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Lee JE, Lee AR, Choi EY, Choi IS, Kim SJ. Effect of nitro-conjugated linoleic acid on the inflammatory response of murine macrophages activated with lipopolysaccharide derived from Prevotella intermedia. Inflammopharmacology 2024; 32:561-573. [PMID: 37921960 DOI: 10.1007/s10787-023-01340-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 09/10/2023] [Indexed: 11/05/2023]
Abstract
Nitro-conjugated linoleic acid (NO2-CLA) has been observed to manifest salutary signaling responses, including anti-inflammatory and antioxidant properties. Here, the authors have explored the influence and underlying mechanisms of NO2-CLA on the proinflammatory reaction of murine macrophages that were challenged with lipopolysaccharide (LPS) derived from Prevotella intermedia, a putative periodontopathic bacterium. Treatment of LPS-activated RAW264.7 cells with NO2-CLA notably dampened the secretion of iNOS-derived NO, IL-1β and IL-6 as well as their gene expressions and significantly enhanced the markers for M2 macrophage polarization. NO2-CLA promoted the HO-1 expression in cells challenged with LPS, and tin protoporphyrin IX, an HO-1 inhibitor, significantly reversed the NO2-CLA-mediated attenuation of NO secretion, but not IL-1β or IL-6. We found that cells treated with NO2-CLA significantly increased mRNA expression of PPAR-γ compared to control cells, and NO2-CLA significantly reverted the decrease in PPAR-γ mRNA caused by LPS. Nonetheless, antagonists to PPAR-γ were unable to reverse the NO2-CLA-mediated suppression of inflammatory mediators. In addition, NO2-CLA did not alter the p38 and JNK activation elicited by LPS. Both NF-κB reporter activity and IκB-α degradation caused by LPS were notably diminished by NO2-CLA. NO2-CLA was observed to interrupt the nuclear translocation and DNA binding of p50 subunits caused by LPS with no obvious alterations in p65 subunits. Further, NO2-CLA attenuated the phosphorylation of STAT1/3 elicited in response to LPS. We propose that NO2-CLA could be considered as a possible strategy for the therapy of periodontal disease, although additional researches are certainly required to confirm this.
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Affiliation(s)
- Jung Eun Lee
- Dental and Life Science Institute, Pusan National University, 49 Busandaehak-Ro, Mulgeum-Eup, Yangsan, Gyeongsangnam-Do 50612, Republic of Korea
- Department of Biological Science, College of Medical and Life Sciences, Silla University, 140 Baegyang-Daero, 700 Beongil, Sasang-Gu, Busan 46958, Korea
| | - Ah Rim Lee
- Dental and Life Science Institute, Pusan National University, 49 Busandaehak-Ro, Mulgeum-Eup, Yangsan, Gyeongsangnam-Do 50612, Republic of Korea
- Department of Biological Science, College of Medical and Life Sciences, Silla University, 140 Baegyang-Daero, 700 Beongil, Sasang-Gu, Busan 46958, Korea
| | - Eun-Young Choi
- Department of Biochemistry, School of Medicine, Pusan National University, Yangsan, Gyeongsangnam-Do 50612, Republic of Korea
| | - In Soon Choi
- Department of Biological Science, College of Medical and Life Sciences, Silla University, 140 Baegyang-Daero, 700 Beongil, Sasang-Gu, Busan 46958, Korea.
| | - Sung-Jo Kim
- Dental and Life Science Institute, Pusan National University, 49 Busandaehak-Ro, Mulgeum-Eup, Yangsan, Gyeongsangnam-Do 50612, Republic of Korea.
- Department of Periodontology, School of Dentistry, Pusan National University, 49 Busandaehak-Ro, Mulgeum-Eup, Yangsan, Gyeongsangnam-Do 50612, Republic of Korea.
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Gegout PY, Stutz C, Huck O. Gels as adjuvant to non-surgical periodontal therapy: A systematic review and meta-analysis. Heliyon 2023; 9:e17789. [PMID: 37455970 PMCID: PMC10345361 DOI: 10.1016/j.heliyon.2023.e17789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 06/14/2023] [Accepted: 06/28/2023] [Indexed: 07/18/2023] Open
Abstract
Objective This systematic review and meta-analysis evaluated the effect of the use of available drugs loaded gels used as adjunct to non-surgical periodontal therapy. Methods Systematic research on PubMed/MEDLINE, Cochrane Central register of Controlled Trials, and Embase databases up to December 2021 was performed. Randomized clinical trials (RCT) which compared the outcomes of scaling and root planing (SRP) + local adjuvant administration (gel) versus SRP + placebo or SRP alone in Humans were included. The primary outcome measures were PPD and CAL changes at 3 months. Results After articles screening, 77 articles were included and assessed for quality. Then, a meta-analysis was conducted in studies with at least 3 months of follow-up. Clinical improvements were found to be significant for tetracyclines (-0.51 [-0.71;-0.31] p < 0.001), macrolides (-0.71 [-1.04;-0.38] p < 0.001), statins (-0.84 [-0.98;-0.70] p < 0.001), metformin (-1.47 [-1.66;-1.29] p < 0.001) and hyaluronan (-1.61 [-2.28;-0.94] p < 0.001) loaded gels, but non-significant for chlorhexidine (-0.48 [-1.10; 0.14] p = 0.13), metronidazole (-0.50 [-1.20; 0.20] p = 0.16) and bisphosphonates (-0.42 [-1.39; 0.54] p = 0.539) gels. Conclusion Adjunctive use of drugs loaded gels to non-surgical periodondal treatment could improve PPD reduction at 3 months. However, huge disparities remain when comparing the outcomes of the differents drugs used. Future comparative studies should be considered to determine precisely short and long term benefits of such treatments.
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Affiliation(s)
- Pierre-Yves Gegout
- Université de Strasbourg, Faculté de Chirurgie Dentaire, Periodontology, Strasbourg, France
- Hôpitaux Universitaires de Strasbourg, Pôle de Médecine et Chirurgie Bucco-dentaires, Strasbourg, France
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Céline Stutz
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Olivier Huck
- Université de Strasbourg, Faculté de Chirurgie Dentaire, Periodontology, Strasbourg, France
- Hôpitaux Universitaires de Strasbourg, Pôle de Médecine et Chirurgie Bucco-dentaires, Strasbourg, France
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
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Choi EY, Lee JE, Lee AR, Choi IS, Kim SJ. Carbon monoxide-releasing molecule-401, a water-soluble manganese-based metal carbonyl, suppresses Prevotella intermedia lipopolysaccharide-induced production of nitric oxide in murine macrophages. Immunopharmacol Immunotoxicol 2023; 45:94-101. [PMID: 36053007 DOI: 10.1080/08923973.2022.2119998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
CONTEXT Many reports in the literature have suggested the therapeutic value of carbon monoxide-releasing molecules (CORMs) against various diseases. However, to date, little is known about their possible influence on periodontal disease. OBJECTIVE This study was performed to investigate the influence of CORM-401 on the generation of nitric oxide (NO) in murine macrophage cells activated with lipopolysaccharide (LPS) derived from Prevotella intermedia, a pathogen associated with periodontal disease. MATERIALS AND METHODS LPS was isolated by the hot phenol-water method. Culture supernatants were analyzed for NO. Real-time PCR and immunoblotting were conducted to quantify mRNA and protein expression, respectively. NF-κB-dependent SEAP levels were estimated by reporter assay. DNA-binding of NF-κB was also analyzed. RESULTS CORM-401 caused an apparent suppression of NO production through inhibition of iNOS at both the mRNA and protein levels in RAW264.7 cells stimulated with P. intermedia LPS. CORM-401 upregulated the expression of both the HO-1 gene and its protein in LPS-activated cells, and treatment with the HO-1 inhibitor significantly reversed the attenuating influence of CORM-401 against LPS-induced generation of NO. CORM-401 caused an apparent attenuation of NF-κB-dependent SEAP release induced by LPS. IκB-α degradation and nuclear translocation of NF-κB p50 subunit induced by LPS were significantly reduced by CORM-401. Additionally, CORM-401 significantly attenuated DNA-binding of p65 and p50 induced by LPS. CORM-401 attenuated NO generation induced by P. intermedia LPS independently of PPAR-γ, JNK, p38 and STAT1/3. CONCLUSION The modulation of host inflammatory response by CORM-401 might be of help in the therapy of periodontal disease.
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Affiliation(s)
- Eun-Young Choi
- Department of Biological Science, College of Medical and Life Sciences, Silla University, Busan, Korea
| | - Jung Eun Lee
- Department of Biological Science, College of Medical and Life Sciences, Silla University, Busan, Korea
| | - Ah Rim Lee
- Department of Biological Science, College of Medical and Life Sciences, Silla University, Busan, Korea
| | - In Soon Choi
- Department of Biological Science, College of Medical and Life Sciences, Silla University, Busan, Korea
| | - Sung-Jo Kim
- Department of Periodontology, School of Dentistry, Pusan National University, Yangsan, Korea.,Dental and Life Science Institute, Pusan National University, Yangsan, Korea
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4
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Spahr A, Divnic‐Resnik T. Impact of health and lifestyle food supplements on periodontal tissues and health. Periodontol 2000 2022; 90:146-175. [PMID: 35916868 PMCID: PMC9804634 DOI: 10.1111/prd.12455] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
According to the new classification, periodontitis is defined as a chronic multifactorial inflammatory disease associated with dysbiotic biofilms and characterized by progressive destruction of the tooth-supporting apparatus. This definition, based on the current scientific evidence, clearly indicates and emphasizes, beside the microbial component dental biofilm, the importance of the inflammatory reaction in the progressive destruction of periodontal tissues. The idea to modulate this inflammatory reaction in order to decrease or even cease the progressive destruction was, therefore, a logical consequence. Attempts to achieve this goal involve various kinds of anti-inflammatory drugs or medications. However, there is also an increasing effort in using food supplements or so-called natural food ingredients to modulate patients' immune responses and maybe even improve the healing of periodontal tissues. The aim of this chapter of Periodontology 2000 is to review the evidence of various food supplements and ingredients regarding their possible effects on periodontal inflammation and wound healing. This review may help researchers and clinicians to evaluate the current evidence and to stimulate further research in this area.
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Affiliation(s)
- Axel Spahr
- Discipline of Periodontics, School of Dentistry, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Tihana Divnic‐Resnik
- Discipline of Periodontics, School of Dentistry, Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
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5
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Nitrooleic acid inhibits macrophage activation induced by lipopolysaccharide from Prevotella intermedia. Nutr Res 2022; 106:35-46. [DOI: 10.1016/j.nutres.2022.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/30/2022] [Accepted: 07/30/2022] [Indexed: 11/22/2022]
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6
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THE EFFECT OF COENZYME Q10 ON PERIODONTITIS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF CLINICAL TRIALS. J Evid Based Dent Pract 2022; 22:101710. [DOI: 10.1016/j.jebdp.2022.101710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 02/11/2022] [Accepted: 02/13/2022] [Indexed: 11/30/2022]
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7
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Lee J, Min HK, Park CY, Kang HK, Jung SY, Min BM. A vitronectin-derived peptide prevents and restores alveolar bone loss by modulating bone re-modelling and expression of RANKL and IL-17A. J Clin Periodontol 2022; 49:799-813. [PMID: 35634689 DOI: 10.1111/jcpe.13671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 04/21/2022] [Accepted: 05/18/2022] [Indexed: 11/27/2022]
Abstract
AIM This study investigated whether a vitronectin-derived peptide (VnP-16) prevents and/or reverses alveolar bone resorption induced by ligature-induced periodontitis in rodents and identified the underlying mechanism. MATERIALS AND METHODS We evaluated the effects of VnP-16 on osteogenic differentiation in human periodontal ligament cells (hPDLCs), lipopolysaccharide-induced inflammatory responses in gingival fibroblasts, and immune response in T lymphocytes. Ligature-induced periodontitis was induced by ligating the bilateral mandibular first molars for 14 days in rats and for 7 days in mice (n = 10/group). VnP-16 (100 μg/10 μl) was applied topically into the gingival sulcus of rats via intra-sulcular injection, whereas the peptide (50 μg/5 μl) was administered directly into the gingiva of mice via intra-gingival injection. To evaluate the preventive and therapeutic effects of VnP-16, micro-computed tomography analysis and histological staining were then performed. RESULTS VnP-16 promoted osteogenic differentiation of periodontal ligament cells and inhibited the production of lipopolysaccharide-induced inflammatory mediators in gingival fibroblasts. Concomitantly, VnP-16 modulated the host immune response by reducing the number of receptor activator of NF-κB ligand (RANKL)-expressing lipopolysaccharide-stimulated CD4+ and CD8+ T cells, and by suppressing RANKL and interleukin (IL)-17A production. Furthermore, local administration of VnP-16 in rats and mice significantly prevented and reversed alveolar bone loss induced by ligature-induced periodontitis. VnP-16 enhanced osteoblastogenesis and simultaneously inhibited osteoclastogenesis and suppressed RANKL and IL-17A expression in vivo. CONCLUSIONS Our findings suggest that VnP-16 acts as a potent therapeutic agent for preventing and treating periodontitis by regulating bone re-modelling and immune and inflammatory responses.
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Affiliation(s)
- Junbeom Lee
- Department of Periodontology, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Hong Ki Min
- Division of Rheumatology, Department of Internal Medicine, Konkuk University Medical Center, Seoul, South Korea
| | - Cho Yeon Park
- Department of Oral Biochemistry and Program in Cancer and Developmental Biology, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Hyun Ki Kang
- Department of Oral Biochemistry and Program in Cancer and Developmental Biology, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Sung Youn Jung
- Department of Oral Biochemistry and Program in Cancer and Developmental Biology, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Byung-Moo Min
- Department of Oral Biochemistry and Program in Cancer and Developmental Biology, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
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Jeon SJ, Lee Y, Keum BR, Choi EY, Choi IS, Kim SJ. Effect of telmisartan on experimental model of periodontitis in mice. Oral Dis 2022. [PMID: 35347812 DOI: 10.1111/odi.14200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 03/19/2022] [Accepted: 03/23/2022] [Indexed: 10/18/2022]
Affiliation(s)
- So Jung Jeon
- Department of Periodontology, School of Dentistry, Pusan National University, Yangsan, Gyeongsangnam-do, Korea
| | - Yohan Lee
- Department of Periodontology, School of Dentistry, Pusan National University, Yangsan, Gyeongsangnam-do, Korea
| | - Bo Ram Keum
- Department of Biological Science, College of Medical and Life Sciences, Silla University, Busan, Korea
| | - Eun-Young Choi
- Department of Biological Science, College of Medical and Life Sciences, Silla University, Busan, Korea
| | - In Soon Choi
- Department of Biological Science, College of Medical and Life Sciences, Silla University, Busan, Korea
| | - Sung-Jo Kim
- Department of Periodontology, School of Dentistry, Pusan National University, Yangsan, Gyeongsangnam-do, Korea.,Dental and Life Science Institute, Pusan National University, Yangsan, Gyeongsangnam-do, Korea.,Department of Dentistry, BHS Hanseo Hospital, Busan, Korea
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9
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Koide Y, Kataoka Y, Hasegawa T, Ota E, Noma H. Effect of systemic bisphosphonate administration on patients with periodontal disease: a systematic review and meta-analysis protocol. BMJ Open 2022; 12:e057768. [PMID: 35246424 PMCID: PMC8900018 DOI: 10.1136/bmjopen-2021-057768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Periodontal disease is a chronic oral infectious disease affecting adults worldwide as well as a lifestyle-related disease related to diabetes. Bisphosphonate is a drug often taken by patients with osteoporosis; however, it reportedly can cause jawbone necrosis. Due to its mechanism of action on bone tissue, bisphosphonate has been used topically on periodontal tissue to treat periodontal disease. However, the long-term systemic effects of bisphosphonates on periodontal tissues are unclear. This paper describes a protocol evaluating the effects of systemic bisphosphonate administration to prevent periodontal tissue destruction in patients with periodontal disease. No systematic review has attempted to summarise the evidence for systemic bisphosphonates in periodontal therapy. The results of the proposed systematic review will inform the practice and design of future clinical trials. METHODS AND ANALYSIS This paper describes a protocol for a systematic review of the relevant published analytic research using an aggregative thematic approach according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines. Two authors will perform a comprehensive search for studies on Medline/PubMed, Scopus, Embase, LILACS and the Cochrane Central Register of Controlled Trials databases. Abstract screening, full-text screening and data extraction will be performed independently by two authors. A meta-analysis will be conducted as appropriate. ETHICS AND DISSEMINATION The protocol of this systematic review will be provided in a peer-reviewed journal. Formal ethics approval is not necessary because researchers will not identify individuals in the report. PROSPERO REGISTRATION NUMBER CRD42020212698 (http://www.crd.york.ac.uk/PROSPERO/).
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Affiliation(s)
- Yoko Koide
- Department of Periodontology, Showa University School of Dentistry, Ota-ku, Tokyo, Japan
| | - Yu Kataoka
- Division of Biomaterials and Engineering, Department of Conservative Dentistry, Showa University School of Dentistry, Shinagawa-ku, Tokyo, Japan
| | - Takeshi Hasegawa
- Showa University Research Administration Center (SURAC), Showa University, Shinagawa-ku, Tokyo, Japan
- Division of Nephrology, Department of Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
- Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan
- Center for Innovative Research for Communities and Clinical Excellence, Fukushima Medical University, Fukushima, Fukushima, Japan
| | - Erika Ota
- Graduate School of Nursing Science, Global Health Nursing, St Luke's International University, Chuo-ku, Tokyo, Japan
- The Tokyo Foundation for Policy Research, Minato-ku, Tokyo, Japan
| | - Hisashi Noma
- Department of Data Science, Institute of Statistical Mathematics, Tachikawa, Tokyo, Japan
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10
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Future Drug Targets in Periodontal Personalised Medicine—A Narrative Review. J Pers Med 2022; 12:jpm12030371. [PMID: 35330371 PMCID: PMC8955099 DOI: 10.3390/jpm12030371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/22/2022] [Accepted: 02/26/2022] [Indexed: 02/08/2023] Open
Abstract
Periodontal disease is an infection-driven inflammatory disease characterized by the destruction of tooth-supporting tissues. The establishment of chronic inflammation will result in progressive destruction of bone and soft tissue changes. Severe periodontitis can lead to tooth loss. The disease has complex pathogenesis with an interplay between genetic, environmental, and host factors and pathogens. Effective management consists of plaque control and non-surgical interventions, along with adjuvant strategies to control inflammation and disrupt the pathogenic subgingival biofilms. Recent studies have examined novel approaches for managing periodontal diseases such as modulating microbial signaling mechanisms, tissue engineering, and molecular targeting of host inflammatory substances. Mounting evidence suggests the need to integrate omics-based approaches with traditional therapy to address the disease. This article discusses the various evolving and future drug targets, including proteomics, gene therapeutics, vaccines, and nanotechnology in personalized periodontal medicine for the effective management of periodontal diseases.
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11
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Understanding the Role of Metalloproteinases and Their Inhibitors in Periodontology. Clin Rev Bone Miner Metab 2022. [DOI: 10.1007/s12018-021-09281-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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12
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Kc K, Bhattarai BP, Shrestha S, Shrestha B, Shrestha M. EFFECT OF LOCALLY DELIVERED BISPHOSPHONATES ON ALVEOLAR BONE: A SYSTEMATIC REVIEW AND META-ANALYSIS. J Evid Based Dent Pract 2021; 21:101580. [PMID: 34479678 DOI: 10.1016/j.jebdp.2021.101580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 02/23/2021] [Accepted: 04/10/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To assess the effect of locally applied bisphosphonate drugs on alveolar bone defects caused by periodontitis and marginal bone level after placement of dental implants. MATERIALS AND METHODS Three electronic databases (PubMed/MEDLINE, Web of Science, and Scopus) were searched from January 2010 until May 2020 for randomized controlled clinical trials reporting the effect of locally delivered bisphosphonates on alveolar bone. The risk of bias was assessed and quantitative synthesis was conducted with both fixed and random-effects meta-analyses by using RevMan version 5.3. Subgroup and sensitivity analyses were performed whenever required. RESULTS Among the included studies, the effect of locally delivered bisphosphonates on alveolar bone regeneration in periodontitis was measured by 15 studies and on marginal bone level after installation of dental implants by three studies. Bisphosphonates showed significantly higher intrabony defect depth reduction than placebo/control in vertical bone defects treated with non-surgical approach (MD = 1.69mm; 95% CI, 1.32-2.05; P < 0.00001; I²=93%) or surgical approach (MD = 0.70mm; 95% CI, 0.23-1.16; P = 0.003; I² = 78%) and in class II furcation defects treated with non-surgical approach (MD = 1.61mm; 95% CI, 1.15-2.07; P < 0.00001; I² = 99%) or surgical approach (MD = 0.24mm; 95% CI, 0.05-0.42; P = 0.01; I² = 62%). Clinical attachment loss increased by 1.39mm (95% CI, 0.92-1.85; P < 0.01; I²=93%) and 1mm (95% CI, 0.75-1.26; P < 0.001; I² = 0%) in vertical bone defects after non-surgical and surgical treatments, respectively, and by 1.95mm (95% CI, 1.37-2.53; P < 0.00001; I² = 96%) and 0.84mm (95% CI, 0.58-1.10; P < 0.01, I² = 47%) after non-surgical and surgical treatment in class II furcation defects, respectively. Lesser marginal bone loss during pre-loading (MD = -0.18 mm; 95% CI, -0.24- -0.12; P<0.00001; I²=0%) and 1-year post-loading (MD = -0.33 mm; 95% CI, -0.59-0.07; P = 0.01; I² = 0%) periods was observed when bisphosphonate coated dental implants were used. CONCLUSION Locally delivered bisphosphonates induce bone regeneration in periodontal defects and decrease the rate of marginal bone loss after dental implant therapy.
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Affiliation(s)
- Kumar Kc
- BDS, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Bishwa Prakash Bhattarai
- BDS, MScD, Department of Clinical Dentistry, Walailak University International College of Dentistry, Bangkok, Thailand
| | - Shilu Shrestha
- BDS, MDS, Department of Periodontology, People's Dental College and Hospital, Kathmandu, Nepal.
| | - Bijaya Shrestha
- BPT, MPH, Department of Society and Health, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand
| | - Manash Shrestha
- BDS, MPH, Department of society and Health, Faculty of Social Sciences and Humanities, Mahidol University, Nakhon Pathom, Thailand
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13
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Assunção M, Carneiro VMA, Stefani CM, de Lima CL. Clinical efficacy of subgingivally delivered propolis as an adjuvant to nonsurgical periodontal treatment of periodontitis: A systematic review and meta-analysis. Phytother Res 2021; 35:5584-5595. [PMID: 34132426 DOI: 10.1002/ptr.7193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 05/27/2021] [Accepted: 05/29/2021] [Indexed: 11/08/2022]
Abstract
This systematic review and meta-analysis evaluated randomized and nonrandomized studies that assessed the effect of local subgingival propolis as an adjunct to nonsurgical periodontal therapy (NSPT) in the treatment of periodontitis. A detailed search was carried out in Cochrane Library, Embase, LILACS, LIVIVO, PubMed, Scopus, and Web of Science, with no time or language restrictions. A grey literature search was also conducted. The methodology of included studies was evaluated by the Cochrane RoB2 tool. The certainty of each clinical outcome was assessed by the GRADE system. Meta-analyses of mean difference were conducted using the random-effects model, through RevMan 5.4 software. Six studies met the eligibility criteria to be synthesized in the qualitative analysis, and three studies were included in the meta-analysis. The subgingival application of propolis as an adjunct to NSPT improved probing pocket depth (PPD), clinical attachment level (CAL), and bleeding on probing (BOP) in most of the assessed studies. The overall mean difference in PPD reduction was 1.49 mm, 30-45 days after treatment, and 0.8 mm, 90 days after treatment, with very low level of certainty. The overall bias was scored as high risk for all included studies. The adjunctive use of locally delivered propolis associated to NSPT to treat periodontitis may improve periodontal clinical parameters, compared with NSPT alone/placebo. However, the evidence was not strong enough to safely base any clinical recommendation.
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Affiliation(s)
- Michelly Assunção
- Faculty of Health Sciences, University of Brasília, University Campus Darcy Ribeiro, Brasília, Brazil
| | - Valéria M A Carneiro
- Department of Dentistry, Faculty of Health Sciences, University of Brasília, University Campus Darcy Ribeiro, Brasília, Brazil
| | - Cristine M Stefani
- Department of Dentistry, Faculty of Health Sciences, University of Brasília, University Campus Darcy Ribeiro, Brasília, Brazil
| | - Caroline L de Lima
- Laboratory of Oral Histopathology, Department of Dentistry, Faculty of Health Sciences, University of Brasília, University Campus Darcy Ribeiro, Brasília, Brazil
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Chen N, Ren R, Wei X, Mukundan R, Li G, Xu X, Zhao G, Zhao Z, Lele SM, Reinhardt RA, Wang D. Thermoresponsive Hydrogel-Based Local Delivery of Simvastatin for the Treatment of Periodontitis. Mol Pharm 2021; 18:1992-2003. [PMID: 33754729 DOI: 10.1021/acs.molpharmaceut.0c01196] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Except for routine scaling and root planing, there are few effective nonsurgical therapeutic interventions for periodontitis and associated alveolar bone loss. Simvastatin (SIM), one of the 3-hydroxy-3-methylglutaryl-cosenzyme A reductase inhibitors, which is known for its capacity as a lipid-lowering medication, has been proven to be an effective anti-inflammatory and bone anabolic agent that has shown promising benefits in mitigating periodontal bone loss. The local delivery of SIM into the periodontal pocket, however, has been challenging due to SIM's poor water solubility and its lack of osteotropicity. To overcome these issues, we report a novel SIM formulation of a thermoresponsive, osteotropic, injectable hydrogel (PF127) based on pyrophosphorolated pluronic F127 (F127-PPi). After mixing F127-PPi with F127 at a 1:1 ratio, the resulting PF127 was used to dissolve free SIM to generate the SIM-loaded formulation. The thermoresponsive hydrogel's rheologic behavior, erosion and SIM release kinetics, osteotropic property, and biocompatibility were evaluated in vitro. The therapeutic efficacy of SIM-loaded PF127 hydrogel on periodontal bone preservation and inflammation resolution was validated in a ligature-induced periodontitis rat model. Given that SIM is already an approved medication for hyperlipidemia, the data presented here support the translational potential of the SIM-loaded PF127 hydrogel for better clinical management of periodontitis and associated pathologies.
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Affiliation(s)
- Ningrong Chen
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, 986125 Nebraska Medical Center, PDD 3020, Omaha, Nebraska 68198-6125, United States
| | - Rongguo Ren
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, 986125 Nebraska Medical Center, PDD 3020, Omaha, Nebraska 68198-6125, United States
| | - Xin Wei
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, 986125 Nebraska Medical Center, PDD 3020, Omaha, Nebraska 68198-6125, United States
| | - Roshni Mukundan
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, 986125 Nebraska Medical Center, PDD 3020, Omaha, Nebraska 68198-6125, United States
| | - Guojuan Li
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, 986125 Nebraska Medical Center, PDD 3020, Omaha, Nebraska 68198-6125, United States
| | - Xiaoke Xu
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, 986125 Nebraska Medical Center, PDD 3020, Omaha, Nebraska 68198-6125, United States
| | - Gang Zhao
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, 986125 Nebraska Medical Center, PDD 3020, Omaha, Nebraska 68198-6125, United States
| | - Zhifeng Zhao
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, 986125 Nebraska Medical Center, PDD 3020, Omaha, Nebraska 68198-6125, United States
| | - Subodh M Lele
- Department of Pathology & Microbiology, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska 68198, United States
| | - Richard A Reinhardt
- Department of Surgical Specialties, College of Dentistry, University of Nebraska Medical Center, Lincoln, Nebraska 68583, United States
| | - Dong Wang
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, 986125 Nebraska Medical Center, PDD 3020, Omaha, Nebraska 68198-6125, United States
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15
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Taherkhani A, Moradkhani S, Orangi A, Jalalvand A, Khamverdi Z. Molecular docking study of flavonoid compounds for possible matrix metalloproteinase-13 inhibition. J Basic Clin Physiol Pharmacol 2020; 32:1105-1119. [PMID: 34898135 DOI: 10.1515/jbcpp-2020-0036] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 09/10/2020] [Indexed: 06/14/2023]
Abstract
OBJECTIVES Matrix metalloproteinase-13 (MMP-13) has been reported to be involved in different biological processes such as degradation of extracellular matrix proteins, activating or degrading some significant regulatory proteins, wound healing, tissue remodeling, cartilage degradation, bone development, bone mineralization, ossification, cell migration, and tumor cell invasion. Further, MMP-13 participates in many oral diseases such as tooth decay, gingivitis, and degradation of enamel and tissue around the implant. In addition, inhibition of MMP-13 has shown therapeutic properties for Alzheimer's disease (AD). We performed molecular docking to assess the binding affinity of 29 flavonoid compounds with the MMP-13. Additionally, pharmacokinetic and toxicity characteristics of the top-ranked flavonoids were studied. The current study also intended to identify the most important amino acids involved in the inhibition of MMP-13 based on topological feature (degree) in the ligand-amino acid network for MMP-13. METHODS Molecular docking and network analysis were studied using AutoDock and Cytoscape software, respectively. Pharmacokinetic and toxicity characteristics of compounds were predicted using bioinformatics web tools. RESULTS The results revealed that nine of the studied flavonoids had considerable estimated free energy of binding and inhibition constant: Rutin, nicotiflorin, orientin, vitexin, apigenin-7-glucoside, quercitrin, isoquercitrin, quercitrin-3-rhamnoside, and vicenin-2. Proline-242 was found to be the most important amino acid inhibiting the enzyme. CONCLUSIONS The results of the current study may be helpful in the prevention and therapeutic procedures of many disorders such as cancer, tooth caries, and AD. Nevertheless, validation tests are required in the future.
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Affiliation(s)
- Amir Taherkhani
- Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Shirin Moradkhani
- Department of Pharmacognosy, School of Pharmacy, Medicinal Plants and Natural Product Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Athena Orangi
- Department of Restorative Dentistry, Dental Research Center, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Alireza Jalalvand
- Department of Influenza and other respiratory viruses, Pasteur Institute of Iran, Tehran, Iran
| | - Zahra Khamverdi
- Department of Restorative Dentistry, Dental Research Center, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran
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16
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Hajishengallis G, Chavakis T, Lambris JD. Current understanding of periodontal disease pathogenesis and targets for host-modulation therapy. Periodontol 2000 2020; 84:14-34. [PMID: 32844416 DOI: 10.1111/prd.12331] [Citation(s) in RCA: 160] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Recent advances indicate that periodontitis is driven by reciprocally reinforced interactions between a dysbiotic microbiome and dysregulated inflammation. Inflammation is not only a consequence of dysbiosis but, via mediating tissue dysfunction and damage, fuels further growth of selectively dysbiotic communities of bacteria (inflammophiles), thereby generating a self-sustained feed-forward loop that perpetuates the disease. These considerations provide a strong rationale for developing adjunctive host-modulation therapies for the treatment of periodontitis. Such host-modulation approaches aim to inhibit harmful inflammation and promote its resolution or to interfere directly with downstream effectors of connective tissue and bone destruction. This paper reviews diverse strategies targeted to modulate the host periodontal response and discusses their mechanisms of action, perceived safety, and potential for clinical application.
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Affiliation(s)
- George Hajishengallis
- Department of Basic and Translational Sciences, Penn Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Triantafyllos Chavakis
- Department of Clinical Pathobiochemistry, Faculty of Medicine, Institute for Clinical Chemistry and Laboratory Medicine, Technische Universität Dresden, Dresden, Germany
| | - John D Lambris
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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17
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Al-Nasser L, Lamster IB. Prevention and management of periodontal diseases and dental caries in the older adults. Periodontol 2000 2020; 84:69-83. [PMID: 32844424 DOI: 10.1111/prd.12338] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
As a result of aging populations, in the future, dental practitioners will be caring for more older adults than ever before. These older adults, especially in developed countries, will demand a greater number of dental services, driven by increased tooth retention and an expectation of excellent oral healthcare throughout the life course. Further, the global rise in the prevalence and incidence of chronic diseases will increase the risk and/or severity of oral diseases and add a layer of complexity to the management of oral diseases in older adults. More older adults will be at a higher risk of periodontal disease and root caries as a result of reduced tooth loss and edentulism. This article reviews information on periodontitis and root caries, oral diseases which reflect the cumulative risk of the individual, and which are best addressed through prevention. Oral healthcare providers must embrace the concept of lifelong emphasis on prevention, as well as participation as active members of a healthcare team which provides healthcare for older adults in various settings (eg, hospital/clinic-based care, community-based settings, and long-term care facilities). National guidelines that address oral health are being considered by some countries, and if these are implemented they will increase the accessibility to oral health for older adults. In parallel to this, revisions of existing older adult insurance schemes (eg, the inclusion of routine oral healthcare in the US Medicare program) would promote the maintenance of a functional dentition that is pain-free and conducive to general health. The opportunity exists to implement a holistic approach to oral health that will align oral health with general health and emphasize that true health can only be achieved with the inclusion of oral health.
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Affiliation(s)
- Lubna Al-Nasser
- Mailman School of Public Health, Columbia University, New York City, New York, USA.,Population Health Research Section, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Ira B Lamster
- School of Dental Medicine, Stony Brook University, Stony Brook, New York, USA.,College of Dental Medicine, Columbia University, New York City, New York, USA
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18
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Penmetsa GS, Mopidevi A, Ramaraju V, Ramachandran R, Ramesh MV. Role of Orthoboon (glucosamine sulfate + collagen + Vitamin C): A novel host-modulating agent in the management of chronic periodontitis. J Indian Soc Periodontol 2020; 24:428-432. [PMID: 33144770 PMCID: PMC7592613 DOI: 10.4103/jisp.jisp_645_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 06/05/2020] [Accepted: 06/11/2020] [Indexed: 12/05/2022] Open
Abstract
Background: Recent trends suggest using novel host-modulating agents as a treatment strategy for chronic periodontitis. Glucosamine sulfate (GS) was proven to have anti-inflammatory actions related to its ability to suppress neutrophil functions. Orthoboon, an anti-arthritic and anti-inflammatory drug, has shown to have a positive therapeutic effect due to its constituents made of a combination of GS, Vitamin C, and collagen. The aim of the study was to evaluate the host modulatory effects of Orthoboon on periodontal status and to estimate the C reactive protein (CRP) levels before and after nonsurgical periodontal therapy (NSPT). Materials and Methods: A total number of 40 patients with chronic periodontitis were randomly divided into two groups of 20 patients each. The test group patients (n = 20) received 500 mg Orthoboon three times daily for 45 days. Prior to the initiation of Orthoboon, all patients in both test group and control group were subjected to Phase I periodontal therapy. CRP levels were estimated immediately after phase I therapy and 45 days after therapy. Clinical parameters including plaque index, gingival index, and bleeding index were recorded before and after NSPT for the two groups. Results: The mean CRP levels were reduced significantly in the test group before and after administration of Orthoboon and also there were statistically significant differences in the mean CRP levels at the end of 45 days between the test group and the control group. Conclusion: Administration of Orthoboon, i.e., GS, with a combination of Vitamin C and collagen was proved to be of a significant benefit in the test group than in the control group.
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Affiliation(s)
- Gautami S Penmetsa
- Department of Periodontics and Implantology, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| | - Anudeep Mopidevi
- Department of Periodontics and Implantology, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| | - Venkata Ramaraju
- Department of Prosthodontics, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| | - Radhika Ramachandran
- Department of Periodontics and Implantology, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| | - M V Ramesh
- Department of Public Health Dentistry, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
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Stańdo M, Piatek P, Namiecinska M, Lewkowicz P, Lewkowicz N. Omega-3 Polyunsaturated Fatty Acids EPA and DHA as an Adjunct to Non-Surgical Treatment of Periodontitis: A Randomized Clinical Trial. Nutrients 2020; 12:E2614. [PMID: 32867199 PMCID: PMC7551834 DOI: 10.3390/nu12092614] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 08/24/2020] [Accepted: 08/25/2020] [Indexed: 12/15/2022] Open
Abstract
Periodontitis is a chronic multifactorial inflammatory disease that leads to the loss of supportive tissues around the teeth with gradual deterioration of masticatory function and esthetics, resulting eventually in the decrease of the life quality. Host immune response triggered by bacterial biofilm is responsible for the chronic periodontal inflammation and ongoing tissue loss. Omega-3 polyunsaturated fatty acids (PUFA) such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have anti-inflammatory properties, thus may be used for the treatment of chronic inflammatory diseases. In this study, we aimed to evaluate the effect of dietary supplementation with omega-3 PUFA in the patients with stage III and IV periodontitis. Thirty otherwise healthy patients were treated with scaling and root planning (SRP). In the test group (n = 16), patients were additionally supplemented with 2.6 g of EPA and 1.8 g of DHA. In the control group (n = 14), patients received only SRP. Periodontal examination was performed at baseline and three months following initial therapy. Salivary samples were taken twice at baseline and at the end of the experiment. We found that there was a statistically significant reduction in the bleeding on probing (BOP) and improvement of clinical attachment loss (CAL) at three months in the test group compared to the control group. Moreover, a statistically significant higher percentage of closed pockets (probing depth ≤ 4 mm without BOP) was achieved in the test group vs. control group after three months of treatment. Accordingly, the levels of pro-inflammatory cytokines/chemokines interleukin (IL)-8 and IL-17 were markedly lower, while the level of anti-inflammatory IL-10 was significantly higher in the salivary samples of the patients supplemented with omega-3 PUFA at three months in comparison to the patients treated with SRP alone. Our findings demonstrate that dietary intervention with high-dose of omega-3 PUFA during non-surgical therapy may have potential benefits in the management of periodontitis.
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Affiliation(s)
- Mirella Stańdo
- Department of Periodontology and Oral Diseases, Medical University of Lodz, 90-419 Lodz, Poland;
| | - Paweł Piatek
- Department of Neurology, Medical University of Lodz, 90-419 Lodz, Poland; (P.P.); (M.N.); (P.L.)
| | - Magdalena Namiecinska
- Department of Neurology, Medical University of Lodz, 90-419 Lodz, Poland; (P.P.); (M.N.); (P.L.)
| | - Przemysław Lewkowicz
- Department of Neurology, Medical University of Lodz, 90-419 Lodz, Poland; (P.P.); (M.N.); (P.L.)
| | - Natalia Lewkowicz
- Department of Periodontology and Oral Diseases, Medical University of Lodz, 90-419 Lodz, Poland;
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20
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Choe SH, Choi EY, Hyeon JY, Keum BR, Choi IS, Kim SJ. Effect of nifedipine, a calcium channel blocker, on the generation of nitric oxide and interleukin-1β by murine macrophages activated by lipopolysaccharide from Prevotella intermedia. Naunyn Schmiedebergs Arch Pharmacol 2020; 394:59-71. [PMID: 32780228 DOI: 10.1007/s00210-020-01958-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 08/03/2020] [Indexed: 12/12/2022]
Abstract
Nifedipine, a calcium channel blocker, has been reported to possess anti-inflammatory and immunosuppressive effects. The current study was undertaken to explore the influence of nifedipine on the generation of proinflammatory mediators by murine macrophages activated by lipopolysaccharide (LPS) prepared from Prevotella intermedia, a putative periodontal pathogen, and associated mechanisms of action as well. LPS was purified by employing phenol-water extraction protocol. Culture supernatants were analyzed for nitric oxide (NO) and interleukin (IL)-1β. Real-time PCR and immunoblotting were conducted to quantify mRNA and protein expression, respectively. NF-κB-dependent secreted embryonic alkaline phosphatase (SEAP) levels were estimated by reporter assay. Nifedipine markedly suppressed the generation of iNOS-derived NO and IL-1β together with their mRNA expressions in murine macrophages activated by P. intermedia LPS. LPS-stimulated cells exposed to nifedipine notably increased the mRNA levels of Arg-1, Ym-1, FIZZ1, and TGF-β, which are typical markers for M2 macrophage polarization. Nifedipine induced HO-1 at both gene and protein levels in cells challenged with P. intermedia LPS, and the nifedipine-mediated inhibition of NO generation was significantly abrogated by adding SnPP, an HO-1 inhibitor. Nifedipine inhibited LPS-evoked generation of NO and IL-1β in a PPAR-γ-independent manner. In addition, NF-κB activation as well as phosphorylation of STAT1/3 induced by P. intermedia LPS was suppressed by nifedipine. Nifedipine is an inhibitor of P. intermedia LPS-evoked production of NO and IL-1β in murine macrophages and encourages macrophage polarization toward the M2 phenotype. Nifedipine possibly has potential to be used for host modulation of periodontal disease and is worth being further researched.
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Affiliation(s)
- So-Hui Choe
- Department of Biological Science, College of Medical and Life Sciences, Silla University, 140 Baegyang-daero, 700beon-gil, Sasang-gu, Busan, 617-736, Korea
| | - Eun-Young Choi
- Department of Biological Science, College of Medical and Life Sciences, Silla University, 140 Baegyang-daero, 700beon-gil, Sasang-gu, Busan, 617-736, Korea
| | - Jin-Yi Hyeon
- Department of Biological Science, College of Medical and Life Sciences, Silla University, 140 Baegyang-daero, 700beon-gil, Sasang-gu, Busan, 617-736, Korea
| | - Bo Ram Keum
- Department of Biological Science, College of Medical and Life Sciences, Silla University, 140 Baegyang-daero, 700beon-gil, Sasang-gu, Busan, 617-736, Korea
| | - In Soon Choi
- Department of Biological Science, College of Medical and Life Sciences, Silla University, 140 Baegyang-daero, 700beon-gil, Sasang-gu, Busan, 617-736, Korea
| | - Sung-Jo Kim
- Department of Periodontology, School of Dentistry, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan, Gyeongsangnam-do, 626-870, Korea. .,Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Gyeongsangnam-do, Korea. .,Dental and Life Science Institute, Pusan National University, Yangsan, Gyeongsangnam-do, Korea.
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21
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Santinoni CS, Silveira FM, Caldeira ML, Genaro V, Martins TM, do Amaral CCF, Maia LP, Mori GG, Ervolino E, Pola NM. Topical sodium alendronate combined or not with photodynamic therapy as an adjunct to scaling and root planing: Histochemical and immunohistochemical study in rats. J Periodontal Res 2020; 55:850-858. [PMID: 32648296 DOI: 10.1111/jre.12777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 04/15/2020] [Accepted: 05/21/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate influence of topical sodium alendronate (ALN), photodynamic therapy (aPDT), or a combination thereof as adjuvant to scaling and root planing (SRP) in the treatment of experimental periodontitis in rats. BACKGROUND Therapeutic protocols to control periodontitis progression that aim to equalize bacterial action and load with tissue immune response are well addressed in current scientific research. METHODS Experimental periodontitis was induced in 96 rats with a ligature around the mandibular left first molar. After 7 days, ligature was removed and animals were treated according to the following experimental groups (n = 8): control-SRP plus saline solution; ALN-SRP plus ALN; aPDT-SRP plus methylene blue irrigation, followed by low-level laser therapy (LLLT); and ALN/aPDT-SRP plus ALN and methylene blue irrigation followed by LLLT. The animals were euthanized at 7, 15, and 30 days after treatments. Collagen maturation (picrosirius red staining) and immunohistochemical analyses (TRAP, RANKL and osteoprotegerin [OPG]) were performed. Data were submitted to statistical analysis (P < .05). RESULTS At 7 days, group ALN presented a significantly higher number of TRAP-positive cells and percentage of immature collagen fibers than group ALN/aPDT, while group ALN/aPDT presented a significantly higher percentage of mature collagen fibers than group ALN. At 30 days, group ALN presented significantly lower percentage of immature collagen fibers and higher percentage of mature collagen fibers than control. CONCLUSION It can be concluded that topical use of ALN coadjutant to SRP, alone or combined with aPDT, enhanced collagen maturation and reduced osteoclastogenesis during the healing of experimental periodontitis.
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Affiliation(s)
- Carolina S Santinoni
- Dental School of Presidente Prudente, Graduate Program in Dentistry (GPD-Master's Degree), University of Western Sao Paulo, Presidente Prudente, Brazil
| | - Felipe M Silveira
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Marcela L Caldeira
- Dental School of Presidente Prudente, Graduate Program in Dentistry (GPD-Master's Degree), University of Western Sao Paulo, Presidente Prudente, Brazil
| | - Vítor Genaro
- Dental School of Presidente Prudente, Graduate Program in Dentistry (GPD-Master's Degree), University of Western Sao Paulo, Presidente Prudente, Brazil
| | - Thiago M Martins
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Caril C F do Amaral
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Luciana P Maia
- Dental School of Presidente Prudente, Graduate Program in Dentistry (GPD-Master's Degree), University of Western Sao Paulo, Presidente Prudente, Brazil
| | - Graziela G Mori
- Dental School of Presidente Prudente, Graduate Program in Dentistry (GPD-Master's Degree), University of Western Sao Paulo, Presidente Prudente, Brazil
| | - Edilson Ervolino
- Dental School of Araçatuba, Department of Basic Sciences, University Estadual Paulista, Araçatuba, Brazil
| | - Natália M Pola
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
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22
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Abstract
With the recognition in the 1960s and 1970s of the periodontopathic importance of the microbial biofilm and its specific anaerobic microorganisms, periodontitis was treated as an infectious disease (more recently, as a dysbiosis). Subsequently, in the 1980s, host-response mechanisms were identified as the mediators of the destruction of the collagen-rich periodontal tissues (gingiva, periodontal ligament, alveolar bone), and the periodontopathogens were now regarded as the "trigger" of the inflammatory/collagenolytic response that characterizes actively destructive periodontitis. Also at this time a new pharmacologic strategy emerged, entitled "host-modulation therapy", based on 2 major findings: (1) that the ability of tetracycline antibiotics to inhibit periodontal breakdown was due (in large part) to their previously unrecognized ability to inhibit the host-derived matrix metalloproteinases (notably, the collagenases, gelatinases, macrophage metalloelastase), and by mechanisms unrelated to the antimicrobial properties of these medications; and (2) that nonsteroidal anti-inflammatory drugs, such as flurbiprofen, again by nonantimicrobial mechanisms, could reduce the severity of periodontitis (however, the adverse effects of long-term therapy precluded their development as safe and effective host-modulatory agents). Additional mechanistic studies resulted in the development of novel nonantimicrobial formulations (Periostat® [now generic] and Oracea®) and compositions of tetracyclines (notably chemically modified tetracycline-3) as host-modulator drugs for periodontitis, arthritis, cardiovascular and pulmonary diseases, cancer, and, more recently, for local and systemic bone loss in postmenopausal women. Identification of the cation-binding active site in the tetraphenolic chemically modified tetracycline molecules drove the development of a new category of matrix metalloproteinase-inhibitor compounds, with a similar active site, the biphenolic chemically modified curcumins. A lead compound, chemically modified curcumin 2.24, has demonstrated safety and efficacy in vitro, in cell culture, and in vivo in mouse, rat, rabbit, and dog models of disease. In conclusion, novel host-modulation compounds have shown significant promise as adjuncts to traditional local therapy in the clinical management of periodontal disease; appear to reduce systemic complications of this all-too-common "inflammatory/collagenolytic" disease; and Oracea® is now commonly prescribed for inflammatory dermatologic diseases.
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Affiliation(s)
- Lorne M. Golub
- Department of Oral Biology & PathologySchool of Dental MedicineStony Brook UniversityStony BrookNew York, USA
| | - Hsi‐Ming Lee
- Department of Oral Biology & PathologySchool of Dental MedicineStony Brook UniversityStony BrookNew York, USA
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Trajano VCDC, Brasileiro CB, Henriques JADS, Cota LDM, Lanza CR, Cortés ME. Doxycycline encapsulated in β-cyclodextrin for periodontitis: a clinical trial. Braz Oral Res 2020; 33:e112. [PMID: 31939496 DOI: 10.1590/1807-3107bor-2019.vol33.0112] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 04/08/2019] [Indexed: 11/22/2022] Open
Abstract
This clinical trial compared the efficacy of doxycycline (DOX) in β-cyclodextrin (DOX)/βCD) with DOX- alone in gel on thirty-three subjects with periodontitis. Patients were randomized to group 1 GI; 10% DOX + scaling and root planning (SRP); group 2 (GII (10% DOX /β-CD + SRP), and group 3 (GIII; SRP). Gels were applied in GI and GII at baseline (T0) and 30 days later (T1). Periodontal Probing Depth (PPD), Clinical Attachment Level (CAL), Bleeding on Probing (BOP) and Visible Plaque Index (VPI) were evaluated at (T0), 30 days (T1) and 60 days after T0 (T2). Bone density was analyzed after 18 months (T3). GII showed the most significant reduction of PPD (2.62 mm; p <0.003), and greatest gain in CAL (2.54 mm p <0.003) at T2. BOP and the VPI had a strong reduction in all groups at T2 (p <0.05), both decreased by ≥5 times and 2 times, respectively, in all groups at T1. Bone density increased in all groups in radiographs (T3). The use of DOX encapsulated in β-CD gel with SRP resulted in significant improvements in clinical periodontal parameters; such molecular inclusion of doxycycline into β-CD in gel for local application is relatively simple and useful in dentistry.
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Affiliation(s)
| | - Cláudia Borges Brasileiro
- Universidade Federal de Minas Gerais - UFMG, Faculty of Dentistry, Department of Oral Clinical, Surgery and Pathology, Belo Horizonte, MG, Brazil
| | - Jonathas Antônio de Souza Henriques
- Universidade Federal de Minas Gerais - UFMG, Faculty of Dentistry, Department of Oral Clinical, Surgery and Pathology, Belo Horizonte, MG, Brazil
| | - Luís de Miranda Cota
- Universidade Federal de Minas Gerais - UFMG, Faculty of Dentistry, Department of Oral Clinical, Surgery and Pathology, Belo Horizonte, MG, Brazil
| | - Célia Regina Lanza
- Universidade Federal de Minas Gerais - UFMG, Faculty of Dentistry, Department of Oral Clinical, Surgery and Pathology, Belo Horizonte, MG, Brazil
| | - Maria Esperanza Cortés
- Universidade Federal de Minas Gerais - UFMG, Faculty of Dentistry, Department of Restorative Dentistry, Belo Horizonte, MG, Brazil
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Topical Host-Modulating Therapy for Periodontal Regeneration: A Systematic Review and Meta-Analysis. TISSUE ENGINEERING PART B-REVIEWS 2019; 25:526-543. [DOI: 10.1089/ten.teb.2019.0184] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Nunes NLT, Messora MR, Oliveira LF, Lisboa M, Garcia MCB, Rêgo RO, Novaes AB, de Souza SLS, Ervolino E, Furlaneto FAC. Effects of local administration of tiludronic acid on experimental periodontitis in diabetic rats. J Periodontol 2019; 89:105-116. [PMID: 28914593 DOI: 10.1902/jop.2017.170228] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 08/16/2017] [Indexed: 01/22/2023]
Abstract
BACKGROUND Tiludronic acid (TIL) presents antiresorptive and anti-inflammatory properties and has not been evaluated in the periodontitis-diabetes mellitus (DM) association to date, to the best knowledge of the authors. This study evaluates effects of local administration of TIL on experimental periodontitis (EP) in rats with streptozotocin-induced DM. METHODS Thirty-two animals (Rattus norvegicus albinus, Wistar) were divided into groups DM/C (Control), DM/EP, DM/EP/TIL1, and DM/EP/TIL3. In EP groups, a ligature was placed around mandibular first molars. In groups DM/EP/TIL1 and DM/EP/TIL3, TIL solutions (1 and 3 mg/kg, respectively) were injected into the gingival tissue of mandibular molars every other day for 10 days, until euthanasia. Periodontal tissues were analyzed by microcomputed tomography (micro-CT), histomorphometry, immunohistochemistry (tartrate-resistant acid phosphatase [TRAP], receptor activator of nuclear factor-κB ligand [RANKL], osteoprotegerin, cleaved caspase 3), and quantitative reverse transcription-polymerase chain reaction (interleukin [IL]-1β, vascular endothelial growth factor [VEGF]). RESULTS In micro-CT analyses, groups DM/EP/TIL1 and DM/EP/TIL3 presented reduced alveolar bone resorption (P < 0.05). Group DM/EP/TIL3 presented decreased attachment loss (P < 0.05). The amount of TRAP-positive multinucleated cells was decreased in TIL groups (P < 0.05). Group DM/EP/TIL3 presented a lower immunolabeling pattern for RANKL (P < 0.05). TIL treatment decreased genic expression of IL-1β, and in group DM/EP/TIL3, expression of VEGF was increased (P < 0.05). CONCLUSION Local administration of TIL promoted a protective effect against tissue destruction in EP in diabetic rats, and the dosage of 3 mg/kg of TIL promoted the best results regarding its antiresorptive and anti-inflammatory effects.
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Affiliation(s)
- Nara L T Nunes
- Department of Clinical Dentistry, Graduate Program in Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Michel R Messora
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of São Paulo, Ribeirao Preto, São Paulo, Brazil
| | - Luiz Fernando Oliveira
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of São Paulo, Ribeirao Preto, São Paulo, Brazil
| | - Mario Lisboa
- Department of Morphology, Faculty of Medicine, Federal University of Ceará
| | - Marina Costa Barcellos Garcia
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of São Paulo, Ribeirao Preto, São Paulo, Brazil
| | - R O Rêgo
- Department of Dentistry, School of Dentistry at Sobral, Federal University of Ceará, Sobral, Ceará, Brazil
| | - Arthur Belém Novaes
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of São Paulo, Ribeirao Preto, São Paulo, Brazil
| | - Sérgio Luís Scombatti de Souza
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of São Paulo, Ribeirao Preto, São Paulo, Brazil
| | - Edilson Ervolino
- Department of Basic Sciences, Division of Histology, Dental School of Araçatuba, São Paulo State University, Araçatuba , São Paulo, Brazil
| | - Flávia A C Furlaneto
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of São Paulo, Ribeirao Preto, São Paulo, Brazil
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Choe SH, Choi EY, Hyeon JY, Keum BR, Choi IS, Kim SJ. Telmisartan, an angiotensin II receptor blocker, attenuates Prevotella intermedia lipopolysaccharide-induced production of nitric oxide and interleukin-1β in murine macrophages. Int Immunopharmacol 2019; 75:105750. [DOI: 10.1016/j.intimp.2019.105750] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 06/29/2019] [Accepted: 07/08/2019] [Indexed: 01/01/2023]
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Sulijaya B, Takahashi N, Yamazaki K. Host modulation therapy using anti-inflammatory and antioxidant agents in periodontitis: A review to a clinical translation. Arch Oral Biol 2019; 105:72-80. [PMID: 31288144 DOI: 10.1016/j.archoralbio.2019.07.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 06/26/2019] [Accepted: 07/02/2019] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To highlight the shifting paradigm of periodontitis, describe mechanism of periodontal bone destruction, and propose an updated host modulation therapy (HMT) strategy. To add further clinical relevance, related studies investigating the efficacy of several HMT agents in periodontitis will be discussed. DESIGN Literature searches were conducted from articles published in PubMed using keywords "periodontal disease AND periodontitis AND host modulation therapy AND anti-inflammatory AND antioxidant", and then the findings were comprehensively summarized and elaborated. RESULT Accumulating evidence indicates that periodontitis is no longer defined solely as a pathogen-induced disease; rather, it is now recognized as a consequence of uncontrolled immune response and oxidative stress leading to periodontal tissue damage. Although periodontopathic bacteria initiate the disease, inflammation and oxidative stress were reported to be the main causes for the severity of tissue destruction. Thus, since the concept of periodontitis has shifted, our approach to its management needs to be adjusted to accommodate the latest paradigm. Nowadays, the modulation of inflammation and oxidative stress is considered a target of HMT. HMT agents, such as probiotics, anti-inflammatory drugs, anti-chemokines, lipid mediators, and bio-active fatty acids, have been extensively investigated for their remarkable functions in modulating the immune response and providing antioxidant effects. CONCLUSION Findings from in vitro, in vivo, and human studies frequently demonstrate positive association by the administration of HMT in periodontitis. HMT strategy targeted on anti-inflammatory and antioxidant in periodontitis might serve as an excellent therapeutic approach to reach the level of clinical benefit.
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Affiliation(s)
- Benso Sulijaya
- Research Unit for Oral-Systemic Connection, Division of Oral Science for Health Promotion, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan; Division of Periodontology, Department of Oral Biological Science, Niigata University Faculty of Dentistry, Niigata, Japan; Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Naoki Takahashi
- Division of Periodontology, Department of Oral Biological Science, Niigata University Faculty of Dentistry, Niigata, Japan; Research Center for Advanced Oral Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kazuhisa Yamazaki
- Research Unit for Oral-Systemic Connection, Division of Oral Science for Health Promotion, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
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H R R, Dhamecha D, Jagwani S, Rao M, Jadhav K, Shaikh S, Puzhankara L, Jalalpure S. Local drug delivery systems in the management of periodontitis: A scientific review. J Control Release 2019; 307:393-409. [PMID: 31255689 DOI: 10.1016/j.jconrel.2019.06.038] [Citation(s) in RCA: 93] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 06/24/2019] [Accepted: 06/26/2019] [Indexed: 12/26/2022]
Abstract
Periodontitis (PD) is a microbial disease of tooth supporting tissues that results in progressive destruction of surrounding soft and hard tissues with eventual tooth mobility and exfoliation. Perioceutics, which includes the delivery of therapeutic agents via systemic and local means as an adjunct to mechanical therapy has revolutionized the arena of periodontal therapy. Selection of a right antimicrobial agent with appropriate route of drug administration is the key to successful periodontal therapy. Irrigating systems, fibers, gels, strips, films, microparticles, nanoparticles and low dose antimicrobial agents are some of the local drug delivery systems (LDDS) available in the field, which aims to deliver antimicrobial agents to sub-gingival diseased sites with minimal or no side-effects on other body sites. The present review aim to summarize the current state-of-the-art technology on LDDS in periodontal therapy ensuring the the practitioners are able to choose LDD agents which are custom made for a specific clinical condition.
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Affiliation(s)
- Rajeshwari H R
- Department of Periodontology, Manipal College of Dental Sciences, Manipal Academy of Higher Education (MAHE), Manipal 576104, Karnataka, India; Manipal McGill Center for Infectious Diseases, Prasanna School of Public Health, Manipal Academy of Higher Education (MAHE), Manipal 576104, Karnataka, India.
| | - Dinesh Dhamecha
- Dr. Prabhakar Kore Basic Science Research Centre, KLE Academy of Higher Education and Research, Belagavi 590010, Karnataka, India.
| | - Satveer Jagwani
- Dr. Prabhakar Kore Basic Science Research Centre, KLE Academy of Higher Education and Research, Belagavi 590010, Karnataka, India
| | - Meghana Rao
- Department of Periodontology, Manipal College of Dental Sciences, Manipal Academy of Higher Education (MAHE), Manipal 576104, Karnataka, India
| | - Kiran Jadhav
- KLE University's College of Pharmacy, KLE Academy of Higher Education and Research, Nehru Nagar, Belagavi 590010, Karnataka, India
| | - Shabana Shaikh
- Dr. Prabhakar Kore Basic Science Research Centre, KLE Academy of Higher Education and Research, Belagavi 590010, Karnataka, India
| | - Lakshmi Puzhankara
- Department of Periodontics, Amrita School of Dentistry, Amrita Vishwavidyapeetham, Kochi 682041, Kerala, India
| | - Sunil Jalalpure
- Dr. Prabhakar Kore Basic Science Research Centre, KLE Academy of Higher Education and Research, Belagavi 590010, Karnataka, India; KLE University's College of Pharmacy, KLE Academy of Higher Education and Research, Nehru Nagar, Belagavi 590010, Karnataka, India
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Evaluation of biodegradable gel containing flax seed extract (Linum usitatissimum) as a targeted drug delivery for management of chronic periodontitis. J Herb Med 2019. [DOI: 10.1016/j.hermed.2018.100254] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Hassan MG, Zaher AR, Palomo JM, Palomo L. Sclerostin Modulation Holds Promise for Dental Indications. Healthcare (Basel) 2018; 6:healthcare6040134. [PMID: 30477095 PMCID: PMC6316148 DOI: 10.3390/healthcare6040134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 11/13/2018] [Accepted: 11/20/2018] [Indexed: 12/31/2022] Open
Abstract
Sclerostin modulation is a novel therapeutic bone regulation strategy. The anti-sclerostin drugs, proposed in medicine for skeletal bone loss may be developed for jaw bone indications in dentistry. Alveolar bone responsible for housing dentition share common bone remodeling mechanisms with skeletal bone. Manipulating alveolar bone turnover can be used as a strategy to treat diseases such as periodontitis, where large bone defects from disease are a surgical treatment challenge and to control tooth position in orthodontic treatment, where moving teeth through bone in the treatment goal. Developing such therapeutics for dentistry is a future line for research and therapy. Furthermore, it underscores the interprofessional relationship that is the future of healthcare.
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Affiliation(s)
- Mohamed G Hassan
- Division of Craniofacial Anomalies, Department of Orofacial Sciences, University of California San Francisco, San Francisco, CA 94143, USA.
- Department of Orthodontics, Faculty of Dentistry, Alexandria University, Alexandria 21526, Egypt.
- Department of Orthodontics, Faculty of Oral and Dental Medicine, South Valley University, Qena 83523, Egypt.
| | - Abbas R Zaher
- Department of Orthodontics, Faculty of Dentistry, Alexandria University, Alexandria 21526, Egypt.
| | - Juan Martin Palomo
- Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, OH 44106-4905, USA.
| | - Leena Palomo
- Department of Periodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, OH 44106-4905, USA.
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Corrêa MG, Pires PR, Ribeiro FV, Pimentel SP, Cirano FR, Napimoga MH, Casati MZ, Casarin RCV. Systemic treatment with resveratrol reduces the progression of experimental periodontitis and arthritis in rats. PLoS One 2018; 13:e0204414. [PMID: 30281626 PMCID: PMC6169914 DOI: 10.1371/journal.pone.0204414] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 09/07/2018] [Indexed: 11/18/2022] Open
Abstract
Rheumatoid arthritis and periodontitis are chronic inflammatory diseases which has been closely associated due to the nature of immune-inflammatory imbalance response. Resveratrol is a naturall product with biological proprieties that may promote immunomodulatory effects on host response. This study investigated resveratrol continuous administration effect on experimental periodontitis and arthritis progression in rats. Thirty-five rats were assigned to the following groups: 1-experimental arthritis + experimental periodontitis + placebo (RA+EP +PL) (n = 12); 2 -RA+EP+ ibuprofen (RA+PE+IB) (n = 11); 3-RA+EP+ resveratrol (RA+PE+RSV) (n = 11). After euthanasia, the specimens were processed for morphometric analysis of bone loss, and the gingival tissue surrounding the first molar was collected for quantification of inflammatory markers using a Luminex/MAGpix assay and anti-citrullinated protein antibody (ACCPA) levels were measured by ELISA assay. Serum level of rheumatoid factor (RF) was measured by ELISA assay. Paw edema was analyzed using a plethysmometer. Higher bone loss was observed in PL group, when compared to IB and RSV groups. RSV group presented higher IL-4 concentration than PL and IB groups. Resveratrol reduced RF serum levels and both IB and RSV decreased ACCPA gingival levels. Besides, paw swelling level was significantly lower in IB and RSV groups in the 21th day and only in RSV group in the 28th day. Histological analyzes showed smooth articular surface and higher width of the subchondral cortical in RSV group. Resveratrol showed modulatory effect and seems to reduce the inflammatory signs of arthritis and articular damage throughout the time.
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Affiliation(s)
- Mônica G. Corrêa
- Dental Research Division, School of Dentistry, Paulista University, São Paulo, São Paulo, Brazil
| | - Paula Rodrigues Pires
- Dental Research Division, School of Dentistry, Paulista University, São Paulo, São Paulo, Brazil
| | - Fernanda Vieira Ribeiro
- Dental Research Division, School of Dentistry, Paulista University, São Paulo, São Paulo, Brazil
| | - Suzana Peres Pimentel
- Dental Research Division, School of Dentistry, Paulista University, São Paulo, São Paulo, Brazil
| | - Fabiano Ribeiro Cirano
- Dental Research Division, School of Dentistry, Paulista University, São Paulo, São Paulo, Brazil
| | - Marcelo Henrique Napimoga
- Laboratory of Immunology and Molecular Biology, São Leopoldo Mandic Institute and Research Center, Campinas, SP, Brazil
| | - Marcio Z. Casati
- Dental Research Division, School of Dentistry, Paulista University, São Paulo, São Paulo, Brazil
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Josamycin suppresses Prevotella intermedia lipopolysaccharide-induced production of nitric oxide and interleukin-1β in murine macrophages. Biomed Pharmacother 2018; 105:498-505. [DOI: 10.1016/j.biopha.2018.05.139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 05/27/2018] [Accepted: 05/28/2018] [Indexed: 11/17/2022] Open
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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: 220] [Impact Index Per Article: 36.7] [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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Ipshita S, Kurian IG, Dileep P, Kumar S, Singh P, Pradeep AR. One percent alendronate and aloe vera gel local host modulating agents in chronic periodontitis patients with class II furcation defects: A randomized, controlled clinical trial. ACTA ACUST UNITED AC 2018; 9:e12334. [PMID: 29722166 DOI: 10.1111/jicd.12334] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 01/19/2018] [Indexed: 12/14/2022]
Abstract
AIM Alendronate (ALN) has antiresorptive and osteostimulative properties. The major component of aloe vera (AV) gel is acemannan, which has been found to have osteogenic properties. The aim of the present study is to explore the effectiveness of 1% ALN and AV gel as an adjunct to scaling and root planing (SRP) in chronic periodontitis patients with class II furcation defects. METHODS Ninety volunteers were randomly assigned to three treatment groups: (a) SRP plus placebo gel; (b) SRP plus 1% ALN gel; and (c) SRP plus AV gel. Clinical and radiographic parameters were recorded at baseline and at 6 and 12 months. RESULTS The mean probing depth reduction and relative horizontal clinical attachment level (CAL) and relative vertical CAL gains were greater in the ALN group than in the AV and placebo groups at 6 and 12 months. Furthermore, a significantly greater mean percentage of defect depth reduction (DDR) was found in the ALN group (38.09 ± 9.53, 44.86 ± 6.29) than the AV groups (11.94 ± 15.10, 14.59 ± 25.49) at 6 and 12 months, respectively. CONCLUSION ALN showed significant improvement in all clinical parameters, along with greater DDR, compared to AV in the treatment of class II furcation defects as an adjunct to SRP.
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Affiliation(s)
- Sahu Ipshita
- Department of Periodontology, Government Dental College and Research Institute, Bangalore, Karnataka, India
| | - Ida G Kurian
- Department of Periodontology, Government Dental College and Research Institute, Bangalore, Karnataka, India
| | - Pankaj Dileep
- Department of Periodontology, Government Dental College and Research Institute, Bangalore, Karnataka, India
| | - Shatrughan Kumar
- Department of Medicine, Employee's State Insurance Postgraduate Institute of Medical Science and Research, Bangalore, Karnataka, India
| | - Priyanka Singh
- Department of Opthalmology, Grant Medical College and JJ Group of Hospitals, Mumbai, Maharashtra, India
| | - Avani R Pradeep
- Department of Periodontology, Government Dental College and Research Institute, Bangalore, Karnataka, India
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Ribeiro DDSF, Freire JMDO, Teixeira AH, Val DRD, Freitas ARD, Gomes FIF, Silva AARE, Bandeira PN, Santos HSD, Santos WPD, Ávila FN, Pereira KMA, Goes P, Pinto VDPT, Cristino-Filho G, Albuquerque MRJR, Chaves HV, Bezerra MM. Tocoyena sellowiana extract decreases bone loss in an experimental model of periodontitis in rats: Putative role for cyclooxygenase-2 and IL-1? inhibition. Biomed Pharmacother 2018; 98:863-872. [PMID: 29571257 DOI: 10.1016/j.biopha.2018.01.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 12/29/2017] [Accepted: 01/03/2018] [Indexed: 12/17/2022] Open
Abstract
Tocoyena sellowiana (Cham. & Schltdl.) K.Schum is one of the most important families of Brazilian medicinal plants. This study aimed to evaluate the effect of Tocoyena sellowiana (Cham. & Schltdl.) K.Schum ethanolic extract in a pre-clinical trial of periodontitis and to investigate possible mechanisms underlying such effects. Periodontitis was induced in Wistar rats by placing a nylon thread ligature around second upper left molars for 11 days. Rats received (per os) Tocoyena sellowiana (0.1, 1 or 10?mg?kg) or vehicle 1?h before ligature and daily until day 11. Macroscopic, histopathological, and COX-2 immunohistochemical analyses were performed to evaluate the periodontium. The gingival tissue was used to quantify the myeloperoxidase (MPO) activity and interleukin (IL)-1? levels by ELISA. Blood samples were collected to evaluate bone-specific alkaline phosphatase (BALP), the dosage of creatinine, aspartate and alanine transaminases. The liver, kidneys, spleen, and body mass variations were also evaluated. Tocoyena sellowiana decreased bone loss, reduced MPO, IL-1? levels as well as COX-2 immunostaining, and increased BALP activity. Moreover, Tocoyena sellowiana did not alter organs nor body weight. Tocoyena sellowiana reduced bone loss in rats and its efficacy was at least partially dependent upon both IL-1? and cyclooxygenase-2 inhibition.
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Affiliation(s)
| | | | - Alrieta Henrique Teixeira
- Graduate Program in Biotechnology - RENORBIO - Ph.D. Program, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Danielle Rocha do Val
- Graduate Program in Biotechnology - RENORBIO - Ph.D. Program, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | | | | | - Antonio Alfredo Rodrigues E Silva
- Faculty of Dentistry, Federal University of Ceará, Sobral, Ceara, Brazil; Graduate Program in Health Sciences, Medical School, Federal University of Ceará, Sobral, Ceará, Brazil
| | - Paulo Nogueira Bandeira
- Department of Chemistry, State University Vale do Acaraú, Sobral, Ceará, Brazil; Graduate Program in Health Sciences, Medical School, Federal University of Ceará, Sobral, Ceará, Brazil
| | | | | | | | - Karuza Maria Alves Pereira
- Department of Morphology, Faculty of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil; Graduate Program in Health Sciences, Medical School, Federal University of Ceará, Sobral, Ceará, Brazil
| | - Paula Goes
- Department of Pathology and Legal Medicine, Federal University of Ceará, Fortaleza, Brazil; Graduate Program in Health Sciences, Medical School, Federal University of Ceará, Sobral, Ceará, Brazil
| | - Vicente de Paulo Teixeira Pinto
- Graduate Program in Biotechnology, Medical School, Federal University of Ceará, Sobral, Ceará, Brazil; Faculty of Medicine, Federal University of Ceará, Sobral, Ceará, Brazil; Graduate Program in Health Sciences, Medical School, Federal University of Ceará, Sobral, Ceará, Brazil
| | - Gerardo Cristino-Filho
- Graduate Program in Biotechnology, Medical School, Federal University of Ceará, Sobral, Ceará, Brazil; Faculty of Medicine, Federal University of Ceará, Sobral, Ceará, Brazil; Graduate Program in Health Sciences, Medical School, Federal University of Ceará, Sobral, Ceará, Brazil
| | | | - Hellíada Vasconcelos Chaves
- Faculty of Dentistry, Federal University of Ceará, Sobral, Ceara, Brazil; Graduate Program in Health Sciences, Medical School, Federal University of Ceará, Sobral, Ceará, Brazil
| | - Mirna Marques Bezerra
- Graduate Program in Biotechnology, Medical School, Federal University of Ceará, Sobral, Ceará, Brazil; Faculty of Medicine, Federal University of Ceará, Sobral, Ceará, Brazil; Graduate Program in Health Sciences, Medical School, Federal University of Ceará, Sobral, Ceará, Brazil.
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Hyeon JY, Choi EY, Choe SH, Park HR, Choi JI, Choi IS, Kim SJ. Agomelatine, a MT1/MT2 melatonergic receptor agonist with serotonin 5-HT2C receptor antagonistic properties, suppresses Prevotella intermedia lipopolysaccharide-induced production of proinflammatory mediators in murine macrophages. Arch Oral Biol 2017; 82:11-18. [DOI: 10.1016/j.archoralbio.2017.05.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 04/18/2017] [Accepted: 05/20/2017] [Indexed: 11/28/2022]
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Choe SH, Choi EY, Hyeon JY, Choi IS, Kim SJ. Effect of nitric oxide-releasing derivative of indomethacin on Prevotella intermedia lipopolysaccharide-induced production of proinflammatory mediators in murine macrophages. Biochem Biophys Res Commun 2017; 492:224-230. [PMID: 28822764 DOI: 10.1016/j.bbrc.2017.08.055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 08/15/2017] [Indexed: 01/17/2023]
Abstract
The purpose of this study was to investigate the influences of NCX 2121, a nitric oxide (NO)-releasing derivative of indomethacin, upon the generation of proinflammatory mediators using murine macrophages activated by lipopolysaccharide (LPS) isolated from Prevotella intermedia, which is one of the pathogens implicated in periodontal diseases. Inducible NO synthase (iNOS)-derived NO, IL-1β and IL-6 as well as their relevant mRNA were significantly attenuated by NCX 2121 in RAW264.7 cells activated by P. intermedia LPS. NCX 2121 was much more effective than the parental compound indomethacin in reducing these proinflammatory mediators. NCX 2121 triggered induction of heme oxygenase-1 (HO-1) in cells exposed to P. intermedia LPS, and its inhibitory influence upon P. intermedia LPS-elicited NO generation was notably blocked by SnPP treatment. NCX 2121 attenuated NF-κB-dependent SEAP release induced by P. intermedia LPS. NCX 2121 did not display inhibitory action towards IκB-α degradation triggered by LPS. Instead, it significantly diminished nuclear translocation as well as DNA-binding action of NF-κB p50 subunit elicited by P. intermedia LPS. Further, NCX 2121 significantly up-regulated SOCS1 mRNA expression in cells challenged with P. intermedia LPS. In summary, NCX 2121 down-regulates P. intermedia LPS-elicited generation of NO, IL-1β and IL-6 in murine macrophages in a mechanism that involves anti-inflammatory HO-1 induction as well as decrement of NF-κB activation, which may be associated with SOCS1 expression. NCX 2121 may have potential benefits as a host immunomodulatory agent for the therapy of periodontal disease.
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Affiliation(s)
- So-Hui Choe
- Department of Biological Science, College of Medical and Life Sciences, Silla University, Busan, South Korea
| | - Eun-Young Choi
- Department of Biological Science, College of Medical and Life Sciences, Silla University, Busan, South Korea
| | - Jin-Yi Hyeon
- Department of Biological Science, College of Medical and Life Sciences, Silla University, Busan, South Korea
| | - In Soon Choi
- Department of Biological Science, College of Medical and Life Sciences, Silla University, Busan, South Korea
| | - Sung-Jo Kim
- Department of Periodontology, School of Dentistry, Pusan National University, Yangsan, Gyeongsangnam-do, South Korea; Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Gyeongsangnam-do, South Korea; Institute of Translational Dental Sciences, Pusan National University, Yangsan, Gyeongsangnam-do, South Korea.
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Yu X, Gong Z, Lin Q, Wang W, Liu S, Li S. Denervation effectively aggravates rat experimental periodontitis. J Periodontal Res 2017. [PMID: 28621056 DOI: 10.1111/jre.12472] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- X. Yu
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration; Department of Periodontology; School and Hospital of Stomatology; Shandong University; Jinan Shandong China
- Department of Endodontics; Jinan Stomatological Hospital; Jinan Shandong China
| | - Z. Gong
- Department of Endodontics; Jinan Stomatological Hospital; Jinan Shandong China
| | - Q. Lin
- Department of Endodontics; Jinan Stomatological Hospital; Jinan Shandong China
| | - W. Wang
- Department of Endodontics; Jinan Stomatological Hospital; Jinan Shandong China
| | - S. Liu
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration; Department of Periodontology; School and Hospital of Stomatology; Shandong University; Jinan Shandong China
| | - S. Li
- Shandong Provincial Key Laboratory of Oral Tissue Regeneration; Department of Periodontology; School and Hospital of Stomatology; Shandong University; Jinan Shandong China
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Agarwal S, Chaubey KK, Chaubey A, Agarwal V, Madan E, Agarwal MC. Clinical efficacy of subgingivally delivered simvastatin gel in chronic periodontitis patients. J Indian Soc Periodontol 2017; 20:409-416. [PMID: 28298823 PMCID: PMC5341316 DOI: 10.4103/0972-124x.194270] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Background: Simvastatin (SMV), a new locally delivered drug of class statins, is a specific competitive inhibitor of 3-hydroxy-2-methyl-glutaryl coenzyme A reductase. Statins, besides having lipid-lowering abilities, also have pleiotropic effects like host modulation and bone regeneration. The present study was designed to investigate the effectiveness of SMV, 1.2 mg, in an indigenously prepared biodegradable controlled-release gel as an adjunct to scaling and root planing (SRP). Materials and Methods: A total of 60 sites, with pocket depth ≥5 mm, two from each of 30 patients after SRP, were categorized into two treatment groups, for subgingival placement of placebo (Gp 1) or SMV (Gp 2). Clinical parameters were recorded at baseline and at 1, 3 and 6 months comprising plaque index, gingival index, probing pocket depth (PPD) and clinical attachment level (CAL). The osseous changes were evaluated radiographically by measuring vertical gain, INFRA 1 and angle of the defect, INFRA 2 from baseline to 6 months. Results: All subjects tolerated the drug, without any post-application complication. The treatment improved the periodontal condition in both the groups but significant reductions in PPD (p= 0.04), and INFRA 1 (p= 0.000), along with gain in CAL (p= 0.02) and INFRA 2 (p= 0.000) were observed in Gp 2. In one site, an unexpected 5 mm decrease in INFRA 1 was found. Conclusion: Local drug delivery of SMV enhanced the beneficial effect of SRP, in pocket reduction, gain in CAL and bone fill.
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Affiliation(s)
- Swati Agarwal
- Department of Periodontics, Kothiwal Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Krishna Kumar Chaubey
- Department of Periodontics, Kothiwal Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Abhinav Chaubey
- Department of Conservative Dentistry and Endodontics, Kothiwal Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Vikas Agarwal
- Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Ellora Madan
- Department of Periodontics, Kothiwal Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Manvi Chandra Agarwal
- Department of Periodontics, Kothiwal Dental College and Research Centre, Moradabad, Uttar Pradesh, India
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Messora MR, Apolinário Vieira GH, Vanderlei JMTMM, Mariguela VC, Fernandes PG, Palioto DB, Scombatti de Souza SL, Novaes AB, Furlaneto F, Taba M. Rosuvastatin promotes benefits on induced periodontitis in hypertensive rats. J Periodontal Res 2017; 52:734-744. [DOI: 10.1111/jre.12442] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2016] [Indexed: 01/04/2023]
Affiliation(s)
- M. R. Messora
- Department of Oral Surgery and Periodontology; Ribeirão Preto School of Dentistry; University of São Paulo - USP; Ribeirão Preto São Paulo Brazil
| | - G. H. Apolinário Vieira
- Department of Oral Surgery and Periodontology; Ribeirão Preto School of Dentistry; University of São Paulo - USP; Ribeirão Preto São Paulo Brazil
| | - J. M. T. M. M. Vanderlei
- Department of Oral Surgery and Periodontology; Ribeirão Preto School of Dentistry; University of São Paulo - USP; Ribeirão Preto São Paulo Brazil
| | - V. C. Mariguela
- Department of Oral Surgery and Periodontology; Ribeirão Preto School of Dentistry; University of São Paulo - USP; Ribeirão Preto São Paulo Brazil
| | - P. G. Fernandes
- Department of Oral Surgery and Periodontology; Ribeirão Preto School of Dentistry; University of São Paulo - USP; Ribeirão Preto São Paulo Brazil
| | - D. B. Palioto
- Department of Oral Surgery and Periodontology; Ribeirão Preto School of Dentistry; University of São Paulo - USP; Ribeirão Preto São Paulo Brazil
| | - S. L. Scombatti de Souza
- Department of Oral Surgery and Periodontology; Ribeirão Preto School of Dentistry; University of São Paulo - USP; Ribeirão Preto São Paulo Brazil
| | - A. B. Novaes
- Department of Oral Surgery and Periodontology; Ribeirão Preto School of Dentistry; University of São Paulo - USP; Ribeirão Preto São Paulo Brazil
| | - F. Furlaneto
- Department of Oral Surgery and Periodontology; Ribeirão Preto School of Dentistry; University of São Paulo - USP; Ribeirão Preto São Paulo Brazil
| | - M. Taba
- Department of Oral Surgery and Periodontology; Ribeirão Preto School of Dentistry; University of São Paulo - USP; Ribeirão Preto São Paulo Brazil
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Smiley CJ, Tracy SL, Abt E, Michalowicz BS, John MT, Gunsolley J, Cobb CM, Rossmann J, Harrel SK, Forrest JL, Hujoel PP, Noraian KW, Greenwell H, Frantsve-Hawley J, Estrich C, Hanson N. Systematic review and meta-analysis on the nonsurgical treatment of chronic periodontitis by means of scaling and root planing with or without adjuncts. J Am Dent Assoc 2017; 146:508-24.e5. [PMID: 26113099 DOI: 10.1016/j.adaj.2015.01.028] [Citation(s) in RCA: 158] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 01/26/2015] [Accepted: 01/28/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Conduct a systematic review and meta-analysis on nonsurgical treatment of patients with chronic periodontitis by means of scaling and root planing (SRP) with or without adjuncts. METHODS A panel of experts convened by the American Dental Association Council on Scientific Affairs conducted a search of PubMed (MEDLINE) and Embase for randomized controlled trials of SRP with or without the use of adjuncts with clinical attachment level (CAL) outcomes in trials at least 6 months in duration and published in English through July 2014. The authors assessed individual study bias by using the Cochrane Risk of Bias Tool and conducted meta-analyses to obtain the summary effect estimates and their precision and to assess heterogeneity. The authors used funnel plots and Egger tests to assess publication bias when there were more than 10 studies. The authors used a modified version of the US Preventive Services Task Force methods to assess the overall level of certainty in the evidence. RESULTS The panel included 72 articles on the effectiveness of SRP with or without the following: systemic antimicrobials, a systemic host modulator (subantimicrobial-dose doxycycline), locally delivered antimicrobials (chlorhexidine chips, doxycycline hyclate gel, and minocycline microspheres), and a variety of nonsurgical lasers (photodynamic therapy with a diode laser, a diode laser, neodymium:yttrium-aluminum-garnet lasers, and erbium lasers). CONCLUSIONS AND PRACTICAL IMPLICATIONS With a moderate level of certainty, the panel found approximately a 0.5-millimeter average improvement in CAL with SRP. Combinations of SRP with assorted adjuncts resulted in a range of average CAL improvements between 0.2 and 0.6 mm over SRP alone. The panel judged the following 4 adjunctive therapies as beneficial with a moderate level of certainty: systemic subantimicrobial-dose doxycycline, systemic antimicrobials, chlorhexidine chips, and photodynamic therapy with a diode laser. There was a low level of certainty in the benefits of the other included adjunctive therapies. The panel provides clinical recommendations in the associated clinical practice guideline.
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Bhavsar NV, Trivedi SR, Dulani K, Brahmbhatt N, Shah S, Chaudhri D. Clinical and radiographic evaluation of effect of risedronate 5 mg as an adjunct to treatment of chronic periodontitis in postmenopausal women (12-month study). Osteoporos Int 2016; 27:2611-9. [PMID: 27026334 DOI: 10.1007/s00198-016-3577-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 03/21/2016] [Indexed: 10/22/2022]
Abstract
UNLABELLED Bisphosphonates are beneficial to women, after menopause, in treatment of gum diseases. In this study, significant improvement in the disease condition was found and that no further progress was noted, and no side effects were reported. Bisphosphonates can be safely and successfully be used to support oral health procedures. INTRODUCTION The purpose of this study was to evaluate host modulating effect of bisphosphonate adjunct with the treatment of chronic periodontitis in osteopenic and osteoporotic postmenopausal women. METHODS Twenty-two osteopenic and osteoporotic postmenopausal women with moderate to severe chronic periodontitis were selected for the study. On intraoral examination, periodontal parameters like probing depth (PD), clinical attachment level (CAL), Plaque Index (PI) and Gingival Index (GI) were recorded. Scaling and root planing were done. Intraoral periapical X-rays were taken, and alveolar bone density (ABD) was measured with cone beam computed tomography (CBCT), and then, medications (risedronate 5 mg once daily (OD), calcium citrate 250 mg OD, vitamin D 400 IU OD) were given. Patients were recalled for follow-up at 3, 6 and 12 months. Intraoral periapical (IOPA) X-rays were taken at 6 and 12 months and ABD was measured at baseline and 12 months. RESULTS There was a significant improvement in all the parameters. There was an increase of 0.02 ± 0.001 cm on CT scan and 0.38 ± 0.005 mm on IOPA in bone height over 12 months from baseline. Bone density increased by 118.56 ± 3.251 Hounsfield units (HU). There was no progress in the disease, and further bone loss was not noticed. This is in correlation with clinical parameters which showed highly significant gain in CAL (3.57 ± 0.234 mm) and reduction in PD (2.20 ± 0.229 mm) CONCLUSIONS Bisphosphonate therapy as an adjunct to scaling and root planing may have significant beneficial clinical effects on the periodontium of postmenopausal women with moderate to severe chronic periodontitis.
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Affiliation(s)
- N V Bhavsar
- Department of Periodontology and Implantology, Government Dental College & Hospital, Asarwa, Ahmedabad, Gujarat, 380016, India.
| | - S R Trivedi
- Department of Periodontology and Implantology, Government Dental College & Hospital, Asarwa, Ahmedabad, Gujarat, 380016, India
| | - K Dulani
- Department of Periodontology and Implantology, Government Dental College & Hospital, Asarwa, Ahmedabad, Gujarat, 380016, India
| | - N Brahmbhatt
- Department of Periodontology and Implantology, Government Dental College & Hospital, Asarwa, Ahmedabad, Gujarat, 380016, India
| | - S Shah
- Department of Periodontology and Implantology, Government Dental College & Hospital, Asarwa, Ahmedabad, Gujarat, 380016, India
| | - D Chaudhri
- Department of Periodontology, Siddhpur Dental College, Siddhpur, Gujarat, India
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Chaffee BW, Couch ET, Ryder MI. The tobacco-using periodontal patient: role of the dental practitioner in tobacco cessation and periodontal disease management. Periodontol 2000 2016; 71:52-64. [PMID: 27045430 PMCID: PMC4842013 DOI: 10.1111/prd.12120] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2015] [Indexed: 12/26/2022]
Abstract
Although the prevalence of tobacco use has declined in some parts of the world, tobacco use remains a persistent and, in some cases, growing problem that will continue to be a fundamental challenge facing dental practitioners in the decades ahead. Dental practitioners have a unique opportunity and professional obligation to be a positive influence in reducing the economic and social burden inflicted by tobacco use on dental and general health. In this article, the current noninvasive, evidence-based approaches are presented for dental practitioners to help patients avoid initiating tobacco use, to encourage and assist patients in ceasing tobacco use and to address tobacco-induced damage to periodontal supporting tissues.
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45
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Golub LM, Elburki MS, Walker C, Ryan M, Sorsa T, Tenenbaum H, Goldberg M, Wolff M, Gu Y. Non-antibacterial tetracycline formulations: host-modulators in the treatment of periodontitis and relevant systemic diseases. Int Dent J 2016; 66:127-35. [PMID: 27009489 DOI: 10.1111/idj.12221] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Traditionally, the dental profession has primarily treated periodontitis using a mechanical/surgical, rather than a pharmaceutical, approach. However, based on experiments several decades ago which demonstrated that tetracyclines, unexpectedly, inhibit collagen- and bone-destructive mammalian-derived enzymes (e.g. the collagenases), and through non-antibiotic mechanisms, the concept of host-modulation therapy (HMT) was developed. Accordingly, two drug-development strategies evolved: (i) the development of non-antimicrobial formulations of doxycycline; and (ii) the chemical modification of tetracyclines to eliminate their antibiotic activity but retain (or even enhance) their anti-collagenase properties. Regarding the latter, these chemically modified tetracyclines (CMTs) showed efficacy in vitro, in animal models of periodontal (and relevant systemic) disease, and in preliminary clinical trials on patients with Kaposi's sarcoma (however, at the high doses used, photosensitivity was a significant side-effect). In the first strategy, subantimicrobial-dose doxycycline (SDD) demonstrated safety and efficacy in human clinical trials and was approved by the U S Food and Drug Administration (U S FDA) and in other countries for the treatment of periodontitis (20 mg, twice daily, i.e. once every 12 hours) adjunctive to scaling and root planing, and for chronic inflammatory skin diseases (40-mg sustained-release 'beads'). SDD also showed efficacy in patients with systemic diseases relevant to periodontitis, including diabetes mellitus and arthritis, and in postmenopausal women with local and systemic bone loss. Importantly, long-term administration of SDD, of up to 2 years, in clinical trials did not produce antibiotic side-effects. SDD (and in the future, new HMTs, such as low-dose CMT-3, resolvins and chemically modified curcumins) may shift the paradigm of periodontal therapy from a predominantly surgical approach to the greater use of medicinal/pharmacologic strategies, ultimately to benefit larger numbers of patients.
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Affiliation(s)
- Lorne M Golub
- Department of Oral Biology and Pathology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Muna S Elburki
- Department of Oral Biology and Pathology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA.,Department of Periodontics, Faculty of Dentistry, Benghazi University, Benghazi, Libya
| | - Clay Walker
- Department of Oral Biology, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Maria Ryan
- Department of Oral Biology and Pathology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, Institute of Dentistry, University of Helsinki, Helsinki, Finland.,Division of Periodontology, Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Howard Tenenbaum
- Department of Periodontics, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada.,Department of Periodontology, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michael Goldberg
- Department of Periodontics, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Mark Wolff
- Department of Cariology and Comprehensive Care, College of Dentistry, New York University, New York City, NY, USA
| | - Ying Gu
- Department of General Dentistry, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA
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46
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Chee B, Park B, Fitzsimmons T, Coates AM, Bartold PM. Omega-3 fatty acids as an adjunct for periodontal therapy-a review. Clin Oral Investig 2016; 20:879-94. [PMID: 26885664 DOI: 10.1007/s00784-016-1750-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 02/10/2016] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The aim of this article is to present an overview of omega-3 fatty acids, their anti-inflammatory properties and potential use as an adjunct for periodontal therapy. MATERIALS AND METHODS A general literature search was conducted to provide an overview of omega-3 fatty acids, their metabolism and anti-inflammatory properties. A more specific literature search of PubMed and EMBASE was conducted to identify articles dealing studies investigating the effects of omega-3 fatty acids in the treatment of periodontitis in animals and humans and included cross-sectional, longitudinal and intervention designs. RESULTS To date, there is good emerging evidence that dietary supplementation with fish oil may be of some benefit and this is enhanced if combined with aspirin. All clinical intervention studies to date have been on small sample sizes, and this indicates there is need for larger and more robust clinical trials to verify these initial findings. CONCLUSIONS Dietary supplementation with fish oil could be a cost-effective adjunctive therapy to the management of periodontal disease. CLINICAL RELEVANCE The host modulatory properties of omega-3 fatty acids warrant further assessment of their use as an adjunct in the management of periodontitis.
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Affiliation(s)
- B Chee
- Department of Dentistry, Colgate Australian Clinical Dental Research Centre, Dental School, University of Adelaide, Frome Road, Adelaide, SA, 5005, Australia
| | - B Park
- Department of Dentistry, Colgate Australian Clinical Dental Research Centre, Dental School, University of Adelaide, Frome Road, Adelaide, SA, 5005, Australia
| | - T Fitzsimmons
- Department of Dentistry, Colgate Australian Clinical Dental Research Centre, Dental School, University of Adelaide, Frome Road, Adelaide, SA, 5005, Australia
| | - A M Coates
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Sansom Institute for Health Research, Division of Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - P M Bartold
- Department of Dentistry, Colgate Australian Clinical Dental Research Centre, Dental School, University of Adelaide, Frome Road, Adelaide, SA, 5005, Australia.
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Choi EY, Choe SH, Hyeon JY, Park HR, Choi JI, Choi IS, Kim SJ. NCX 4040, a nitric oxide-donating aspirin derivative, inhibits Prevotella intermedia lipopolysaccharide-induced production of proinflammatory mediators in murine macrophages. Eur J Pharmacol 2015; 768:87-95. [PMID: 26511379 DOI: 10.1016/j.ejphar.2015.10.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Revised: 09/15/2015] [Accepted: 10/19/2015] [Indexed: 10/22/2022]
Abstract
In this study, the effects and underlying mechanisms of NCX 4040, a nitric oxide (NO)-donating aspirin derivative, on the production of proinflammatory mediators were examined using murine macrophages exposed to lipopolysaccharide (LPS) from Prevotella intermedia, a pathogen implicated in the etiology of periodontal disease. NCX 4040 significantly reduced P. intermedia LPS-induced production of inducible NO synthase (iNOS)-derived NO, IL-1β and IL-6 as well as their mRNA expression in RAW264.7 cells. Notably, NCX 4040 was much more effective than the parental compound aspirin in reducing LPS-induced production of inflammatory mediators. NCX 4040 induced the expression of heme oxygenase-1 (HO-1) in cells treated with P. intermedia LPS, and the suppressive effect of NCX 4040 on LPS-induced NO production was significantly reversed by SnPP, a competitive HO-1 inhibitor. NCX 4040 did not influence LPS-induced phosphorylation of JNK and p38. IκB-α degradation as well as nuclear translocation and DNA-binding activities of NF-κB p65 and p50 subunits induced by P. intermedia LPS were significantly reduced by NCX 4040. Besides, LPS-induced phosphorylation of STAT1 and STAT3 was significantly down-regulated by NCX 4040. Further, NCX 4040 elevated the SOCS1 mRNA in cells stimulated with LPS. This study indicates that NCX 4040 inhibits P. intermedia LPS-induced production of NO, IL-1β and IL-6 in murine macrophages through anti-inflammatory HO-1 induction and suppression of NF-κB, STAT1 and STAT3 activation, which is associated with the activation of SOCS1 signaling. NCX 4040 could potentially be a promising tool in the treatment of periodontal disease, although further studies are required to verify this.
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Affiliation(s)
- Eun-Young Choi
- Department of Biological Science, College of Medical and Life Sciences, Silla University, Busan, Korea
| | - So-Hui Choe
- Department of Biological Science, College of Medical and Life Sciences, Silla University, Busan, Korea
| | - Jin-Yi Hyeon
- Department of Biological Science, College of Medical and Life Sciences, Silla University, Busan, Korea
| | - Hae Ryoun Park
- Department of Oral Pathology, School of Dentistry, Pusan National University, Yangsan, Gyeongsangnam-do, Korea; Institute of Translational Dental Sciences, Pusan National University, Yangsan, Gyeongsangnam-do, Korea
| | - Jeom-Il Choi
- Department of Periodontology, School of Dentistry, Pusan National University, Yangsan, Gyeongsangnam-do, Korea; Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Gyeongsangnam-do, Korea
| | - In Soon Choi
- Department of Biological Science, College of Medical and Life Sciences, Silla University, Busan, Korea
| | - Sung-Jo Kim
- Department of Periodontology, School of Dentistry, Pusan National University, Yangsan, Gyeongsangnam-do, Korea; Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Gyeongsangnam-do, Korea; Institute of Translational Dental Sciences, Pusan National University, Yangsan, Gyeongsangnam-do, Korea.
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48
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Choi EY, Bae SH, Ha MH, Choe SH, Hyeon JY, Choi JI, Choi IS, Kim SJ. Genistein suppresses Prevotella intermedia lipopolysaccharide-induced inflammatory response in macrophages and attenuates alveolar bone loss in ligature-induced periodontitis. Arch Oral Biol 2015; 62:70-9. [PMID: 26655950 DOI: 10.1016/j.archoralbio.2015.11.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 09/08/2015] [Accepted: 11/23/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Genistein is a major isoflavone subclass of flavonoids found in soybean and a potent tyrosine kinase inhibitor. The present study aimed to assess the effect of genistein on the production of proinflammatory mediators in murine macrophages stimulated with lipopolysaccharide (LPS) isolated from Prevotella intermedia, a pathogen associated with different forms of periodontal disease, and to evaluate its possible influence on alveolar bone loss in ligature-induced periodontitis using micro-computed tomography (micro-CT) analysis as well. DESIGN LPS was isolated from P. intermedia ATCC 25611 by using the standard hot phenol-water method. Culture supernatants were analyzed for nitric oxide (NO) and interleukin-6 (IL-6). Inducible NO synthase (iNOS) protein expression was evaluated by immunoblot analysis. Real-time PCR was carried out to measure iNOS and IL-6 mRNA expression. In addition, effect of genistein on alveolar bone loss was evaluated in a rat model of experimental periodontitis using micro-CT analysis. RESULTS Genistein significantly attenuated P. intermedia LPS-induced production of iNOS-derived NO and IL-6 with attendant decrease in their mRNA expression in RAW264.7 cells. In addition, when genistein was administered to rats, decreases in alveolar bone height and bone volume fraction induced by ligature placement were significantly inhibited. Genistein administration also prevented ligature-induced alterations in the microstructural parameters of trabecular bone, including trabecular thickness, trabecular separation, bone mineral density and structure model index. CONCLUSIONS While additional studies are required, we suggest that genistein could be utilized for the therapy of human periodontitis in the future.
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Affiliation(s)
- Eun-Young Choi
- Department of Biological Science, College of Medical and Life Sciences, Silla University, Busan, Republic of Korea
| | - Seung Han Bae
- Department of Periodontology, School of Dentistry, Pusan National University, Yangsan, Gyeongsangnam-do, Republic of Korea
| | - Min Hee Ha
- Department of Periodontology, School of Dentistry, Pusan National University, Yangsan, Gyeongsangnam-do, Republic of Korea
| | - So-Hui Choe
- Department of Biological Science, College of Medical and Life Sciences, Silla University, Busan, Republic of Korea
| | - Jin-Yi Hyeon
- Department of Biological Science, College of Medical and Life Sciences, Silla University, Busan, Republic of Korea
| | - Jeom-Il Choi
- Department of Periodontology, School of Dentistry, Pusan National University, Yangsan, Gyeongsangnam-do, Republic of Korea; Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Gyeongsangnam-do, Republic of Korea
| | - In Soon Choi
- Department of Biological Science, College of Medical and Life Sciences, Silla University, Busan, Republic of Korea
| | - Sung-Jo Kim
- Department of Periodontology, School of Dentistry, Pusan National University, Yangsan, Gyeongsangnam-do, Republic of Korea; Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Gyeongsangnam-do, Republic of Korea; Institute of Translational Dental Sciences, Pusan National University, Yangsan, Gyeongsangnam-do, Republic of Korea.
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Çalışır M, Akpınar A, Poyraz Ö, Göze F, Çınar Z. The histopathological and morphometric investigation of the effects of systemically administered humic acid on alveolar bone loss in ligature-induced periodontitis in rats. J Periodontal Res 2015; 51:499-507. [DOI: 10.1111/jre.12329] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2015] [Indexed: 11/28/2022]
Affiliation(s)
- M. Çalışır
- Department of Periodontology; Faculty of Dentistry; Adıyaman University; Adıyaman Turkey
| | - A. Akpınar
- Department of Periodontology; Faculty of Dentistry; Cumhuriyet University; Sivas Turkey
| | - Ö. Poyraz
- Department of Microbiology; Faculty of Medicine; Cumhuriyet University; Sivas Turkey
| | - F. Göze
- Department of Pathology; Faculty of Medicine; Cumhuriyet University; Sivas Turkey
| | - Z. Çınar
- Department of Biostatistics; Faculty of Medicine; Cumhuriyet University; Sivas Turkey
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50
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Carbon monoxide-releasing molecule-3 suppresses Prevotella intermedia lipopolysaccharide-induced production of nitric oxide and interleukin-1β in murine macrophages. Eur J Pharmacol 2015; 764:22-29. [DOI: 10.1016/j.ejphar.2015.06.039] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 06/17/2015] [Accepted: 06/18/2015] [Indexed: 01/10/2023]
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