
Abstract
Periodontitis is a persistent inflammation of the soft tissue around the teeth that affects 60% of the population in the globe. The self-maintenance of the inflammatory process can cause periodontal damage from the alveolar bone resorption to tooth loss in order to contrast the effects of periodontitis, the main therapy used is scaling and root planing (SRP). At the same time, studying the physiopathology of periodontitis has shown the possibility of using a local drug delivery system as an adjunctive therapy. Using local drug delivery devices in conjunction with SRP therapy for periodontitis is a potential tool since it increases drug efficacy and minimizes negative effects by managing drug release. This review emphasized how the use of local drug delivery agents and natural agents could be promising adjuvants for the treatment of periodontitis patients affected or not by cardiovascular disease, diabetes, and other system problems. Moreover, the review evidences the current issues and new ideas that can inspire potential later study for both basic research and clinical practice for a tailored approach.
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Affiliation(s)
- Gaia Viglianisi
- Department of General Surgery and Surgical-Medical Specialities, School of Dentistry, University of Catania, Catania, Italy
| | - Simona Santonocito
- Department of General Surgery and Surgical-Medical Specialities, School of Dentistry, University of Catania, Catania, Italy
| | - Saturnino Marco Lupi
- Department of Clinical Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Mariacristina Amato
- Department of General Surgery and Surgical-Medical Specialities, School of Dentistry, University of Catania, Catania, Italy
| | - Gianrico Spagnuolo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Naples, Italy
| | - Paolo Pesce
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialities, School of Dentistry, University of Catania, Via Santa Sofia 78, Catania 95123, Italy
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Jambhekar S, Soman M, Shrivastava R, Ventrapragada R, Sarate S, Kodem T. Comparative Evaluation of Tetracycline Hydrochloride Fiber and Simvastatin Gel as an Adjunct to Scaling and Root Planing in Periodontitis Patients. Cureus 2023; 15:e42314. [PMID: 37621803 PMCID: PMC10445047 DOI: 10.7759/cureus.42314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 07/21/2023] [Indexed: 08/26/2023] Open
Abstract
Inflammation of oral soft tissues, caused by periodontal disease, results in the loss of attachment to supporting therapy and is a severe threat to dental health. Although there are a number of therapeutic options available, mechanical debridement continues to be the gold standard. Scaling and root planing is the gold standard therapy for periodontitis, but this research aims to examine the efficacy of tetracycline fibers and simvastatin gel as local drug delivery methods. We evaluated 60 sites, splitting them into three groups: 20 sites received just scaling and root planing; 20 sites received scaling and root planing plus simvastatin gel; and 20 sites received scaling and root planing plus tetracycline fibers. Clinical indicators such as the gingival index, the modified sulcular bleeding index, and the probing depth were measured at the start of the study, after one week, after one month, after three months, and after six months. After six months, the simvastatin group reduced the gingival index and modified sulcular bleeding index more than the tetracycline group, whereas the tetracycline group reduced probing depth more than the simvastatin group.
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Affiliation(s)
- Samidha Jambhekar
- Department of Periodontics, Dr. DY Patil Dental College and Hospital, Mumbai, IND
| | - Mrunmayee Soman
- Department of Dentistry, Dr. DY Patil Dental College and Hospital, Pimpri, IND
| | - Ratika Shrivastava
- Department of Periodontology, Rishiraj College of Dental Science & Research Center, Bhopal, IND
| | - Roja Ventrapragada
- Department of Periodontology, Partha Dental Skin Hair Clinic, Mangalagiri, IND
| | - Shweta Sarate
- Department of Periodontology, People's College of Dental Sciences, Bhopal, IND
| | - Tejaswi Kodem
- Department of Periodontology, Gitam Dental College and Hospital, Visakhapatnam, IND
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Amato M, Santonocito S, Polizzi A, Tartaglia GM, Ronsivalle V, Viglianisi G, Grippaudo C, Isola G. Local Delivery and Controlled Release Drugs Systems: A New Approach for the Clinical Treatment of Periodontitis Therapy. Pharmaceutics 2023; 15:pharmaceutics15041312. [PMID: 37111796 PMCID: PMC10143241 DOI: 10.3390/pharmaceutics15041312] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 04/13/2023] [Accepted: 04/19/2023] [Indexed: 04/29/2023] Open
Abstract
Periodontitis is an inflammatory disease of the gums characterized by the degeneration of periodontal ligaments, the formation of periodontal pockets, and the resorption of the alveolar bone, which results in the destruction of the teeth's supporting structure. Periodontitis is caused by the growth of diverse microflora (particularly anaerobes) in the pockets, releasing toxins and enzymes and stimulating the immune system. Various approaches, both local and systemic, have been used to treat periodontitis effectively. Successful treatment depends on reducing bacterial biofilm, bleeding on probing (BOP), and reducing or eliminating pockets. Currently, the use of local drug delivery systems (LDDSs) as an adjunctive therapy to scaling and root planing (SRP) in periodontitis is a promising strategy, resulting in greater efficacy and fewer adverse effects by controlling drug release. Selecting an appropriate bioactive agent and route of administration is the cornerstone of a successful periodontitis treatment plan. In this context, this review focuses on applications of LDDSs with varying properties in treating periodontitis with or without systemic diseases to identify current challenges and future research directions.
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Affiliation(s)
- Mariacristina Amato
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy
| | - Simona Santonocito
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy
| | - Alessandro Polizzi
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy
| | - Gianluca Martino Tartaglia
- UOC Maxillo-Facial Surgery and Dentistry, Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, 20100 Milan, Italy
| | - Vincenzo Ronsivalle
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy
| | - Gaia Viglianisi
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy
| | - Cristina Grippaudo
- Department of Head and Neck, Division of Oral Surgery and Implantology, Catholic University of the Sacred Heart, Fondazione Policlinico Gemelli IRCCS, 00168 Rome, Italy
| | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy
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Wei Y, Deng Y, Ma S, Ran M, Jia Y, Meng J, Han F, Gou J, Yin T, He H, Wang Y, Zhang Y, Tang X. Local drug delivery systems as therapeutic strategies against periodontitis: A systematic review. J Control Release 2021; 333:269-282. [PMID: 33798664 DOI: 10.1016/j.jconrel.2021.03.041] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 03/27/2021] [Accepted: 03/27/2021] [Indexed: 12/14/2022]
Abstract
Periodontitis is a chronic inflammation of the soft tissue surrounding and supporting the teeth, which causes periodontal structural damage, alveolar bone resorption, and even tooth loss. Its prevalence is very high, with nearly 60% of the global population affected. Hence, periodontitis is an important public health concern, and the development of effective healing treatments for oral diseases is a major target of the health sciences. Currently, the application of local drug delivery systems (LDDS) as an adjunctive therapy to scaling and root planning (SRP) in periodontitis is a promising strategy, giving higher efficacy and fewer side effects by controlling drug release. The cornerstone of successful periodontitis therapy is to select an appropriate bioactive agent and route of administration. In this context, this review highlights applications of LDDS with different properties in the treatment of periodontitis with or without systemic diseases, in order to reveal existing challenges and future research directions.
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Affiliation(s)
- Ying Wei
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning, China
| | - Yaxin Deng
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning, China
| | - Shuting Ma
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning, China
| | - Meixin Ran
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning, China
| | - Yannan Jia
- Affiliated Hospital of Inner Mongolia University for the Nationalities, Tongliao 028000, Neimenggu, China
| | - Jia Meng
- Liaoning Institute of Basic Medicine, Shenyang 110016, Liaoning, China
| | - Fei Han
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning, China.
| | - Jingxin Gou
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning, China
| | - Tian Yin
- School of Functional Food and Wine, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning, China
| | - Haibing He
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning, China
| | - Yanjiao Wang
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning, China
| | - Yu Zhang
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning, China.
| | - Xing Tang
- Department of Pharmaceutics, School of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning, China
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Zardawi F, Gul S, Abdulkareem A, Sha A, Yates J. Association Between Periodontal Disease and Atherosclerotic Cardiovascular Diseases: Revisited. Front Cardiovasc Med 2021; 7:625579. [PMID: 33521070 PMCID: PMC7843501 DOI: 10.3389/fcvm.2020.625579] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 12/17/2020] [Indexed: 01/15/2023] Open
Abstract
Atherosclerotic cardiovascular disease (ACVD) is an inflammatory disease of the coronary arteries associated with atheroma formation, which can cause disability and often death. Periodontitis is ranked as the sixth most prevalent disease affecting humans affecting 740 million people worldwide. In the last few decades, researchers have focused on the effect of periodontal disease (PD) on cardiovascular disease. The aim of this review was to investigate the association between these two diseases. PD is a potential risk factor that may initiate the development, maturation, and instability of atheroma in the arteries. Two mechanisms were proposed to explain such association, either periodontal pathogens directly invade bloodstream or indirectly by increasing systemic level of inflammatory mediators. Interestingly, it has been suggested that improvement in the condition of one disease positively impact the condition of the other one. Highlighting the association between these two diseases, the importance of early diagnosis and treatment of PD and its impact on cardiovascular status may be of great value in reducing the complications associated with ACVDs. Further in vitro and in vivo studies with longer follow up are necessary to confirm the causal relationship between PD and ACVDs.
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Affiliation(s)
- Faraedon Zardawi
- Periodontics Department, College of Dentistry, University of Sulaimani, Sulaymaniyah, Iraq
| | - Sarhang Gul
- Periodontics Department, College of Dentistry, University of Sulaimani, Sulaymaniyah, Iraq
| | - Ali Abdulkareem
- Department of Periodontics, College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Aram Sha
- Periodontics Department, College of Dentistry, University of Sulaimani, Sulaymaniyah, Iraq
| | - Julian Yates
- Division of Dentistry, School of Medical Sciences, University of Manchester, Manchester, United Kingdom
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Rahman S, GV G, Mehta D. A clinico-microbiological and biochemical study evaluating the adjunctive use of antimicrobial photodynamic therapy and local drug delivery of 1.2 % simvastatin gel compared to scaling and root planing alone. Photodiagnosis Photodyn Ther 2020; 32:102017. [DOI: 10.1016/j.pdpdt.2020.102017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 08/03/2020] [Accepted: 09/11/2020] [Indexed: 12/14/2022]
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Vancomycin hydrochloride-loaded stearic acid/lauric acid in situ forming matrix for antimicrobial inhibition in patients with joint infection after total knee arthroplasty. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2020; 115:110761. [PMID: 32600673 DOI: 10.1016/j.msec.2020.110761] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 01/20/2020] [Accepted: 02/17/2020] [Indexed: 12/24/2022]
Abstract
Knee joint infection following total knee arthroplasty (TKA) is a serious condition and the treatments are complicated. The intra-articular solvent exchange-induced in situ forming matrix is of interest for modulating the release of antibiotics with a high drug concentration and a long period of exposed time at the target site. Stearic acid (S) and lauric acid (L) at various ratios were used as matrix formers by dissolving them in biocompatible solvents such as N-methyl pyrrolidone (NMP) and dimethyl sulfoxide (DMSO). Their matrix formation behaviors in phosphate buffer (pH7.4) and hyaluronic acid (HA) solution were evaluated. Also, the density, viscosity, injectability, solvent diffusion, in vitro degradability and drug release using the dialysis tube method were investigated. The L:S ratio of 1:1 in DMSO exhibited rapid matrix formation and a remarkably low viscosity (7.67±0.03 cp) with acceptable injectability (0.608±0.027N and 0.867±0.010N through 18-G and 27-G, respectively). Vancomycin HCl (V)-loaded L/S in situ forming matrix still provided ease of injection (1.079±0.215N and 1.230±0.145N through 18-G and 27-G needle, respectively) with fatty acid matrix formation after solvent exchange within 1min, whilst V sustainably released over 6days. It also presented effective antimicrobial activities against standard Staphylococcus aureus and methicillin-resistant Staphylococcus aureus strains. Therefore, V-loaded solvent exchange-induced in situ forming matrix using L and S as the matrix formers may be a potential local delivery system for treating knee joint infections occurring after TKA in the future.
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Liang J, Peng X, Zhou X, Zou J, Cheng L. Emerging Applications of Drug Delivery Systems in Oral Infectious Diseases Prevention and Treatment. Molecules 2020; 25:E516. [PMID: 31991678 PMCID: PMC7038021 DOI: 10.3390/molecules25030516] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 01/17/2020] [Accepted: 01/20/2020] [Indexed: 12/27/2022] Open
Abstract
The oral cavity is a unique complex ecosystem colonized with huge numbers of microorganism species. Oral cavities are closely associated with oral health and sequentially with systemic health. Many factors might cause the shift of composition of oral microbiota, thus leading to the dysbiosis of oral micro-environment and oral infectious diseases. Local therapies and dental hygiene procedures are the main kinds of treatment. Currently, oral drug delivery systems (DDS) have drawn great attention, and are considered as important adjuvant therapy for oral infectious diseases. DDS are devices that could transport and release the therapeutic drugs or bioactive agents to a certain site and a certain rate in vivo. They could significantly increase the therapeutic effect and reduce the side effect compared with traditional medicine. In the review, emerging recent applications of DDS in the treatment for oral infectious diseases have been summarized, including dental caries, periodontitis, peri-implantitis and oral candidiasis. Furthermore, oral stimuli-responsive DDS, also known as "smart" DDS, have been reported recently, which could react to oral environment and provide more accurate drug delivery or release. In this article, oral smart DDS have also been reviewed. The limits have been discussed, and the research potential demonstrates good prospects.
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Affiliation(s)
| | | | | | - Jing Zou
- State Key Laboratory of Oral Diseases& West China School of Stomatology& National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu 610041, China; (J.L.); (X.P.); (X.Z.)
| | - Lei Cheng
- State Key Laboratory of Oral Diseases& West China School of Stomatology& National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu 610041, China; (J.L.); (X.P.); (X.Z.)
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Li X, Liu X, Ni S, Liu Y, Sun H, Lin Q. Enhanced osteogenic healing process of rat tooth sockets using a novel simvastatin-loaded injectable microsphere-hydrogel system. J Craniomaxillofac Surg 2019; 47:1147-1154. [DOI: 10.1016/j.jcms.2019.04.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 03/01/2019] [Accepted: 04/18/2019] [Indexed: 12/21/2022] Open
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12
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Contribution of Statins towards Periodontal Treatment: A Review. Mediators Inflamm 2019; 2019:6367402. [PMID: 30936777 PMCID: PMC6415285 DOI: 10.1155/2019/6367402] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 12/23/2018] [Indexed: 01/09/2023] Open
Abstract
The pleiotropic effects of statins have been evaluated to assess their potential benefit in the treatment of various inflammatory and immune-mediated diseases including periodontitis. Herein, the adjunctive use of statins in periodontal therapy in vitro, in vivo, and in clinical trials was reviewed. Statins act through several pathways to modulate inflammation, immune response, bone metabolism, and bacterial clearance. They control periodontal inflammation through inhibition of proinflammatory cytokines and promotion of anti-inflammatory and/or proresolution molecule release, mainly, through the ERK, MAPK, PI3-Akt, and NF-κB pathways. Moreover, they are able to modulate the host response activated by bacterial challenge, to prevent inflammation-mediated bone resorption and to promote bone formation. Furthermore, they reduce bacterial growth, disrupt bacterial membrane stability, and increase bacterial clearance, thus averting the exacerbation of infection. Local statin delivery as adjunct to both nonsurgical and surgical periodontal therapies results in better periodontal treatment outcomes compared to systemic delivery. Moreover, combination of statin therapy with other regenerative agents improves periodontal healing response. Therefore, statins could be proposed as a potential adjuvant to periodontal therapy. However, optimization of the combination of their dose, type, and carrier could be instrumental in achieving the best treatment response.
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