Effect of locally administered novel biodegradable chitosan based risedronate/zinc-hydroxyapatite intra-pocket dental film on alveolar bone density in rat model of periodontitis

A five-in-one novel MOF-modified injectable hydrogel with thermo-sensitive and adhesive properties for promoting alveolar bone repair in periodontitis: Antibacterial, hemostasis, immune reprogramming, pro-osteo-/angiogenesis and recruitment

Periodontitis is a chronic inflammatory disease caused by plaque that destroys the alveolar bone tissues, resulting in tooth loss. Poor eradication of pathogenic microorganisms, persistent malignant inflammation and impaired osteo-/angiogenesis are currently the primary challenges to control disease progression and rebuild damaged alveolar bone. However, existing treatments for periodontitis fail to comprehensively address these issues. Herein, an injectable composite hydrogel (SFD/CS/ZIF-8@QCT) encapsulating quercetin-modified zeolitic imidazolate framework-8 (ZIF-8@QCT) is developed. This hydrogel possesses thermo-sensitive and adhesive properties, which can provide excellent flowability and post-injection stability, resist oral fluid washout as well as achieve effective tissue adhesion. Inspirationally, it is observed that SFD/CS/ZIF-8@QCT exhibits a rapid localized hemostatic effect following implantation, and then by virtue of the sustained release of zinc ions and quercetin exerts excellent collective functions including antibacterial, immunomodulation, pro-osteo-/angiogenesis and pro-recruitment, ultimately facilitating excellent alveolar bone regeneration. Notably, our study also demonstrates that the inhibition of osteo-/angiogenesis of PDLSCs under the periodontitis is due to the strong inhibition of energy metabolism as well as the powerful activation of oxidative stress and autophagy, whereas the synergistic effects of quercetin and zinc ions released by SFD/CS/ZIF-8@QCT are effective in reversing these biological processes. Overall, our study presents innovative insights into the advancement of biomaterials to regenerate alveolar bone in periodontitis.

The association between diets and periodontitis: a bidirectional two-sample Mendelian randomization study

Background

Periodontitis, a complex inflammatory condition, has been associated with dietary habits and antioxidants. While the association between certain dietary patterns and periodontitis has been documented, the bidirectional relationship remains unclear. This study utilizes Mendelian randomization (MR) analysis to investigate the bidirectional associations between dietary factors comprising dietary antioxidants, and periodontitis.

Methods

Employing a two-sample MR approach, this study analyzed genome-wide association study (GWAS) data on diets and periodontitis from large databases and published literature. Instrumental variables (IVs) were selected and filtered based on genetic variants associated with dietary factors and periodontitis, respectively. Various MR methods, including Inverse Variance Weighted, MR-Egger, Weighted Median, Weighted Mode, and Simple Mode were applied to assess the bidirectional associations. Sensitivity analyses were conducted to validate the robustness of the findings.

Results

Our analysis revealed significant associations between certain dietary factors and the risk of periodontitis. Specifically, higher intake of filtered coffee, low-calorie drinks, and other cereals, as well as increased metabolic circulating levels of gamma-tocopherol, were associated with an elevated risk of periodontitis. Conversely, consumption of cheese, white rice, chocolate bars, unsalted peanuts, and higher absolute circulating levels of vitamin C were linked to a reduced risk. Additionally, the study suggests that periodontitis may influence dietary habits, indicating a bidirectional relationship.

Conclusion

This study provides additional evidence of a bidirectional association between dietary factors and periodontitis. It highlights the importance of dietary interventions in the prevention and management of periodontitis. The findings underscore the need for incorporating dietary counseling into periodontal disease management protocols and suggest the potential of personalized dietary strategies for periodontitis patients. Further research is warranted to explore the mechanisms underlying these associations and to confirm these findings in diverse populations.

Chitosan nanoparticle applications in dentistry: a sustainable biopolymer

The epoch of Nano-biomaterials and their application in the field of medicine and dentistry has been long-lived. The application of nanotechnology is extensively used in diagnosis and treatment aspects of oral diseases. The nanomaterials and its structures are being widely involved in the production of medicines and drugs used for the treatment of oral diseases like periodontitis, oral carcinoma, etc. and helps in maintaining the longevity of oral health. Chitosan is a naturally occurring biopolymer derived from chitin which is seen commonly in arthropods. Chitosan nanoparticles are the latest in the trend of nanoparticles used in dentistry and are becoming the most wanted biopolymer for use toward therapeutic interventions. Literature search has also shown that chitosan nanoparticles have anti-tumor effects. This review highlights the various aspects of chitosan nanoparticles and their implications in dentistry.

Cemental and alveolar bone defects after chronic exposure to amoxicillin in rats (histopathologic and radiographic study)

OBJECTIVES

This study aimed to shed new light on the potential detrimental effects on cementum and adjacent alveolar bone after chronic exposure to amoxicillin.

METHODS

Six pregnant adult Albino rats were equally divided into two groups. Saline solution and amoxicillin (100 mg/Kg) were given to rats of control and amoxicillin group, respectively from the 13th to the 21st day of pregnancy. The same treatment was given to the pups till the 42nd day. The cementum of the first molar teeth and the surrounding alveolar bone were examined qualitatively by histopathological and scanning electron microscope, and quantitatively by energy dispersive X-ray spectroscopy and cone beam computed tomography.

RESULTS

Amoxicillin group depicted cemental and alveolar bone defects along with resorption lacunae. Statistically significant decreases in calcium and calcium/phosphorus ratio in cementum and in calcium only in alveolar bone were evident (p ≤ 0.05). Overall cementum and alveolar bone densities also showed statistically significant decreases (p ≤ 0.05).

CONCLUSION

Chronic amoxicillin administration displayed destructive effects on cementum and the surrounding alveolar bone which may disturb tooth attachment integrity. Therefore, it is recommended to minimize its haphazard usage during pregnancy and early childhood.

An injectable photopolymerizable chitosan hydrogel doped anti-inflammatory peptide for long-lasting periodontal pocket delivery and periodontitis therapy

Periodontitis is a common chronic inflammatory disease caused by plaque that leads to alveolar bone resorption and tooth loss. Inflammation control and achieving better tissue repair are the key to periodontitis treatment. In this study, human β-Defensin 1 short motif Pep-B with inflammation inhibition and differentiation regulation properties, is firstly used in the treatment of periodontitis, and an injectable photopolymerizable Pep-B/chitosan methacryloyl composite hydrogel (CMSA/Pep-B) is constructed. We confirm that Pep-B improves inflammation, and restores osteogenic behavior and function of injured stem cells. CMSA/Pep-B has good injectability, fluidity and photopolymerizability, and can sustainably release Pep-B to maintain drug concentration in periodontal pockets. Furthermore, animal experiments showed that CMSA/Pep-B significantly ameliorated the inflammation of the periodontium and reduced the alveolar bone loss by decreasing inflammatory infiltration, osteoclast formation and collagen destruction. In conclusion, CMSA/Pep-B is envisaged to be a novel bioactive material or therapeutic drug for treating periodontitis.

Risedronate-loaded aerogel scaffolds for bone regeneration

Sugarcane bagasse-derived nanofibrillated cellulose (NFC), a type of cellulose with a fibrous structure, is potentially used in the pharmaceutical field. Regeneration of this cellulose using a green process offers a more accessible and less ordered cellulose II structure (amorphous cellulose; AmC). Furthermore, the preparation of cross-linked cellulose (NFC/AmC) provides a dual advantage by building a structural block that could exhibit distinct mechanical properties. 3D aerogel scaffolds loaded with risedronate were prepared in our study using NFC or cross-linked cellulose (NFC/AmC), then combined with different concentrations of chitosan. Results proved that the aerogel scaffolds composed of NFC and chitosan had significantly improved the mechanical properties and retarded drug release compared to all other fabricated aerogel scaffolds. The aerogel scaffolds containing the highest concentration of chitosan (SC-T3) attained the highest compressive strength and mean release time values (415 ± 41.80 kPa and 2.61 ± 0.23 h, respectively). Scanning electron microscope images proved the uniform highly porous microstructure of SC-T3 with interconnectedness. All the tested medicated as well as unmedicated aerogel scaffolds had the ability to regenerate bone as assessed using the MG-63 cell line, with the former attaining a higher effect than the latter. However, SC-T3 aerogel scaffolds possessed a lower regenerative effect than those composed of NFC only. This study highlights the promising approach of the use of biopolymers derived from agro-wastes for tissue engineering.

The changes and potential effects of zinc homeostasis in periodontitis microenvironment

Zinc is a very important and ubiquitous element, which is present in oral environment, daily diet, oral health products, dental restorative materials, and so on. However, there is a lack of attention to the role of both extracellular or intracellular zinc in the progression of periodontitis and periodontal regeneration. This review summarizes the characteristics of immunological microenvironment and host cells function in several key stages of periodontitis progression, and explores the regulatory effect of zinc during this process. We find multiple evidence indicate that zinc may be involved and play a key role in the stages of immune defense, inflammatory response and bone remodeling. Zinc supplementation in an appropriate dose range or regulation of zinc transport proteins can promote periodontal regeneration by either enhancing immune defense or up-regulating local cells proliferation and differentiation functions. Therefore, zinc homeostasis is essential in periodontal remodeling and regeneration. More attention is suggested to be focused on zinc homeostasis regulation and consider it as a potential strategy in the studies on periodontitis treatment, periodontal-guided tissue regeneration, implant material transformation, and so on.

Dissolving microneedle transdermal patch loaded with Risedronate sodium and Ursolic acid bipartite nanotransfersomes to combat osteoporosis: Optimization, characterization, in vitro and ex vivo assessment

Osteoporosis is a fatal bone-wearing malady and a substantial reason behind the impermanence of human life and economic burden. Risedronate Sodium along with Ursolic acid has been studied to ameliorate osteoporosis. To bypass problems associated with bioavailability, we have developed a microneedle transdermal patch loaded with optimized formulation nanotransfersomes. It was optimized using three factor, three-level Central composite design with independent variables namely, the concentration of phospholipid, surfactant, and sonication time on dependent variables (vesicle size, entrapment efficiency and Polydispersity index). Vesicles of size 271.9 ± 8.45 nm with PDI 0.184 ± 0.01, having entrapment efficiency of 86.12 ± 5.20% and 85.65 ± 4.88% for RIS and UA respectively were observed. In vitro release study showed the sustained release pattern with 78.16 ± 1.12% and 75.72 ± 1.01% release of RIS and UA respectively. Dissolving MN patch prepared from gelatin was found to have good strength and folding endurance with uniform drug content (98.68 ± 0.004%). Ex vivo permeation study revealed that up to 80% of the drug can be permeated within 24 h. CLSM analysis was also performed to show penetration of RU-NTRs. From the results obtained, we can conclude that dissolving MN patch loaded with RU-NTRs has great potential than its conventional counterpart.

Can locally applied risedronate be an effective agent when combined with xenografts? An animal study

BACKGROUND

To examine the effects of local risedronate application with xenografts on healing of rabbit skull defects using histological, histomorphometric, immunohistochemical, and three-dimensional radiological methods.

METHODS

Two critical-sized defects with a diameter of 10 mm were created in 16 rabbits and filled with xenogenic bone graft and xenogenic bone graft + 5 mg risedronate in the control I and risedronate (RIS) groups, respectively. Residual graft, new bone, soft tissue areas, and bone volume were evaluated in the 4- and 8-week study groups.

RESULTS

In both the 4- and 8-week samples, the RIS group samples had significantly higher mean new bone area values than the C group (p < 0.05). In both groups, the values for the new bone area were significantly higher in the 8-week-old samples than in the 4-week-old samples (p < 0.05). The h scores obtained for sialoprotein and osteopontin did not differ significantly between the groups at either time point (p > 0.05). The results of radiological evaluation showed that the bone density value was significantly higher in the C group than in the RIS group at either time point (p < 0.05).

CONCLUSIONS

Although this study aimed to demonstrate the effect of risedronate on the osteoconductive properties of xenografts when applied locally, targeted results could not be achieved.

Effects of a locally administered risedronate/autogenous bone graft combination on bone healing in a critical-size rabbit defect model

BACKGROUND

Risedronate is a bisphosphonate with poor oral absorption. An extremely hydrophilic molecule that has a high affinity for bone, risedronate also inhibits the farnesyl diphosphate synthase enzyme, inhibiting osteoclastic activity and reducing bone turnover and resorption. Autogenous bone grafts contain osteogenic cells and osteoinductive factors that are essential for bone regeneration and are therefore considered the gold standard. Thus, this study aimed to investigate the impact of local risedronate administered with autogenous bone grafts on the healing of defects in rabbit skulls using histological, histomorphometric, immunohistochemical, and three-dimensional radiological methods.

METHODS

Two 10-mm-diameter critical-size defects were created in 16 rabbits and filled with autogenous bone graft and autogenous bone graft + 5 mg risedronate in the control (C) and risedronate (RIS) groups, respectively. Residual graft, new bone, soft tissue areas, and bone volume were evaluated in the 4- and 8-week study groups.

RESULTS

There were no statistically significant differences in bone graft, new bone, or soft tissue area between the groups at 4 weeks (p > 0.05). At 8 weeks, the new bone area was significantly higher in the RIS group than in the C group (p < 0.05). The h scores obtained from sialoprotein and osteopontin did not differ significantly between the groups (p > 0.05). The radiologically measured total bone volume was significantly higher in the RIS group than in the C group at both time points (p < 0.05).

CONCLUSIONS

In this study, risedronate enhanced the osteoconductive properties of autogenous bone grafts and rapidly created better-quality bone. This could improve future patient outcomes.

Recent Trends in Hydroxyapatite Supplementation for Osteoregenerative Purposes

Bone regeneration has gained attention in the biomedical field, which has led to the development of materials and synthesis methods meant to improve osseointegration and cellular bone activity. The properties of hydroxyapatite, a type of calcium phosphate, have been researched to determine its advantages for bone tissue engineering, particularly its biocompatibility and ability to interact with bone cells. Recently, the advantages of utilizing nanomolecules of hydroxyapatite, combined with various substances, in order to enhance and combine their characteristics, have been reported in the literature. This review will outline the cellular and molecular roles of hydroxypatite, its interactions with bone cells, and its nano-combinations with various ions and natural products and their effects on bone growth, development, and bone repair.

PVA/Chitosan Thin Films Containing Silver Nanoparticles and Ibuprofen for the Treatment of Periodontal Disease

Local delivery of drugs or antimicrobial agents is a suitable approach in the management of periodontitis when the infection is localized deep in the pockets and does not adequately respond to mechanical debridement and/or systemic antibiotic treatment. In this context, the objective of this study was to prepare new biocomposite films with antimicrobial, anti-inflammatory, and good mechanical properties to be applied in periodontal pockets. The composite film is eco-friendly synthesized from poly(vinyl alcohol) (PVA) cross-linked with oxidized chitosan (OxCS). Silver nanoparticles (AgNps) were inserted during film synthesis by adding freshly chitosan-capped AgNps colloidal solution to the polymer mixture; the addition of AgNps up to 1.44 wt.% improves the physico-chemical properties of the film. The characterization of the films was performed by FT-IR, atomic mass spectrometry, X-ray spectroscopy, and SEM. The films displayed a high swelling ratio (162%), suitable strength (1.46 MPa), and excellent mucoadhesive properties (0.6 N). Then, ibuprofen (IBF) was incorporated within the best film formulation, and the IBF-loaded PVA/OxCS-Ag films could deliver the drug in a sustained manner up to 72 h. The biocomposite films have good antimicrobial properties against representative pathogens for oral cavities. Moreover, the films are biocompatible, as demonstrated by in vitro tests on HDFa cell lines.

Estradiol and zinc-doped nano hydroxyapatite as therapeutic agents in the prevention of osteoporosis; oxidative stress status, inflammation, bone turnover, bone mineral density, and histological alterations in ovariectomized rats

Osteoporosis (OP) is a serious health problem, and the most popular therapeutic strategy for OP is hormone replacement (estrogen); however, it increases the risk of reproductive cancers. Hydroxyapatite (HA) nanoparticles have a similar chemical structure to the bone mineral component and can be used as a new remedy for OP. This study was designed to investigate the osteoporosis-protective potential of nano zinc hydroxyapatite (ZnHA-NPs) and/or estradiol (E2) combined therapy. A total of 35 adult female rats were assigned into five groups (n = 7): 1) control group; 2) ovariectomized group (OVX); 3) OVX received oral estradiol replacement therapy (OVX/E2); 4) OVX received ZnHA replacement therapy (OVX/ZnHA); and 5) OVX received both estradiol and ZnHA-NPs combined therapy (OVX/E2+ZnHA). After 3 months of treatment, serum bone markers and estrogen level, oxidative/antioxidant, and inflammatory cytokines were determined. Additionally, femoral expression of estrogen receptors alpha and beta (ESR1; ESR2), receptor activator of nuclear factor-kappa B (RANKL) ligand, osteoprotegerin (OPG), bone mineral density (BMD), histological alterations, and immunohistochemical expression of vascular endothelial growth factor (VEGF) and proliferating cell nuclear antigen (PCNA) were assessed. ALP, PINP, Ca, and P concentrations improved significantly (p < 0.05) in all treatment groups, especially in the OVX/E + ZnHA group. MDA and NO were higher in OVX rats, while SOD activity and GSH were lower (p < 0.05). E2 alone or with ZnHA-NPs restored the estimated antioxidant molecules and cytokines toward normal levels in OVX rats (p < 0.05). On the other hand, E2 and ZnHA increased OPG and OC expression in femurs while decreasing ESR1, ESR2, and NF-kB expression (p < 0.05). The combination treatment was superior in the restoration of normal femoral histoarchitecture and both cortical and trabecular BMD (p < 0.05). Overall, the combined therapy of OVX/E2+ZnHA was more effective than the individual treatments in attenuating excessive bone turnover and preventing osteoporosis.

Gradual Drug Release Membranes and Films Used for the Treatment of Periodontal Disease

Periodontitis is an inflammatory disease that, if not treated, can cause a lot of harm to the oral cavity, to the patients' quality of life, and to the entire community. There is no predictable standardized treatment for periodontitis, but there have been many attempts, using antibiotics, tissue regeneration techniques, dental scaling, or root planning. Due to the limits of the above-mentioned treatment, the future seems to be local drug delivery systems, which could gradually release antibiotics and tissue regeneration inducers at the same time. Local gradual release of antibiotics proved to be more efficient than systemic administration. In this review, we have made a literature search to identify the articles related to this topic and to find out which carriers have been tested for drug release as an adjuvant in the treatment of periodontitis. Considering the inclusion and exclusion criteria, 12 articles were chosen to be part of this review. The selected articles indicated that the drug-releasing carriers in periodontitis treatment were membranes and films fabricated from different types of materials and through various methods. Some of the drugs released by the films and membranes in the selected articles include doxycycline, tetracycline, metronidazole, levofloxacin, and minocycline, all used with good outcome regarding their bactericide effect; BMP-2, Zinc-hydroxyapatite nanoparticles with regenerative effect. The conclusion derived from the selected studies was that gradual drug release in the periodontal pockets is a promising strategy as an adjuvant for the treatment of periodontal disease.

The association of healthy eating index with periodontitis in NHANES 2013-2014

Background

Periodontal disease is very common worldwide and is one of the main causes of tooth loss in adults. Periodontal disease is characterized by chronic inflammation that can destroy adjacent alveolar bone and lead to a loss of periodontal ligaments. Although previous studies have found that a daily diet can influence the development of periodontal disease (e.g., a diet low in carbohydrates and rich in vitamins C and D and fiber can have a protective effect). Periodontal disease may present as gingivitis or periodontitis. However, studies on the role of healthy eating index in periodontitis are lacking. The purpose of this study was to assess the association between healthy eating index and periodontitis.

Methods

We analyzed data collected from participants in the National Health and Nutrition Examination Survey (NHANES), a nationally representative survey conducted in 2-year cycles from 2013 to 2014. As part of our analysis, we developed multivariate logistic regression models to examine the independent association between the healthy eating index and periodontitis. We evaluated the significance of association using odds ratios (OR) with 95% confidence intervals (95%CI).

Results

Individuals with a lower total healthy eating index had a higher prevalence of periodontitis. Adjusted multivariate regression models showed that a higher healthy diet index was associated with a lower prevalence of periodontitis (OR = 0.69, 95% CI: 0.55-0.86, P < 0.05).

Conclusion

The results of the study showed that dietary structure was associated with the prevalence of periodontitis. Patients with a higher healthy eating index had a lower prevalence of periodontitis. These findings will need to be confirmed by longitudinal, prospective studies in the future.

Bone Density around Titanium Dental Implants Coating Tested/Coated with Chitosan or Melatonin: An Evaluation via Microtomography in Jaws of Beagle Dogs

Peri-implant bone density plays an important role in the osseointegration of dental implants. The aim of the study was to evaluate via micro-CT, in Hounsfield units, the bone density around dental implants coated with chitosan and melatonin and to compare it with the bone density around implants with a conventional etched surface after 12 weeks of immediate post-extraction placement in the jaws of Beagle dogs. Six dogs were used, and 48 implants were randomly placed: three groups—melatonin, chitosan, and control. Seven 10 mm × 10 mm regions of interest were defined in each implant (2 in the crestal zone, 4 in the medial zone, and 1 in the apical zone). A total of 336 sites were studied with the AMIDE tool, using the Norton and Gamble classification to assess bone density. The effect on bone density of surface coating variables (chitosan, melatonin, and control) at the crestal, medial, and apical sites and the implant positions (P2, P3, P4, and M1) was analyzed at bivariate and multivariate levels (linear regression). Adjusted effects on bone density did not indicate statistical significance for surface coatings (p = 0.653) but did for different levels of ROIs (p < 0.001) and for positions of the implants (p = 0.032). Micro-CT, with appropriate software, proved to be a powerful tool for measuring osseointegration.

Dental Applications of Systems Based on Hydroxyapatite Nanoparticles—An Evidence-Based Update

Hydroxyapatite is one of the most studied biomaterials in the medical and dental field, because of its biocompatibility; it is the main constituent of the mineral part of teeth and bones. In dental science, hydroxyapatite nanoparticles (HAnps) or nano-hydroxyapatite (nano-HA) have been studied, over the last decade, in terms of oral implantology and bone reconstruction, as well in restorative and preventive dentistry. Hydroxyapatite nanoparticles have significant remineralizing effects on initial enamel lesions, and they have also been used as an additive material in order to improve existing and widely used dental materials, mainly in preventive fields, but also in restorative and regenerative fields. This paper investigates the role of HAnps in dentistry, including recent advances in the field of its use, as well as their advantages of using it as a component in other dental materials, whether experimental or commercially available. Based on the literature, HAnps have outstanding physical, chemical, mechanical and biological properties that make them suitable for multiple interventions, in different domains of dental science. Further well-designed randomized controlled trials should be conducted in order to confirm all the achievements revealed by the in vitro or in vivo studies published until now.

Effectiveness of Nanohydroxyapatite on Demineralization of Enamel and Cementum Surrounding Margin of Yttria-Stabilized Zirconia Polycrystalline Ceramic Restoration

Introduction

Prosthetic dentistry has shifted toward prevention of caries occurrence surrounding restorative margin through the anti-demineralization process. This study examines the ability of nanohydroxyapatite (NHA) gel and Clinpro (CP) on enhancing resistance to demineralization of enamel and cementum at margin of restoration.

Materials and Methods

Thirty extracted mandibular third molars were segregated at 1 mm above and below cementoenamel junction (CEJ) to separate CEJ portions and substituted with zirconia disks by bonding to crown and root portions with resin adhesive. The enamel and cementum area of 4 × 4 mm² neighboring zirconia was applied with either NHA or CP, while one group was left no treatment (NT) before demineralized with carbopal. Vickers hardness (VHN) of enamel and cementum was evaluated before material application (B_M), after material application (A_M), and after demineralization (A_D). Analysis of variance (ANOVA) and post hoc multiple comparisons were used to justify for the significant difference (α = 0.05). Scanning electron microscopy (SEM) and X-ray diffraction (XRD) were determined for surface evaluations.

Results

The mean ± SD of VHN for B_M, A_M, and A_D for enamel and cementum was 393.24 ± 26.27, 392.89 ± 17.22, 155.00 ± 5.68 and 69.89 ± 4.59, 66.28 ± 3.61, 18.13 ± 0.54 for NT groups, respectively, 390.10 ± 17.69, 406.77 ± 12.86, 181.55 ± 7.99 and 56.01 ± 9.26, 62.71 ± 6.15, 19.09 ± 1.16 for NHA groups, respectively, and 387.90 ± 18.07, 405.91 ± 9.83, 188.95 ± 7.43 and 54.68 ± 7.30, 61.81 ± 4.30, 19.22 ± 1.25 for CP groups, respectively. ANOVA indicated a significant increase in anti-demineralization of enamel and cementum upon application of NHA or CP (p < 0.05). Multiple comparisons indicated the capability in inducing surface strengthening to resist demineralization for enamel and cementum of NHA which was comparable to CP (p > 0.05) as evidenced by SEM and XRD data indicating NHA and CP deposition and crystallinity accumulation.

Conclusion

NHA and CP were capable of enhancing anti-demineralization for enamel and cementum. The capability in resisting the demineralization process of NHA was comparable with CP. NHA was highly recommended for anti-demineralization for enamel and cementum surrounding restorative margin.

Functional Chitosan-based Materials for Biological Applications

Background:

Bio-based materials, as the plentiful and renewable resources for natural constituents which are essential for biomedical and pharmaceutical applications, have not been exploited adequately yet. Chitosan is a naturally occurring polysaccharide obtained from chitin, which has recently attracted widespread attention owing to its excellent activity. This review shows the methods of extraction and modification of chitosan and provides recent progress of synthesis and use of chitosan-based materials in biological applications.

Methods:

By consulting the research literature of the last decade, the recent progresses of functional chitosan-based materials for biological applications were summarized and divided into the methods of extraction chitosan, the chemical modification of chitosan, chitosan-based materials for biological applications were described and discussed.

Results:

Chemical modification of chitosan broadens its applications, leading to developing numerous forms of chitosan-based materials with excellent properties. The excellent bioactivity of chitosan-based material enables it serves potential applications in biomedical fields.

Conclusion:

Chitosan-based materials not only exhibit the excellent activities of chitosan but also show other appealing performance of combined materials, even give the good synergistic properties of chitosan and its composite materials. Further studies are needed to define the ideal physicochemical properties of chitosan for each type of biomedical applications. The development of various functional chitosan-based materials for biological applications will be an important field of research, and this kind of material has important commercial value.

Emerging Nanotechnology in Non-Surgical Periodontal Therapy in Animal Models: A Systematic Review

Periodontitis is one of the most prevalent inflammatory diseases. Its treatment, mostly mechanical and non-surgical, shows limitations. The aim of this systematic review was to investigate the effect of nanoparticles as a treatment alone in non-surgical periodontal therapy in animal models. A systematic search was conducted in Medline/PubMed, Web of Science, The Cochrane Library and Science Direct. The eligibility criteria were: studies (i) using nanoparticles as chemotherapeutic agent or as delivery system; (ii) including preclinical controlled animal model (experimental periodontitis); (iii) reporting alveolar bone loss; (iv) written in English; and (v) published up to June 2019. Risk of bias was evaluated according to the SYstematic Review Centre for Laboratory Animal Experimentation. On the 1324 eligible studies, 11 were included. All reported advantages in using nanoparticles for the treatment of periodontitis, highlighted by a reduction in bone loss. Agents modulating inflammation seem to be more relevant than antibiotics, in terms of efficiency and risk of antibiotic resistance. In addition, poly(lactic-co-glycolic acid) or drugs used as their own carrier appear to be the most interesting nanoparticles in terms of biocompatibility. Risk of bias assessment highlighted many criteria scored as unclear. There are encouraging preclinical data of using nanoparticles as a contribution to the treatment of periodontitis.

Applications of nano-materials in diverse dentistry regimes

Research and development in the applied sciences at the atomic or molecular level is the order of the day under the domain of nanotechnology or nano-science with enormous influence on nearly all areas of human health and activities comprising diverse medical fields such as pharmacological studies, clinical diagnoses, and supplementary immune system. The field of nano-dentistry has emerged due to the assorted dental applications of nano-technology. This review provides a brief introduction to the general nanotechnology field and a comprehensive overview of the synthesis features and dental uses of nano-materials including current innovations and future expectations with general comments on the latest advancements in the mechanisms and the most significant toxicological dimensions.

Zinc Adequacy Is Essential for the Maintenance of Optimal Oral Health

Zinc, a metal found in the Earth's crust, is indispensable for human health. In the human body, around 60% of zinc is present in muscles, 30% in bones, and the remaining 10% in skin, hair, pancreas, kidneys and plasma. An adequate zinc balance is essential for the maintenance of skeletal growth, development and function. It is also necessary for basic cellular functions including enzyme activation, cell signaling and energy metabolism. Inadequate zinc status is associated with a wide variety of systemic disorders including cardiovascular impairment, musculoskeletal dysfunctions and oromaxillary diseases. In this article, we briefly discuss the role of zinc deficiency in the genesis of various oromaxillary diseases, and explain why adequate zinc homeostasis is vital for the maintenance of oral and general health.

Development of nanotechnology for advancement and application in wound healing: a review

Wound healing is a series of different dynamic and complex phenomena. Many studies have been carried out based on the type and severity of wounds. However, to recover wounds faster there are no suitable drugs available, which are highly stable, less expensive as well as has no side effects. Nanomaterials have been proven to be the most promising agent for faster wound healing among all the other wound healing materials. This review briefly discusses the recent developments of wound healing by nanotechnology, their applicability and advantages. Nanomaterials have unique physicochemical, optical, and biological properties. Some of them can be directly applied for wound healing or some of them can be incorporated into scaffolds to create hydrogel matrix or nanocomposites, which promote wound healing through their antimicrobial, as well as selective anti- and pro-inflammatory, and proangiogenic properties. Owing to their high surface area to volume ratio, nanomaterials have not only been used for drug delivery vectors but also can affect wound healing by influencing collagen deposition and realignment and provide approaches for skin tissue regeneration.

Anionic versus cationic bilosomes as oral nanocarriers for enhanced delivery of the hydrophilic drug risedronate

Albeit its well known potency as a postmenopausal osteoporosis treatment, Risedronate suffers from poor oral bioavailability and high oral toxicity. This is the first work to assess the potential of bilosomes to address challenges of RS oral delivery. Furthermore, impact of integrating cationic moiety into bilosomes on intestinal digestability and toxicity of RS nanovesicles was first investigated in this article. Prepared formulations were optimized based on physicochemical properties, digestibility, intestinal permeation and local toxicity studies. Optimized preparations were prepared by reversed phase evaporation technique with three extrusion cycles and loaded by 10 mg/ml RS. Molar lipid to bile salt to cholesterol ratio was adjusted to 4:1:1 at pH 5. Addition of cholesterol had significantly improved bilosomes stability to digestive media. Results also revealed that permeation of anionic vesicles increased permeation by 1.5 times more than RS solution and reduced drug toxicity by 2 folds. On the other hand, Cationic bilosomes showed good stability in GIT fluids but their induced oral toxicity could limit their use. In conclusion, bilosomes are superior over liposomes regarding protection of delivery system from the damaging effect of external in digestive bile salts. In addition, it decreases toxicity issues of orally administered drugs.

Chitin/Chitosan: Versatile Ecological, Industrial, and Biomedical Applications

Chitin is a linear polysaccharide of N-acetylglucosamine, which is highly abundant in nature and mainly produced by marine crustaceans. Chitosan is obtained by hydrolytic deacetylation. Both polysaccharides are renewable resources, simply and cost-effectively extracted from waste material of fish industry, mainly crab and shrimp shells. Research over the past five decades has revealed that chitosan, in particular, possesses unique and useful characteristics such as chemical versatility, polyelectrolyte properties, gel- and film-forming ability, high adsorption capacity, antimicrobial and antioxidative properties, low toxicity, and biocompatibility and biodegradability features. A plethora of chemical chitosan derivatives have been synthesized yielding improved materials with suggested or effective applications in water treatment, biosensor engineering, agriculture, food processing and storage, textile additives, cosmetics fabrication, and in veterinary and human medicine. The number of studies in this research field has exploded particularly during the last two decades. Here, we review recent advances in utilizing chitosan and chitosan derivatives in different technical, agricultural, and biomedical fields.

A review of using green chemistry methods for biomaterials in tissue engineering

Although environmentally safe, or green, technologies have revolutionized other fields (such as consumables, automobiles, etc.), its use in biomaterials is still at its infancy. However, in the few cases in which safe manufacturing technology and materials have been implemented to prevent postpollution and reduce the consumption of synthesized scaffold (such as bone, cartilage, blood cell, nerve, skin, and muscle) has had a significant impact on different applications of tissue engineering. In the present research, we report the use of biological materials as templates for preparing different kinds of tissues and the application of safe green methods in tissue engineering technology. These include green methods for bone and tissue engineering-based biomaterials, which have received the greatest amount of citations in recent years. Thoughts on what is needed for this field to grow are also critically included. In this paper, the impending applications of safe, ecofriendly materials and green methods in tissue engineering have been detailed.

The possibility of healing alveolar bone defects with simvastatin thermosensitive gel: in vitro/in vivo evaluation

Background

In this study, simvastatin (SVT) in situ gels were successfully produced by our group.

Methods

The preparations were characterized in the following aspects: in vitro gelation, drug release, stability and pharmacodynamics.

Results

In this study, drug content of prepared gels was found to be in the range between 89 and 92%. The pH value was in the range between 6.5 and 7.0. The gelation temperature of the prepared thermogelling solutions was 37°C. In vitro release showed that the release of SVT from in situ gels was slow with burst effects at an early stage. Researches indicated that intraorally slow release SVT in situ gels could effectively promote bone regeneration repair of alveolar bone defect.

Conclusion

This drug delivery system could prove to be a novel form able to prolong the residence time and to control the release of drug when administered into the oral cavity.

Remineralization potential of nano-hydroxyapatite on enamel and cementum surrounding margin of computer-aided design and computer-aided manufacturing ceramic restoration

Objective

This study investigates the effects of nano-hydroxyapatite (NHA) gel and Clinpro (CP) on remineralization potential of enamel and cementum at the cavosurface area of computer-aided design and computer-aided manufacturing ceramic restoration.

Materials and methods

Thirty extracted human mandibular third molars were sectioned at 1 mm above and below the cemento-enamel junction to remove the cemento-enamel junction portions and replaced them with zirconia ceramic disks by bonding them to the crown and root portions with resin cement. The enamel and cementum with an area of 4×4 mm² surrounding the ceramic disk was demineralized with carbopol. The demineralized surfaces were treated with either NHA or CP, while 1 group was left with no treatment. Vickers microhardness of enamel and cementum were determined before demineralization, after demineralization, and after remineralization. Analysis of variance and Tukey multiple comparisons were used to determine statistically significant differences at 95% level of confidence. Scanning electron microscopy and X-ray diffraction were used to evaluate for surface alterations.

Results

The mean ± SD of Vickers microhardness for before demineralization, after demineralization, and after remineralization for enamel and cementum were 377.37±22.99, 161.95±10.54, 161.70±5.92 and 60.37±3.81, 17.65±0.91, 17.04±1.00 for the no treatment group; 378.20±18.76, 160.72±8.38, 200.08±8.29 and 62.58±3.37, 18.38±1.33, 27.99±2.68 for the NHA groups; and 380.53±25.14, 161.94±5.66, 193.16±7.54 and 62.78±4.75, 19.07±1.30, 24.46±2.02 for the CP groups. Analysis of variance indicated significant increase in microhardness of demineralized enamel and cementum upon the application of either NHA or CP (p<0.05). Post hoc multiple comparisons indicated significantly higher remineralization capability of NHA for both enamel and cementum than CP (p<0.05), as evidenced by scanning electron microscopy, indicating NHA particle deposition in the area of remineralization, and crystallinity accumulation, as indicated by X-ray diffraction.

Conclusion

NHA gel and CP were capable of remineralization of the enamel and cementum. NHA was more capable in the remineralization process than CP. NHA was extremely capable in the remineralization process for enamel and cementum surrounding the margin of the computer-aided design and computer-aided manufacturing ceramic.

The Anatomical Nature of Dental Paresthesia: A Quick Review

Dental paresthesia is loss of sensation caused by maxillary or mandibular anesthetic administration before dental treatment. This review examines inferior alveolar block paresthesia symptoms, side effect and complications. Understanding the anatomy of the pterygomandibular fossa will help in understanding the nature and causes of the dental paresthesia. In this review, we review the anatomy of the region surrounding inferior alveolar injections, anesthetic agents and also will look also into the histology and injury process of the inferior alveolar nerve.