Near-Infrared-Enhanced Dual Enzyme-Mimicking Ag-TiO2-x@Alginate Microspheres with Antibactericidal and Oxygeneration Abilities to Treat Periodontitis

Biomaterials based on advanced oxidation processes in tooth whitening: fundamentals, progress, and models

The increasing desire for aesthetically pleasing teeth has resulted in the widespread use of tooth whitening treatments. Clinical tooth whitening products currently rely on hydrogen peroxide formulations to degrade dental pigments through oxidative processes. However, they usually cause side effects such as tooth sensitivity and gingival irritation due to the use of high concentrations of hydrogen peroxide or long-time contact. In recent years, various novel materials and reaction patterns have been developed to tackle the issues related to H2O2-based tooth whitening. These can be broadly classified as advanced oxidation processes (AOPs). AOPs generate free radicals that have potent oxidizing properties, which can thereby increase the oxidation power and/or reduce the exposure time and can probably minimize the side effects of tooth bleaching. While there have been several reviews on clinical tooth whitening and the application of novel nanomaterials, a review based on the concept of AOPs in tooth bleaching application has not yet been conducted. This review describes the common types and mechanisms of AOPs, summarizes the latest research progress of new tooth bleaching materials based on AOPs, and proposes a model for tooth bleaching and a rate control step at the molecular level. The paper also reviews the shortcomings and suggests future development directions.

Stimuli-responsive materials in oral diseases: a review

OBJECTIVES

Oral diseases, such as dental caries, periodontitis, and oral cancers, are highly prevalent worldwide. Many oral diseases are typically associated with bacterial infections or the proliferation of malignant cells, and they are usually located superficially.

MATERIALS AND METHODS

Articles were retrieved from PubMed/Medline, Web of Science. All studies focusing on stimuli-responsive materials in oral diseases were included and carefully evaluated.

RESULTS

Stimulus-responsive materials are innovative materials that selectively undergo structural changes and trigger drug release based on shifts at the molecular level, such as changes in pH, electric field, magnetic field, or light in the surrounding environment. These changes lead to alterations in the properties of the materials at the macro- or microscopic level. Consequently, stimuli-responsive materials are particularly suitable for treating superficial site diseases and have found extensive applications in antibacterial and anticancer therapies. These characteristics make them convenient and effective for addressing oral diseases.

CONCLUSIONS

This review aimed to summarize the classification, mechanism of action, and application of stimuli-responsive materials in the treatment of oral diseases, point out the existing limitations, and speculate the prospects for clinical applications.

CLINICAL RELEVANCE

Our findings may provide useful information of stimuli-responsive materials in oral diseases for dental clinicians.

Emerging nanozyme therapy incorporated into dental materials for diverse oral pathologies

OBJECTIVE

Nanozyme materials combine the advantages of natural enzymes and artificial catalysis, and have been widely applied in new technologies for dental materials and oral disease treatment. Based on the role of reactive oxygen species (ROS) and oxidative stress pathways in the occurrence and therapy of oral diseases, a comprehensive review was conducted on the methods and mechanisms of nanozymes and their dental materials in treating different oral diseases.

METHODS

This review is based on literature surveys from PubMed and Web of Science databases, as well as reviews of relevant researches and publications on nanozymes in the therapy of oral diseases and oral tumors in international peer-reviewed journals.

RESULTS

Given the unique function of nanozymes in the generation and elimination of ROS, they play an important role in the occurrence, development, and treatment of different oral diseases. The application of nanozymes in dental materials and oral disease treatment was introduced, including the latest advances in their use for dental caries, pulpitis, jaw osteomyelitis, periodontitis, oral mucosal diseases, temporomandibular joint disorders, and oral tumors. Future approaches were also summarized and proposed based on the characteristics of these diseases.

SIGNIFICANCE

This review will guide biomedical researchers and oral clinicians to understand the mechanisms and applications of nanozymes in the therapy of oral diseases, promoting further development in the field of dental materials within the oral medication. It is anticipated that more suitable therapeutic agents or dental materials encapsulating nanozymes, specifically designed for the oral environment and simpler for clinical utilization, will emerge in the forthcoming future.

Preparation of an injectable zinc-containing hydrogel with double dynamic bond and its potential application in the treatment of periodontitis

Periodontal tissue regeneration continues to face significant clinical challenges. Periodontitis leads to alveolar bone resorption and even tooth loss due to persistent microbial infection and persistent inflammatory response. As a promising topical drug delivery system, the application of hydrogels in the controlled release of periodontal bioactive drugs has aroused great interest. Therefore, the design and preparation of an injectable hydrogel with self-repairing properties for periodontitis treatment is still in great demand. In this study, polysaccharide-based self-healing hydrogels with antimicrobial osteogenic properties were developed. Zinc ions are introduced into a dynamic cross-linking network formed by dynamic Schiff bases between carboxymethyl chitosan and oxidized hyaluronic acid via coordination bonds. The OC-Zn hydrogels exhibited good tissue adhesion, good fatigue resistance, excellent self-healing ability, low cytotoxicity, good broad-spectrum antimicrobial activity, and osteogenic activity. Therefore, the designed hydrogels allow the development of drug delivery systems as a potential treatment for periodontitis.

Metal Ion-Containing Hydrogels: Synthesis, Properties, and Applications in Bone Tissue Engineering

Hydrogel, as a unique scaffold material, features a three-dimensional network system that provides conducive conditions for the growth of cells and tissues in bone tissue engineering (BTE). In recent years, it has been discovered that metal ion-containing hybridized hydrogels, synthesized with metal particles as the foundation, exhibit excellent physicochemical properties, osteoinductivity, and osteogenic potential. They offer a wide range of research prospects in the field of BTE. This review provides an overview of the current state and recent advancements in research concerning metal ion-containing hydrogels in the field of BTE. Within materials science, it covers topics such as the binding mechanisms of metal ions within hydrogel networks, the types and fabrication methods of various metal ion-containing hydrogels, and the influence of metal ions on the properties of hydrogels. In the context of BTE, the review delves into the osteogenic mechanisms of various metal ions, the applications of metal ion-containing hydrogels in BTE, and relevant experimental studies in vitro and in vivo. Furthermore, future improvements in bone repair can be anticipated through advancements in bone bionics, exploring interactions between metal ions and the development of a wider range of metal ions and hydrogel types.

Cuttlefish-Inspired Photo-Responsive Antibacterial Microparticles with Natural Melanin Nanoparticles Spray

Topical antibiotics can be utilized to treat periodontitis, while their delivery stratagems with controlled release and long-lasting bactericidal inhibition are yet challenging. Herein, inspired by the defensive behavior of cuttlefish expelling ink, this work develops innovative thermal-responsive melanin-integrated porous microparticles (MPs) through microfluidic synthesis for periodontitis treatment. These MPs are composed of melanin nanoparticles (NPs), poly(N-isopropylacrylamide) (PNIPAM), and agarose. Benefiting from the excellent biocompatibility and large surface area ratio of MPs, they can deliver abundant melanin NPs. Under near-infrared irradiation, the melanin NPs can convert photo energy into thermal energy. This leads to agarose melting and subsequent shrinkage of the microspheres induced by pNIPAM, thereby facilitating the release of melanin NPs. In addition, the released melanin NPs can serve as a highly effective photothermal agent, displaying potent antibacterial activity against porphyromonas gingivalis and possessing natural anti-inflammatory properties. These unique characteristics are further demonstrated through in vivo experiments, showing the antibacterial effects in the treatment of infected wounds and periodontitis. Therefore, the catfish-inspired photo-responsive antibacterial MPs with controlled-release drug delivery hold tremendous potential in clinical antibacterial applications.

Emerging polymeric materials for treatment of oral diseases: design strategy towards a unique oral environment

Oral diseases are prevalent but challenging diseases owing to the highly movable and wet, microbial and inflammatory environment. Polymeric materials are regarded as one of the most promising biomaterials due to their good compatibility, facile preparation, and flexible design to obtain multifunctionality. Therefore, a variety of strategies have been employed to develop materials with improved therapeutic efficacy by overcoming physicobiological barriers in oral diseases. In this review, we summarize the design strategies of polymeric biomaterials for the treatment of oral diseases. First, we present the unique oral environment including highly movable and wet, microbial and inflammatory environment, which hinders the effective treatment of oral diseases. Second, a series of strategies for designing polymeric materials towards such a unique oral environment are highlighted. For example, multifunctional polymeric materials are armed with wet-adhesive, antimicrobial, and anti-inflammatory functions through advanced chemistry and nanotechnology to effectively treat oral diseases. These are achieved by designing wet-adhesive polymers modified with hydroxy, amine, quinone, and aldehyde groups to provide strong wet-adhesion through hydrogen and covalent bonding, and electrostatic and hydrophobic interactions, by developing antimicrobial polymers including cationic polymers, antimicrobial peptides, and antibiotic-conjugated polymers, and by synthesizing anti-inflammatory polymers with phenolic hydroxy and cysteine groups that function as immunomodulators and electron donors to reactive oxygen species to reduce inflammation. Third, various delivery systems with strong wet-adhesion and enhanced mucosa and biofilm penetration capabilities, such as nanoparticles, hydrogels, patches, and microneedles, are constructed for delivery of antibiotics, immunomodulators, and antioxidants to achieve therapeutic efficacy. Finally, we provide insights into challenges and future development of polymeric materials for oral diseases with promise for clinical translation.

Deinococcus wulumuqiensis R12 synthesized silver nanoparticles with peroxidase-like activity for synergistic antibacterial application

The use of a combination of several antibacterial agents for therapy holds great promise in reducing the dosage and side effects of these agents, improving their efficiency, and inducing potential synergistic therapeutic effects. Herein, this study provides an innovative antibacterial treatment strategy by synergistically combining R12-AgNPs with H2O2 therapy. R12-AgNPs were simply produced with the supernatant of an ionizing radiation-tolerant bacterium Deinococcus wulumuqiensis R12 by one-step under room temperature. In comparison with chemically synthesized AgNPs, the biosynthesized AgNPs presented fascinating antibacterial activity and peroxidase-like properties, which endowed it with the capability to catalyze the decomposition of H2O2 to generate hydroxyl radical. After the combination of R12-AgNPs and H2O2, an excellent synergistic bacteriostatic activity was observed for both Escherichia coli and Staphylococcus aureus, especially at low concentrations. In addition, in vitro cytotoxicity tests showed R12-AgNPs had good biocompatibility. Thus, this work presents a novel antibacterial agent that exhibits favorable synergistic antibacterial activity and low toxicity, without the use of antibiotics or a complicated synthesis process.

Multifunctional Metal-Phenolic Composites Promote Efficient Periodontitis Treatment via Antibacterial and Osteogenic Properties

Periodontitis, a complex inflammatory disease initiated by bacterial infections, presents a significant challenge in public health. The increased levels of reactive oxygen species and the subsequent exaggerated immune response associated with periodontitis often lead to alveolar bone resorption and tooth loss. Herein, we develop multifunctional metal-phenolic composites (i.e., Au@MPN-BMP2) to address the complex nature of periodontitis, where gold nanoparticles (AuNPs) are coated by metal-phenolic networks (MPNs) and bone morphogenetic protein 2 (BMP2). In this design, MPNs exhibit remarkable antibacterial and antioxidant properties, and AuNPs and BMP2 promote osteogenic differentiation of bone marrow mesenchymal stem cells under inflammatory conditions. In a rat model of periodontitis, treatment with Au@MPN-BMP2 leads to notable therapeutic outcomes, including mitigated oxidative stress, reduced progression of inflammation, and the significant prevention of inflammatory bone loss. These results highlight the multifunctionality of Au@MPN-BMP2 nanoparticles as a promising therapeutic approach for periodontitis, addressing both microbial causative factors and an overactivated immune response. We envision that the rational design of metal-phenolic composites will provide versatile nanoplatforms for tissue regeneration and potential clinical applications.

Spotlight on therapeutic efficiency of green synthesis metals and their oxide nanoparticles in periodontitis

Periodontitis, one of the most prevalent dental diseases, causes the loss of bone and gum tissue that hold teeth in place. Several bacteria, commonly present in clinically healthy oral cavities, may induce and perpetuate periodontitis when their concentration rises in the gingival sulcus. Antibacterial effect against various Gram-negative and Gram-positive bacteria, including pathogenic and drug-resistant ones, has been shown for several distinct transient metal and metal oxide NPs. Therefore, NPs may be used in biomedicine to treat periodontal problems and in nanotechnology to inhibit the development of microorganisms. Instead of using harmful chemicals or energy-intensive machinery, biosynthesis of metal and metal oxide nanoparticles (NPs) has been suggested. To produce metal and metal oxide NPs, the ideal technique is "Green" synthesis because of its low toxicity and safety for human health and the environment. Gold NPs (AuNPs) appear to be less toxic to mammalian cells than other nanometals because their antibacterial activity is not dependent on reactive oxygen species (ROS). AgNPs also possess chemical stability, catalytic activity, and superior electrical and thermal conductivity, to name a few of their other advantageous characteristics. It was observed that zinc oxide (ZnO) NPs and copper (Cu) NPs exhibited discernible inhibitory effects against gram-positive and gram-negative bacterial strains, respectively. ZnO NPs demonstrated bactericidal activity against the microorganisms responsible for periodontitis. Medications containing magnetic NPs are highly effective against multidrug-resistant bacterial and fungal infections. The titanium dioxide (TiO2) NPs are implicated in elevating salivary peroxidase activity in individuals diagnosed with chronic periodontitis. Furthermore, specific metallic NPs have the potential to enhance the antimicrobial efficacy of periodontitis treatments when combined. Therefore, these NPs, as well as their oxide NPs, are only some of the metals and metal oxides that have been synthesized in environmentally friendly ways and shown to have therapeutic benefits against periodontitis.

Scalable Fabrication of Polymeric Composite Microspheres to Inhibit Oral Pathogens and Promote Osteogenic Differentiation of Periodontal Membrane Stem Cells

Periodontitis is a worldwide bacterial infectious disease, resulting in the resorption of tooth-supporting structures. Biodegradable polymeric microspheres are emerging as an appealing local therapy candidate for periodontal defect regeneration but suffer from tedious procedures and low yields. Herein, we developed a facile yet scalable approach to prepare polylactide composite microspheres with outstanding drug-loading capability. It was realized by blending equimolar polylactide enantiomers at the temperature between the melting point of homocrystallites and stereocomplex (sc) crystallites, enabling the precipitation of sc crystallites in the form of microspheres. Meanwhile, epigallocatechin gallate (EGCG) and nano-hydroxyapatite were encapsulated in the microspheres in the designated amount. Such an assembly allowed the fast and sustained release of EGCG and Ca2+ ions. The resultant hybrid composite microspheres not only exhibited strong antimicrobial activity against typical oral pathogens (Porphyromonas gingivalis and Enterococcus faecalis), but also directly promoted osteogenic differentiation of periodontal ligament stem cells with good cytocompatibility. These dual-functional composite microspheres offer a desired drug delivery platform to address the practical needs for periodontitis treatment.