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Levrini L, Rossini M, Truppello E, Sevi S, Fiorini E, Benedicenti S, Pasquale C, Farronato D. Evaluation of Sterify Gel as an Adjunctive Treatment to Scaling and Root Planing in Promoting Healing of Periodontal Pockets: A Split-Mouth Randomized Controlled Trial. Int J Dent 2024; 2024:3113479. [PMID: 38213553 PMCID: PMC10783987 DOI: 10.1155/2024/3113479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 11/22/2023] [Accepted: 12/07/2023] [Indexed: 01/13/2024] Open
Abstract
Background Periodontal disease is a common infectious disease that leads to the destruction of tooth-supporting structures. Current treatments, such as scaling and root planing (SRP), have limitations in deep and complex pockets, and antibiotic use carries the risk of resistance. Sterify Gel, a medical device composed of polyvinyl polymers, hydroxytyrosol, nisin, and magnesium ascorbyl phosphate, offers a new approach to periodontal care. This study aims to evaluate the safety and efficacy of Sterify Gel as an adjunctive treatment to SRP in promoting the healing of periodontal pockets. Methods The study includes 34 patients with moderate to advanced chronic periodontal disease. Randomization assigned one site for SRP alone (control) and the other site for SRP with Sterify Gel (treatment). Periodontal parameters were evaluated at baseline, 1, 2, and 3 months after treatment bacterial contamination was assessed through quantitative PCR at baseline and 3 months after treatment. Statistical analysis was conducted using ANOVA and Wilcoxon test. Results Treatment with Sterify Gel and SRP demonstrated significant improvements in pocket depth, gingival recession, and clinical attachment level compared with SRP alone. Bleeding and plaque indexes, pain perception, tooth mobility, and furcations showed no significant differences between the two groups. The treatment group showed a reduction in bacterial contamination at 3 months. Conclusions Sterify Gel in combination with SRP shows the potential for improving periodontal health by promoting healing and reducing periodontal pockets. It may offer benefits in preventing bacterial recolonization and reducing reliance on antibiotics.
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Affiliation(s)
- Luca Levrini
- Department of Human Sciences, Innovation and Territory, Postgraduate School of Orthodontic, University of Insubria, 21100, Varese, Italy
| | - Michela Rossini
- Department of Medicine and Surgery, School of Dental Hygiene, University of Insubria, 21100, Varese, Italy
| | - Elisa Truppello
- Department of Medicine and Surgery, School of Dental Hygiene, University of Insubria, 21100, Varese, Italy
| | - Simone Sevi
- Department of Medicine and Surgery, School of Dental Hygiene, University of Insubria, 21100, Varese, Italy
| | - Enrico Fiorini
- Department of Medicine and Surgery, School of Dental Hygiene, University of Insubria, 21100, Varese, Italy
| | - Stefano Benedicenti
- Department of Surgical and Diagnostic Sciences, University of Genoa, 16132, Genoa, Italy
| | - Claudio Pasquale
- Department of Surgical and Diagnostic Sciences, University of Genoa, 16132, Genoa, Italy
| | - Davide Farronato
- Department of Medicine and Surgery, School of Dental Hygiene, University of Insubria, 21100, Varese, Italy
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Hasan N, Nayak AK, Sanaullah S, Sami F, Majeed S, Badgujar VB, Hasnain S, Ansari MT. Design and evaluation of dental pastes Containing anti-inflammatory drugs. BRAZ J PHARM SCI 2022. [DOI: 10.1590/s2175-97902022e18655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
| | | | | | - Farheen Sami
- Universiti Kuala Lumpur Royal College of Medicine Perak, Malaysia
| | - Shahnaz Majeed
- Universiti Kuala Lumpur Royal College of Medicine Perak, Malaysia
| | | | | | - Mohammed Tahir Ansari
- Universiti Kuala Lumpur Royal College of Medicine Perak, Malaysia; University of Nottingham Malaysia, Malaysia
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Abstract
Causes of the progression of periodontitis such as an imbalance between the immune response by the host by the release of inflammatory mediators in the response of the oral pathogenic dysbiotic biofilm have been identified. New insights on specific cell signaling pathways that appear during periodontitis have attracted the attention of researchers in the study of new personalised approaches for the treatment of periodontitis. The gold standard of non-surgical therapy of periodontitis involves the removal of supra and subgingival biofilm through professional scaling and root planing (SRP) and oral hygiene instructions. In order to improve periodontal clinical outcomes and overcome the limitations of traditional SRP, additional adjuvants have been developed in recent decades, including local or systemic antibiotics, antiseptics, probiotics, anti-inflammatory and anti-resorptive drugs and host modulation therapies. This review is aimed to update the current and recent evolution of therapies of management of periodontitis based on the adjunctive and target therapies. Moreover, we discuss the advances in host modulation of periodontitis and the impact of targeting epigenetic mechanisms approaches for a personalised therapeutic success in the management of periodontitis. In conclusion, the future goal in periodontology will be to combine and personalise the periodontal treatments to the colonising microbial profile and to the specific response of the individual patient.
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Elnagdy S, Raptopoulos M, Kormas I, Pedercini A, Wolff LF. Local Oral Delivery Agents with Anti-Biofilm Properties for the Treatment of Periodontitis and Peri-Implantitis. A Narrative Review. Molecules 2021; 26:5661. [PMID: 34577132 PMCID: PMC8467993 DOI: 10.3390/molecules26185661] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/26/2021] [Accepted: 09/10/2021] [Indexed: 02/06/2023] Open
Abstract
Despite many discoveries over the past 20 years regarding the etiopathogenesis of periodontal and peri-implant diseases, as well as significant advances in our understanding of microbial biofilms, the incidence of these pathologies continues to rise. For this reason, it was clear that other strategies were needed to eliminate biofilms. In this review, the literature database was searched for studies on locally delivered synthetic agents that exhibit anti-biofilm properties and their potential use in the treatment of two important oral diseases: periodontitis and peri-implantitis.
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Affiliation(s)
- Shorouk Elnagdy
- Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA; (M.R.); (I.K.); (A.P.); (L.F.W.)
| | - Michail Raptopoulos
- Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA; (M.R.); (I.K.); (A.P.); (L.F.W.)
| | - Ioannis Kormas
- Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA; (M.R.); (I.K.); (A.P.); (L.F.W.)
- Department of Periodontics, College of Dentistry, Texas A&M University, Dallas, TX 75246, USA
| | - Alessandro Pedercini
- Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA; (M.R.); (I.K.); (A.P.); (L.F.W.)
| | - Larry F. Wolff
- Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA; (M.R.); (I.K.); (A.P.); (L.F.W.)
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5
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Iova GM, Calniceanu H, Popa A, Szuhanek CA, Marcu O, Ciavoi G, Scrobota I. The Antioxidant Effect of Curcumin and Rutin on Oxidative Stress Biomarkers in Experimentally Induced Periodontitis in Hyperglycemic Wistar Rats. Molecules 2021; 26:molecules26051332. [PMID: 33801378 PMCID: PMC7958623 DOI: 10.3390/molecules26051332] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 02/14/2021] [Accepted: 02/25/2021] [Indexed: 11/18/2022] Open
Abstract
Background: There is a growing interest in the correlation between antioxidants and periodontal disease. In this study, we aimed to investigate the effect of oxidative stress and the impact of two antioxidants, curcumin and rutin, respectively, in the etiopathology of experimentally induced periodontitis in diabetic rats. Methods: Fifty Wistar albino rats were randomly divided into five groups and were induced with diabetes mellitus and periodontitis: (1) (CONTROL)—control group, (2) (DPP)—experimentally induced diabetes mellitus and periodontitis, (3) (DPC)—experimentally induced diabetes mellitus and periodontitis treated with curcumin (C), (4) (DPR)—experimentally induced diabetes mellitus and periodontitis treated with rutin (R) and (5) (DPCR)—experimentally induced diabetes mellitus and periodontitis treated with C and R. We evaluated malondialdehyde (MDA) as a biomarker of oxidative stress and reduced glutathione (GSH), oxidized glutathione (GSSG), GSH/GSSG and catalase (CAT) as biomarkers of the antioxidant capacity in blood harvested from the animals we tested. The MDA levels and CAT activities were also evaluated in the gingival tissue. Results: The control group effect was statistically significantly different from any other groups, regardless of whether or not the treatment was applied. There was also a significant difference between the untreated group and the three treatment groups for variables MDA, GSH, GSSG, GSH/GSSG and CAT. There was no significant difference in the mean effect for the MDA, GSH, GSSG, GSH/GSSG and CAT variables in the treated groups of rats with curcumin, rutin and the combination of curcumin and rutin. Conclusions: The oral administration of curcumin and rutin, single or combined, could reduce the oxidative stress and enhance the antioxidant status in hyperglycemic periodontitis rats.
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Affiliation(s)
- Gilda M. Iova
- Dental Medicine Department, Faculty of Medicine and Pharmacy, University of Oradea, 410068 Oradea, Romania; (G.M.I.); (G.C.); (I.S.)
| | - Horia Calniceanu
- Department of Periodontology Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Periodontal and Periimplant Diseases Research Center “Prof. Dr. Anton Sculean”, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Correspondence: (H.C.); (A.P.); Tel.: +40-745-322-649 (H.C.); +40-751-119-437 (A.P.)
| | - Adelina Popa
- Department of Orthodontics, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- Orthodontic Research Center (ORTHO-CENTER), Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Correspondence: (H.C.); (A.P.); Tel.: +40-745-322-649 (H.C.); +40-751-119-437 (A.P.)
| | - Camelia A. Szuhanek
- Department of Orthodontics, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- Orthodontic Research Center (ORTHO-CENTER), Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Olivia Marcu
- Preclinics Department, Faculty of Medicine and Pharmacy, University of Oradea, 410068 Oradea, Romania;
| | - Gabriela Ciavoi
- Dental Medicine Department, Faculty of Medicine and Pharmacy, University of Oradea, 410068 Oradea, Romania; (G.M.I.); (G.C.); (I.S.)
| | - Ioana Scrobota
- Dental Medicine Department, Faculty of Medicine and Pharmacy, University of Oradea, 410068 Oradea, Romania; (G.M.I.); (G.C.); (I.S.)
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Effects of rutin on the oxidative stress, proliferation and osteogenic differentiation of periodontal ligament stem cells in LPS-induced inflammatory environment and the underlying mechanism. J Mol Histol 2020; 51:161-171. [DOI: 10.1007/s10735-020-09866-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 03/18/2020] [Indexed: 12/12/2022]
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Tan OL, Safii SH, Razali M. Commercial Local Pharmacotherapeutics and Adjunctive Agents for Nonsurgical Treatment of Periodontitis: A Contemporary Review of Clinical Efficacies and Challenges. Antibiotics (Basel) 2019; 9:E11. [PMID: 31905889 PMCID: PMC7169417 DOI: 10.3390/antibiotics9010011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 12/24/2019] [Accepted: 12/27/2019] [Indexed: 12/19/2022] Open
Abstract
Periodontal infections tend to be site-specific, mostly confined to the periodontal pocket. With the surge of antibiotic-resistant bacteria, the trend is shifting towards other therapeutic modalities, especially locally delivered approaches that include other pharmacotherapeutic drugs and medical devices. This narrative review aimed to provide insights into the clinical efficacy of local drug delivery and adjunctive agents used in nonsurgical management of periodontitis. Electronic (PubMed/MEDLINE, CENTRAL, and EMBASE) and bibliographic searches of past systematic reviews were carried out to identify previous publications on the topic. Only relevant literature and randomized controlled trials published in English were selected. In addition, a literature review was developed based on the selected articles. Experimental drugs or agents were excluded. This review highlights the clinically proven and commercially available therapeutic agents related to the management of periodontal disease with comparisons of their clinical efficacies and challenges. A vast array of commercial local pharmacotherapeutic agents had been clinically tested, but the methodologies and clinical results varied within and between each agent used, causing difficulty in drawing conclusions and providing support to the superiority of one agent over another. Considering the benefit-cost ratio with the modest clinical results, the long-term usefulness of these agents remains debatable.
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Affiliation(s)
- Oi Leng Tan
- Faculty of Dentistry, Centre for Restorative Dentistry, Unit of Periodontology, National University of Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Syarida Hasnur Safii
- Faculty of Dentistry, Department of Restorative Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia;
| | - Masfueh Razali
- Faculty of Dentistry, Centre for Restorative Dentistry, Unit of Periodontology, National University of Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
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Dong Z, Sun Y, Chen Y, Liu Y, Tang C, Qu X. Injectable Adhesive Hydrogel through a Microcapsule Cross-Link for Periodontitis Treatment. ACS APPLIED BIO MATERIALS 2019; 2:5985-5994. [PMID: 35021519 DOI: 10.1021/acsabm.9b00912] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Zhanhai Dong
- Department of Stomatology, 306 Hospital of PLA, Beijing 100101, China
| | - Yining Sun
- Center of Materials Science and Optoelectronics Engineering, College of Materials Science and Optoelectronic Technology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yuhui Chen
- Department of Stomatology, 306 Hospital of PLA, Beijing 100101, China
| | - Yan Liu
- Department of Stomatology, 306 Hospital of PLA, Beijing 100101, China
| | - Chuhua Tang
- Department of Stomatology, 306 Hospital of PLA, Beijing 100101, China
| | - Xiaozhong Qu
- Center of Materials Science and Optoelectronics Engineering, College of Materials Science and Optoelectronic Technology, University of Chinese Academy of Sciences, Beijing 100049, China
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Sachdeva S, Grover V, Malhotra R, Kapoor A, Mohanty K. Comparison of clinical effectiveness of single and multiple applications of 1% chlorhexidine varnish (Cervitec Plus) along with scaling and root planing in patients with chronic periodontitis. J Indian Soc Periodontol 2019; 22:523-528. [PMID: 30631231 PMCID: PMC6305086 DOI: 10.4103/jisp.jisp_252_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background: Local drug delivery is most commonly used as an adjunct to scaling and root planing (SRP) for the treatment of periodontal disease. Varied success rates have been documented for various vehicles used for intrasite delivery of active therapeutic agents. Recently, varnishes acting as a reservoir of chlorhexidine have shown potential for the management of chronic periodontitis patients. The aim of the present investigation was a comparative evaluation of the clinical effectiveness of single and multiple applications of 1% chlorhexidine and thymol varnish (Cervitec Plus) along with SRP in patients with chronic periodontitis. Materials and Methods: The present study included 30 patients with chronic periodontitis divided into three groups based on the number of subgingival applications of chlorhexidine varnish single application (Group A), two applications at a week's interval (Group B), and three applications with 7-day interval in between two applications (Group C). Clinical parameters, namely plaque index (PI), sulcus bleeding index, probing pocket depth (PPD), and relative attachment level (RAL) were recorded at baseline, 1 month and 3 months in all three groups to compare the clinical efficacy. Results: A statistically significant reduction was observed in PI, sulcus bleeding index, PPD, and RAL at 1 and 3 months in all the three groups. Greater (though statistically nonsignificant) improvements were observed in Groups B and C. Conclusion: Within limitations of the study, it can be concluded that multiple applications of 1% chlorhexidine and thymol varnish (Cervitec Plus) have an added benefit over the single application in the treatment of chronic periodontitis.
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Affiliation(s)
- Sonia Sachdeva
- Sai Dental Clinic and Implant Centre, Jalandhar, Punjab, India
| | - Vishakha Grover
- Department of Periodontology and Oral Implantology, Dr. H. S. J. Institute of Dental Sciences and Hospital, Punjab University, Chandigarh, India
| | - Ranjan Malhotra
- Department of Periodontology and Oral Implantology, Himachal Dental College and Hospital, Sundernagar, Himachal Pradesh, India
| | - Anoop Kapoor
- Department of Periodontology and Oral Implantology, Sri Sukhmani Dental College and Hospital, Dera Bassi, Punjab, India
| | - Kanishk Mohanty
- Sai Dental Clinic and Implant Centre, Jalandhar, Punjab, India
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Graziani F, Karapetsa D, Alonso B, Herrera D. Nonsurgical and surgical treatment of periodontitis: how many options for one disease? Periodontol 2000 2018; 75:152-188. [PMID: 28758300 DOI: 10.1111/prd.12201] [Citation(s) in RCA: 235] [Impact Index Per Article: 39.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Treatment of periodontitis aims at preventing further disease progression with the intentions to reduce the risk of tooth loss, minimize symptoms and perception of the disease, possibly restore lost periodontal tissue and provide information on maintaining a healthy periodontium. Therapeutic intervention includes introduction of techniques to change behavior, such as: individually tailored oral-hygiene instructions; a smoking-cessation program; dietary adjustment; subgingival instrumentation to remove plaque and calculus; local and systemic pharmacotherapy; and various types of surgery. No single treatment option has shown superiority, and virtually all types of mechanical periodontal treatment benefit from adjunctive antimicrobial chemotherapy. Periodontal treatment, because of the chronic nature of periodontitis, is a lifelong commitment to intricate oral-hygiene techniques, which, when properly implemented, will minimize the risk of disease initiation and progression.
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12
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Hans VM, Grover HS, Deswal H, Agarwal P. Antimicrobial Efficacy of Various Essential Oils at Varying Concentrations against Periopathogen Porphyromonas gingivalis. J Clin Diagn Res 2016; 10:ZC16-ZC19. [PMID: 27790572 DOI: 10.7860/jcdr/2016/18956.8435] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 06/23/2016] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Porphyromonas gingivalis (P.gingivalis) is a notorious perio-pathogen with the ability to evade host defense mechanism and invade into the periodontal tissues. Many antimicrobial agents have been tested that curb its growth, although these agents tend to produce side effects such as antibiotic resistance and opportunistic infections. Therefore search for naturally occurring anti-microbials with lesser side effects is the need of the hour. AIM The aim of this study was to substantiate the antimicrobial activity of various essential oils; eucalyptus oil, chamomile oil, tea tree oil and turmeric oil against P. gingivalis. MATERIALS AND METHODS Pure cultures of P. gingivalis were grown on selective blood agar. Antimicrobial efficacy of various concentrations of essential oils (0%, 25%, 50% and 100%) was assessed via disc diffusion test. Zone of inhibition were measured around disc after 48 hours in millimeters. RESULTS Zones of inhibition were directly proportional to the concentration of essential oils tested. At 100% concentration all the tested oils possess antimicrobial activity against P.gingivalis with eucalyptus oil being most effective followed by tea tree oil, chamomile oil and turmeric oil. CONCLUSION All essential oils tested were effective against P.gingivalis. After testing for their clinical safety they could be developed into local agents to prevent and treat periodontitis.
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Affiliation(s)
- Veenu Madaan Hans
- Reader, Department of Periodontology, Faculty of Dental Sciences, SGT University , Gurgaon, Delhi-NCR, India
| | - Harpreet Singh Grover
- Professor, Department of Periodontology, Faculty of Dental Sciences, SGT University , Gurgaon, Delhi-NCR, India
| | - Himanshu Deswal
- Post Graduate Student, Department of Periodontology, Faculty of Dental Sciences, SGT University , Gurgaon, Delhi-NCR, India
| | - Preeti Agarwal
- Microbiologist, Department of Microbiology, Faculty of Medicine and Health Sciences, SGT University , Gurgaon, Delhi-NCR, India
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Sundararaj SC, Thomas MV, Peyyala R, Dziubla TD, Puleo DA. Design of a multiple drug delivery system directed at periodontitis. Biomaterials 2013; 34:8835-42. [PMID: 23948165 PMCID: PMC3773615 DOI: 10.1016/j.biomaterials.2013.07.093] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Accepted: 07/26/2013] [Indexed: 02/07/2023]
Abstract
Periodontal disease is highly prevalent, with 90% of the world population affected by either periodontitis or its preceding condition, gingivitis. These conditions are caused by bacterial biofilms on teeth, which stimulate a chronic inflammatory response that leads to loss of alveolar bone and, ultimately, the tooth. Current treatment methods for periodontitis address specific parts of the disease, with no individual treatment serving as a complete therapy. The present research sought to demonstrate development of a multiple drug delivery system for stepwise treatment of different stages of periodontal disease. More specifically, multilayered films were fabricated from an association polymer comprising cellulose acetate phthalate and Pluronic F-127 to achieve sequential release of drugs. The four types of drugs used were metronidazole, ketoprofen, doxycycline, and simvastatin to eliminate infection, inhibit inflammation, prevent tissue destruction, and aid bone regeneration, respectively. Different erosion times and adjustable sequential release profiles were achieved by modifying the number of layers or by inclusion of a slower-eroding polymer layer. Analysis of antibiotic and anti-inflammatory bioactivity showed that drugs released from the devices retained 100% bioactivity. The multilayered CAPP delivery system offers a versatile approach for releasing different drugs based on the pathogenesis of periodontitis and other conditions.
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Affiliation(s)
- Sharath C. Sundararaj
- Department of Biomedical Engineering, University of Kentucky, Lexington, KY 40506-0070, USA
| | - Mark V. Thomas
- College of Dentistry, University of Kentucky, Lexington, KY 40536-0298, USA
| | - Rebecca Peyyala
- College of Dentistry, University of Kentucky, Lexington, KY 40536-0298, USA
| | - Thomas D. Dziubla
- Department of Chemical and Materials Engineering, University of Kentucky, Lexington, KY 40506-0046, USA
| | - David A. Puleo
- Department of Biomedical Engineering, University of Kentucky, Lexington, KY 40506-0070, USA
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Gamal AY, Kumper RM, Al Gendy AERR. Doxycycline-Loaded β-Tricalcium Phosphate Release Following EDTA Root Surface Etching Improved the Clinical Outcomes in Chronic Periodontitis: An In Vivo Study. J Periodontol 2013; 84:924-33. [DOI: 10.1902/jop.2012.120343] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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15
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Herrera D, Matesanz P, Bascones-Martínez A, Sanz M. Local and Systemic Antimicrobial Therapy in Periodontics. J Evid Based Dent Pract 2012; 12:50-60. [DOI: 10.1016/s1532-3382(12)70013-1] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Yan N, Zhang X, Cai Q, Yang X, Zhou X, Wang B, Deng X. The Effects of Lactidyl/Glycolidyl Ratio and Molecular Weight of Poly(D,L -Lactide-co-Glycolide) on the Tetracycline Entrapment and Release Kinetics of Drug-Loaded Nanofibers. JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION 2012; 23:1005-19. [PMID: 21477461 DOI: 10.1163/092050611x568223] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Na Yan
- a Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, Beijing 100081, P. R. China
| | - Xuehui Zhang
- b Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, Beijing 100081, P. R. China
| | - Qing Cai
- c The Key Laboratory of Beijing City on Preparation and Processing of Novel Polymer Materials, Beijing University of Chemical Technology, Beijing 100029, P. R. China
| | - Xiaoping Yang
- d The Key Laboratory of Beijing City on Preparation and Processing of Novel Polymer Materials, Beijing University of Chemical Technology, Beijing 100029, P. R. China
| | - Xuegang Zhou
- e The Key Laboratory of Beijing City on Preparation and Processing of Novel Polymer Materials, Beijing University of Chemical Technology, Beijing 100029, P. R. China
| | - Bo Wang
- f Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, Beijing 100081, P. R. China
| | - Xuliang Deng
- g Department of Geriatric Dentistry, Peking University School and Hospital of Stomatology, Beijing 100081, P. R. China.
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Berakdar M, Callaway A, Eddin MF, Ross A, Willershausen B. Comparison between scaling-root-planing (SRP) and SRP/photodynamic therapy: six-month study. Head Face Med 2012; 8:12. [PMID: 22480188 PMCID: PMC3353176 DOI: 10.1186/1746-160x-8-12] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2012] [Accepted: 04/05/2012] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION The purpose of this long-term clinical study was to examine the additional efficacy of photodynamic therapy (PDT) to scaling and root planing (SRP) in patients with chronic periodontal disease. METHODS A total of 22 patients (mean age: 59.3 ± 11.7 years) with chronic periodontal disease and four teeth with probing depth ≥ 5 mm were enrolled in the study. Inclusion criteria were: no systemic disease, no smoking, no pregnancy and no long-term medication. Beside the anamnesis, the following clinical parameters were assessed at baseline (one week before therapy), and one, three and six months after the therapy: bleeding on probing (BOP), plaque index (PI) probing depth (PD), and clinical attachment loss. All measurements were done by the same examiner with a fixed periodontal probe (PCP 12, Hu-Friedy) at six measurements/tooth. In each patient, two teeth were treated with SRP alone and two teeth with SRP and PDT (Periowave, Ondine Biopharma, Vancouver, Canada). The nonparametric Wilcoxon test for paired samples was used for comparison of the effect of the two treatments (p ≤ 0.05). RESULTS After both types of treatment, the number of teeth positive for BOP declined. At baseline, the CAL measured 7.2 ± 1.2 mm (SRP) or 8.1 ± 1.3 mm (SRP/PDT); one, three and six months after both types of treatment an improvement was observed. At baseline, the probing depth was 5.9 ± 0.8 mm (SRP) or 6.4 ± 0.8 mm (SRP/PDT); after six months, an improvement of 2.4 ± 0.6 mm (SRP) or 2.9 ± 0.8 mm (SRP/PDT) was found. The greater reduction of the PD, achieved by a combination of SRP/PDT, was statistically significant after six months (p = 0.007). CONCLUSION This clinical study demonstrates that SRP in combination with PDT seems to be effective and is therefore suitable as an adjuvant therapy to the mechanical conditioning of the periodontal pockets in patients with chronic periodontal diseases.
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Affiliation(s)
- Mohammad Berakdar
- Department of Operative Dentistry, University Medical Center of the Johannes Gutenberg University Mainz, Germany
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A randomized clinical trial on the clinical and microbiological efficacy of a xanthan gel with chlorhexidine for subgingival use. Clin Oral Investig 2012; 17:55-66. [DOI: 10.1007/s00784-012-0685-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2011] [Accepted: 01/27/2012] [Indexed: 10/28/2022]
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Fernandes LA, Martins TM, Almeida JMD, Nagata MJH, Theodoro LH, Garcia VG, Bosco AF. Experimental periodontal disease treatment by subgingival irrigation with tetracycline hydrochloride in rats. J Appl Oral Sci 2011; 18:635-40. [PMID: 21308297 PMCID: PMC3881757 DOI: 10.1590/s1678-77572010000600017] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2009] [Accepted: 05/21/2010] [Indexed: 11/22/2022] Open
Abstract
Objective The aim of this study was to compare subgingival irrigation with tetracycline
hydrochloride (TTC-HCL) as adjunctive treatment to scaling and root planning (SRP)
on induced periodontitis in rats. Material and methods In 60 rats, periodontal disease was ligature-induced at the mandibular left first
molar. After 7 days, the ligature was removed and all animals were submitted to
SRP, and divided into 2 groups according to the following treatment: C (n=30) -
subgingival irrigation with 1 mL of saline; T (n=30) - subgingival irrigation with
1 mL of TTC-HCL (50 mg/mL). Ten animals in each group were euthanized at 7, 15 and
30 days posttreatment. The histometric values were statistically analyzed
(p<0.05). Results In the histometric analysis, at 7, 15 and 30 days, Group T (0.72±0.05
mm2, 0.57±0.14 mm2, 0.62±0.07 mm2), showed
less bone loss (p<0.05) than Group C (1.35±0.25 mm2; 1.40±0.31
mm2; 1.29±0.27 mm2), respectively. Conclusions Subgingival irrigation with TTC-HCL was an effective adjunctive treatment for
periodontal disease induced in rats.
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Affiliation(s)
- Leandro Araújo Fernandes
- Department of Surgery and Integrated Clinic, Araçatuba Dental School, São Paulo State Universit, Araçatuba, SP, Brazil.
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Sankar V, Hearnden V, Hull K, Juras DV, Greenberg MS, Kerr AR, Lockhart PB, Patton LL, Porter S, Thornhill M. Local drug delivery for oral mucosal diseases: challenges and opportunities. Oral Dis 2011; 17 Suppl 1:73-84. [PMID: 21382140 DOI: 10.1111/j.1601-0825.2011.01793.x] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
There are few topical formulations used for oral medicine applications most of which have been developed for the management of dermatological conditions. As such, numerous obstacles are faced when utilizing these preparations in the oral cavity, namely enzymatic degradation, taste, limited surface area, poor tissue penetration and accidental swallowing. In this review, we discuss common mucosal diseases such as oral cancer, mucositis, vesiculo-erosive conditions, infections, neuropathic pain and salivary dysfunction, which could benefit from topical delivery systems designed specifically for the oral mucosa, which are capable of sustained release. Each condition requires distinct penetration and drug retention profiles in order to optimize treatment and minimize side effects. Local drug delivery may provide a more targeted and efficient drug-delivery option than systemic delivery for diseases of the oral mucosa. We identify those mucosal diseases currently being treated, the challenges that must be overcome and the potential of novel therapies. Novel biological therapies such as macromolecular biological drugs, peptides and gene therapy may be of value in the treatment of many chronic oral conditions and thus in oral medicine if their delivery can be optimized.
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Affiliation(s)
- V Sankar
- Department of Comprehensive Dentistry, The University of Texas Health Science Center at San Antonio, TX, USA
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Chakraborti M, Jackson JK, Plackett D, Brunette DM, Burt HM. Drug intercalation in layered double hydroxide clay: application in the development of a nanocomposite film for guided tissue regeneration. Int J Pharm 2011; 416:305-13. [PMID: 21708236 DOI: 10.1016/j.ijpharm.2011.06.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2011] [Revised: 06/09/2011] [Accepted: 06/12/2011] [Indexed: 10/18/2022]
Abstract
It has been proposed that localized and controlled delivery of alendronate and tetracycline to periodontal pocket fluids via guided tissue regeneration (GTR) membranes may be a valuable adjunctive treatment for advanced periodontitis. The objectives of this work were to develop a co-loaded, controlled release tetracycline and alendronate nanocomposite plasticized poly(lactic-co-glycolic acid) (PLGA) film that would form a suitable matrix supporting osteoblast proliferation and differentiation. Alendronate release was successfully controlled, with complete suppression of the burst phase of release by intercalation of alendronate anions in magnesium/aluminum layered double hydroxide (LDH) clay nanoparticles and dispersed in the PLGA film matrix. Tetracycline, loaded as free drug into the film together with alendronate-LDH clay complex released more rapidly than alendronate, but showed evidence of intercalation in the LDH clay particles. The dual drug loaded nanocomposite films were biocompatible with osteoblasts and after 5 week incubations, significant increase in alkaline phosphatase activity and bone nodule formation were observed.
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Paolantonio M, D'Ercole S, Pilloni A, D'Archivio D, Lisanti L, Graziani F, Femminella B, Sammartino G, Perillo L, Tetè S, Perfetti G, Spoto G, Piccolomini R, Perinetti G. Clinical, Microbiologic, and Biochemical Effects of Subgingival Administration of a Xanthan-Based Chlorhexidine Gel in the Treatment of Periodontitis: A Randomized Multicenter Trial. J Periodontol 2009; 80:1479-92. [DOI: 10.1902/jop.2009.090050] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Carvalho J, Novak MJ, Mota LF. Evaluation of the Effect of Subgingival Placement of Chlorhexidine Chips as an Adjunct to Scaling and Root Planing. J Periodontol 2007; 78:997-1001. [PMID: 17539711 DOI: 10.1902/jop.2007.060122] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The purpose of this 9-month study was to compare the effect of scaling and root planing alone (control) to that of scaling and root planing plus application of chlorhexidine chips (test). METHODS Twenty-six subjects having two non-adjacent sites in non-molar teeth with probing depth > or =5 mm and bleeding on probing participated in this split-mouth trial. At baseline, the patients received full-mouth scaling and root planing followed by placement of chlorhexidine chips secured by cyanoacrylate at test sites and placement of cyanoacrylate alone at control sites. Test sites still > or =5 mm deep at 3 and 6 months were retreated with renewed chlorhexidine chip application. Recordings of bleeding on probing, probing depths, and clinical attachment levels were performed at baseline, after 6 weeks, and after 3, 6, and 9 months. RESULTS Improvements of bleeding scores, probing depths and clinical attachment levels were observed for both test and control sites at 6 weeks compared to baseline. Subsequently, all three measurements remained comparatively stable throughout the study. No differences in improvements were found comparing test and control sites. CONCLUSION This study failed to observe any adjunctive effect of subgingival placement of chlorhexidine chips after scaling and root planing.
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Affiliation(s)
- Juliana Carvalho
- Department of Periodontics, School of Dentistry, Loma Linda University, Loma Linda, CA, USA.
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Ferraz MP, Mateus AY, Sousa JC, Monteiro FJ. Nanohydroxyapatite microspheres as delivery system for antibiotics: Release kinetics, antimicrobial activity, and interaction with osteoblasts. J Biomed Mater Res A 2007; 81:994-1004. [PMID: 17252559 DOI: 10.1002/jbm.a.31151] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Severe periodontitis treatment, where massive alveolar bone loss occurs, involves bone defect filling and intensive systemic log-term antibiotics administration. This study aims at developing novel injectable drug delivery systems (nanohydroxyapatite microspheres) with the drug releasing capability for periodontitis treatment and simultaneously initiating the osteointegration process. Materials were characterized by XRD, SEM, inverted stand optical microscope analysis, and mercury porosimetry method. Amoxicillin, amoxicillin + clavulanic acid, and erythromycin were the antibiotics used. Release properties during 28 days from the hydroxyapatite (HA) granules, and two types of nanoHA microspheres were investigated. Biocompatibility was assessed by cytotoxicity assays. HA granules were inadequate, releasing all antibiotic during the first hours. The concentration of antibiotics released in the first days from HA-2 was higher than from HA-1 microspheres, because of the increased porosity and surface area. The release profiles (fast initial release followed by long-term sustained release) of effective doses of antibiotics make these systems good alternatives for antibiotics delivery. Osteoblasts proliferated well on both types of microspheres, being cell growth enhanced in the presence of antibiotics. Erythromycin presented the most beneficial effect. Combining the sustained antibiotic release with the osteoconduction, resorbability, and potential use as injectable bone filling material of porous HA microspheres, these systems provided a forth fold beneficial effect.
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Affiliation(s)
- M P Ferraz
- INEB-Instituto de Engenharia Biomédica, Laboratório de Biomateriais, Rua do Campo Alegre, 823, 4150-180 Porto, Portugal.
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