1
|
Diehl D, Friedmann A, Bachmann HS. Prenyltransferase gene expression reveals an essential role of prenylation for the inflammatory response in human gingival fibroblasts. J Periodontol 2023; 94:1450-1460. [PMID: 37432945 DOI: 10.1002/jper.23-0220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/08/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND Prenyltrasferases (PTases) are a class of enzymes known to be responsible for promoting posttranslational modification at the carboxyl terminus of proteins containing a so-called CaaX-motif. The process is responsible for proper membrane localization and the appropriate function of several intracellular signaling proteins. Current research demonstrating the pathomechanistic importance of prenylation in inflammatory illnesses emphasizes the requirement to ascertain the differential expression of PT genes under inflammatory settings, particularly in periodontal disease. METHODS Telomerase-immortalized human gingival fibroblasts (HGF-hTert) were cultured and treated with either inhibitors of prenylation (PTI) lonafarnib, tipifarnib, zoledronic acid, or atorvastatin at concentrations of 10 μM in combination with or without 10 μg Porphyromonas gingivalis lipopolysaccharide (LPS) for 24 h. Prenyltransferase genes FNTB, FNTA, PGGT1B, RABGGTA, RABGGTB, and PTAR1 as well as inflammatory marker genes MMP1 and IL1B were detected using quantitative real-time polymerase chain reaction (RT-qPCR). Immunoblot and protein immunoassay were used to confirm the results on the protein level. RESULTS RT-qPCR experiments revealed significant upregulation of IL1B, MMP1, FNTA, and PGGT1B upon LPS treatment. PTase inhibitors caused significant downregulation of the inflammatory cytokine expression. Interestingly, FNTB expression was significantly upregulated in response to any PTase inhibitor in combination with LPS, but not upon LPS treatment only, indicating a vital role of protein farnesyltransferase in the proinflammatory signaling cascade. CONCLUSIONS In this study, distinct PTase gene expression patterns in pro-inflammatory signaling were discovered. Moreover, PTase inhibiting drugs ameliorated inflammatory mediator expression by a significant margin, indicating that prenylation is a major pre-requisite for innate immunity in periodontal cells.
Collapse
Affiliation(s)
- Daniel Diehl
- Institute of Pharmacology and Toxicology, Center for Biomedical Education and Research (ZBAF), Faculty of Health, Witten/Herdecke University, Witten, Germany
- Department of Periodontology, Center for Biomedical Education and Research (ZBAF), Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Anton Friedmann
- Department of Periodontology, Center for Biomedical Education and Research (ZBAF), Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Hagen S Bachmann
- Institute of Pharmacology and Toxicology, Center for Biomedical Education and Research (ZBAF), Faculty of Health, Witten/Herdecke University, Witten, Germany
| |
Collapse
|
2
|
Jung D, Bachmann HS. Regulation of protein prenylation. Biomed Pharmacother 2023; 164:114915. [PMID: 37236024 DOI: 10.1016/j.biopha.2023.114915] [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: 03/27/2023] [Revised: 05/17/2023] [Accepted: 05/18/2023] [Indexed: 05/28/2023] Open
Abstract
Prenyltransferases (PTases) are known to play a role in embryonic development, normal tissue homeostasis and cancer by posttranslationally modifying proteins involved in these processes. They are being discussed as potential drug targets in an increasing number of diseases, ranging from Alzheimer's disease to malaria. Protein prenylation and the development of specific PTase inhibitors (PTIs) have been subject to intense research in recent decades. Recently, the FDA approved lonafarnib, a specific farnesyltransferase inhibitor that acts directly on protein prenylation; and bempedoic acid, an ATP citrate lyase inhibitor that might alter intracellular isoprenoid composition, the relative concentrations of which can exert a decisive influence on protein prenylation. Both drugs represent the first approved agent in their respective substance class. Furthermore, an overwhelming number of processes and proteins that regulate protein prenylation have been identified over the years, many of which have been proposed as molecular targets for pharmacotherapy in their own right. However, certain aspects of protein prenylation, such as the regulation of PTase gene expression or the modulation of PTase activity by phosphorylation, have attracted less attention, despite their reported influence on tumor cell proliferation. Here, we want to summarize the advances regarding our understanding of the regulation of protein prenylation and the potential implications for drug development. Additionally, we want to suggest new lines of investigation that encompass the search for regulatory elements for PTases, especially at the genetic and epigenetic levels.
Collapse
Affiliation(s)
- Dominik Jung
- Institute of Pharmacology and Toxicology, Center for Biomedical Education and Research (ZBAF), School of Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Hagen S Bachmann
- Institute of Pharmacology and Toxicology, Center for Biomedical Education and Research (ZBAF), School of Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany.
| |
Collapse
|
3
|
Ozden FO, Demir E, Lutfioglu M, Acarel EE, Bilgici B, Atmaca A. Effects of periodontal and bisphosphonate treatment on the gingival crevicular levels of sclerostin and dickkopf-1 in postmenopausal osteoporosis with and without periodontitis. J Periodontal Res 2022; 57:849-858. [PMID: 35665506 DOI: 10.1111/jre.13023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 05/12/2022] [Accepted: 05/25/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE AND BACKGROUND Both periodontitis and osteoporosis are associated with osteoclast-related bone resorption. Bone metabolism is regulated by wingless-type MMTV integration site family (WNT), and WNT/β-catenin signals are controlled by physiological antagonists including dickkopf-1 (DKK-1) and sclerostin (SOST). This study examined the effects of periodontal and bisphosphonate (BP) treatment on the gingival crevicular fluid (GCF) sclerostin (SOST) and dickkopf-related protein-1 (DKK-1) levels in osteoporotic and systemically healthy postmenopausal women with and without periodontitis. MATERIALS AND METHODS A total of 48 postmenopausal women were divided into 4 groups (n = 12) according to periodontal health and osteoporosis status, as follows: Group OP/P: subjects with both osteoporosis and periodontitis; Group P: systemically healthy subjects with periodontitis; Group OP: periodontally healthy subjects with osteoporosis; Group H: systemically and periodontally healthy controls. Clinical data and GCF SOST and DKK-1 levels of the participants were collected at baseline and at 6 and 12 months following the initiation of periodontal and/or BP treatment in the experimental groups. GCF SOST and DKK-1 data were obtained by ELISA. RESULTS Clinical improvements were observed in all experimental groups. GCF SOST and DKK1 baseline levels varied significantly between groups due to periodontal disease (p < .001). Following treatment, significant increases in SOST and DKK-1 concentrations and significant decreases in total amounts of SOST were observed in both periodontitis groups (OP/P, P). However, while total amounts of DKK-1 decreased in Group OP/P, in Group P, these amounts had significantly increased at 12 months post-treatment (p < .05). At both 6 and 12 months post-treatment, SOST and DDK1 total amounts in Groups OP/P, OP, and H were similar (p > .05), whereas significant differences were observed between Groups H and P, indicating a deviation from periodontal health in Group P (p < .01). CONCLUSIONS Significant changes in GCF SOST and DKK-1 levels were observed among women with osteoporosis who received both periodontal and BP treatment. A more detailed examination of how these treatment protocols can be combined may lead to new therapeutic approaches towards periodontal disease.
Collapse
Affiliation(s)
- Feyza Otan Ozden
- Department of Periodontology, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
| | - Esra Demir
- Department of Periodontology, Faculty of Dentistry, Bezmialem Vakıf University, İstanbul, Turkey
| | - Müge Lutfioglu
- Department of Periodontology, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
| | - Elif Eser Acarel
- Department of Periodontology, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
| | - Birsen Bilgici
- Department of Biochemistry, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Aysegül Atmaca
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| |
Collapse
|
4
|
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/).
Collapse
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
| |
Collapse
|
5
|
Kajimoto NDC, de Paiva Buischi Y, Loomer PM, Bromage TG, Ervolino E, Fucini SE, Pola NM, Pirovani BO, Morábito MJS, de Almeida JM, Chaves Furlaneto FA, Nagata MJH. Adjuvant therapy with 1% alendronate gel for experimental periodontitis treatment in rats. J Periodontal Implant Sci 2021; 51:374-385. [PMID: 34965617 PMCID: PMC8718338 DOI: 10.5051/jpis.2100700035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 04/12/2021] [Accepted: 05/10/2021] [Indexed: 11/08/2022] Open
Abstract
Purpose The aim of this study was to evaluate the effects of locally delivered 1% alendronate (ALN) gel used as an adjunct to non-invasive periodontal therapy. Methods Ligature-induced periodontitis was performed in 96 rats. The ligature was tied in the cervical area of the mandibular left first molar. The animals were randomly divided into 4 groups: 1) NT, no treatment; 2) SRP, scaling and root planning; 3) SRP/PLA, SRP followed by filling the periodontal pocket with placebo gel (PLA); and 4) SRP/ALN, SRP followed by filling the periodontal pockets with 1% ALN gel. Histomorphometric (percentage of bone in the furcation region [PBF]) and immunohistochemical (receptor activator of nuclear factor-κB ligand, osteoprotegerin, and tartrate-resistant acid phosphatase) analyses were performed. Data were statistically analyzed, with the threshold of statistical significance set at P≤0.05. Results The SRP, SRP/PLA, and SRP/ALN groups presented a higher PBF than the NT group (P≤0.01) at 7, 15, and 30 days. The SRP/ALN group presented a higher PBF than the SRP/PLA group in all experimental periods, as well as a higher PBF than the SRP group at 15 and 30 days. No differences were observed in the immunohistochemical analyses (P>0.05 for all). Conclusions Locally delivered 1% ALN gel used as an adjunct to SRP enhanced bone regeneration in the furcation region in a rat model of experimental periodontitis.
Collapse
Affiliation(s)
- Natália de Campos Kajimoto
- Department of Periodontics, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
| | - Yvonne de Paiva Buischi
- Department of Periodontics, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.,Department of Periodontology and Implant Dentistry, New York University College of Dentistry, New York, NY, USA
| | - Peter Michael Loomer
- Department of Periodontics, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Timothy G Bromage
- Department of Biomaterials & Biomimetics, New York University College of Dentistry, New York, NY, USA
| | - Edilson Ervolino
- Division of Histology, Department of Basic Sciences, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | | | - Natália Marcumini Pola
- Division of Periodontics, Department of Semiology and Clinic, Federal University of Pelotas (UFPEL), School of Dentistry, Pelotas, RS, Brazil
| | - Beatriz Ommati Pirovani
- Division of Periodontology, Department of Surgery and Integrated Clinic, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Maria Juliana Sismeiro Morábito
- Division of Periodontology, Department of Surgery and Integrated Clinic, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Juliano Milanezi de Almeida
- Division of Periodontology, Department of Surgery and Integrated Clinic, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Flávia Aparecida Chaves Furlaneto
- Division of Periodontology, Departament of Oral Maxillofacial Surgery and Periodontology, University of São Paulo (USP), School of Dentistry, Ribeirão Preto, SP, Brazil
| | - Maria José Hitomi Nagata
- Division of Periodontology, Department of Surgery and Integrated Clinic, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| |
Collapse
|
6
|
Reddy M. A Tribute to the Enduring Lessons of Marjorie Jeffcoat. J Dent Res 2021. [DOI: 10.1177/00220345211001360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- M.S. Reddy
- UCSF School of Dentistry, Oral Health Affairs, University of California San Francisco, San Francisco, CA, USA
| |
Collapse
|
7
|
Donos N, Calciolari E, Brusselaers N, Goldoni M, Bostanci N, Belibasakis GN. The adjunctive use of host modulators in non-surgical periodontal therapy. A systematic review of randomized, placebo-controlled clinical studies. J Clin Periodontol 2021; 47 Suppl 22:199-238. [PMID: 31834951 DOI: 10.1111/jcpe.13232] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 11/10/2019] [Accepted: 12/01/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Considering the role of the inflammatory host response in the pathogenesis of periodontitis, different host modulators have been proposed to enhance the outcomes of non-surgical periodontal therapy (NSPT), but their efficacy has not been fully clarified. OBJECTIVES This systematic review investigated the efficacy of host modulators combined with NSPT in reducing probing pocket depth (PPD) in periodontitis patients. MATERIALS AND METHODS Placebo-controlled RCTs with ≥6 months follow-up were searched. Meta-analysis was conducted when ≥5 studies using the same host modulator were identified. RESULTS Fifty eight studies met the inclusion criteria. After 6 months, local administration of 1.2% statin gels as adjuncts to NSPT significantly improved PPD reduction (1.83 mm) in infrabony defects and systemic administration of sub-antimicrobial dose doxycycline (SDD) in addition to NSPT improved PPD reduction of deep pockets. Administration of probiotics conferred limited clinical benefits. Local bisphosphonate and metformin gels showed potential for clinical use in infrabony defects, which needs to be confirmed. CONCLUSIONS Local delivery of statins in infrabony defects and systemic SDD for deep pockets may confer additional clinical benefits to NSPT. Their long-term effectiveness and safety need to be confirmed in independent multi-centred studies. Further studies are needed to confirm the benefit of other host modulators.
Collapse
Affiliation(s)
- Nikolaos Donos
- Centre for Oral Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research, Barts and The London School of Medicine & Dentistry, Institute of Dentistry, Queen Mary University of London (QMUL), London, UK
| | - Elena Calciolari
- Centre for Oral Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research, Barts and The London School of Medicine & Dentistry, Institute of Dentistry, Queen Mary University of London (QMUL), London, UK
| | - Nele Brusselaers
- Centre of Translational Microbiome Research, Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet, Stockholm, Sweden
| | - Matteo Goldoni
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Nagihan Bostanci
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Georgios N Belibasakis
- Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
8
|
Zymperdikas VF, Yavropoulou MP, Kaklamanos EG, Papadopoulos MA. Bisphosphonates as Supplement to Dental Treatment: A Network Meta-Analysis. J Dent Res 2020; 100:341-351. [PMID: 33208008 DOI: 10.1177/0022034520972945] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
The objective of this study was to assess clinical measurements related to the effectiveness of bisphosphonate (BP) administration as a supplement to conventional dental treatment in patients free of bone-related diseases using a network meta-analysis. Only randomized controlled trials (RCTs) were included that provided dental clinical measurements on human patients treated with BPs with or without similar untreated controls or treated with placebo. Information sources included a systematic search of 17 electronic databases up to August 2020, complemented by manual searches. Risk of bias assessment was performed with the revised Cochrane risk of bias tool for randomized trials (RoB 2.0). Extracted measurements were pooled according to time of evaluation. The random-effects model by DerSimonian and Laird was used to calculate mean differences (MDs) and the respective 95% confidence intervals (CIs). Seven RCTs were included in the network meta-analysis, assessing 391 subjects reporting on periodontal treatment effects after 2 to 12 mo of BP administration. BP treatment was associated with significant improvement of most clinical measurements, compared with BP-naive controls. According to the network ranking, alendronate was more efficient in improvement of probing depth and clinical attachment gain when compared to zoledronate or alendronate/risedronate. Similarly, the local application of alendronate as a gel was more effective than the oral administration. A long-term analysis of the pharmaceutical effects was not possible due to insufficient data. The current review, performed according to existing guidelines, included only RCTs and, through appropriate statistical analyses, provided precise estimates for most assessed outcomes. However, no adverse effects or long-term treatment results were analyzed due to inadequate pertinent data. BP administration seems to be beneficial in the short term for the treatment of periodontal diseases, mainly through controlling periodontal inflammation.
Collapse
Affiliation(s)
- V F Zymperdikas
- Department of Orthodontics, School of Health Sciences, Faculty of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Dental Department, 424 Military Hospital of Thessaloniki, Thessaloniki, Greece
| | - M P Yavropoulou
- First Propaedeutic Department of Internal Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - E G Kaklamanos
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - M A Papadopoulos
- Department of Orthodontics, School of Health Sciences, Faculty of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| |
Collapse
|
9
|
Gupta S, Mathur S, Kapoor A, Vijay S, Khatri RK, Srivastava R. Clinical efficacy of amino bisphosphonate on periodontal disease status in postmenopausal women: Randomized double-blind placebo-controlled trial. J Family Med Prim Care 2020; 9:4919-4924. [PMID: 33209822 PMCID: PMC7652136 DOI: 10.4103/jfmpc.jfmpc_724_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/11/2020] [Accepted: 07/03/2020] [Indexed: 11/17/2022] Open
Abstract
Objectives: Osteoporosis is a common skeletal disorder affecting postmenopausal women. Data suggest that postmenopausal women are at increased risk of periodontal diseases. Amino bisphosphonates are potent inhibitors of bone resorption and effectively used in the treatment of osteoporosis. Preliminary data indicate that there is a potential role for bisphosphonates in the management of periodontitis. Hence, this randomized placebo-controlled trial was designed to investigate the clinical efficacy of amino bisphosphonate on periodontal disease status among postmenopausal women. Materials and Methods: Thirty patients were randomly allocated to two treatment groups: Group A, which received scaling and root debridement and 70 mg weekly single oral dose of alendronate drug, and Group B, which received scaling and root debridement and placebo drug for 6 months. Clinical periodontal measurements were carried out for all patients at the baseline and 6 months later. Mandibular bone mineral density (BMD) was measured using a dual energy X-ray absorptiometer at the beginning of the study and the end of 6 months. Results: A weekly single oral dose of 70 mg alendronate was well-tolerated. The intragroup comparison showed significant improvement in periodontal parameters in both groups. The intergroup comparison showed a significant increase in BMD after 6 months in Group A when compared with Group B (P = 0.0179). Conclusion: Single oral dose of 70 mg alendronate per week is well-tolerable, gastro-intestinally safe, and improves the clinical outcome of nonsurgical periodontal therapy.
Collapse
Affiliation(s)
- Shikha Gupta
- Department of Periodontics, RUHS College of Dental Sciences, Jaipur, Rajasthan, India
| | - Setu Mathur
- Department of Periodontics, RUHS College of Dental Sciences, Jaipur, Rajasthan, India
| | - Anjali Kapoor
- Department of Periodontics, RUHS College of Dental Sciences, Jaipur, Rajasthan, India
| | - Sharmistha Vijay
- Department of Periodontics, RUHS College of Dental Sciences, Jaipur, Rajasthan, India
| | - Rohit K Khatri
- Department of Conservative Dentistry and Endodontics, RUHS College of Dental Sciences, Jaipur, Rajasthan, India
| | - Rashi Srivastava
- Department of Oral Pathology, Rajasthan Dental College, Jaipur, Rajasthan, India
| |
Collapse
|
10
|
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.
Collapse
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
| |
Collapse
|
11
|
Taguchi A, Shiraki M, Tanaka S, Ohshige H, Nakamura T. Improved periodontal disease and prevention of tooth loss in osteoporosis patients receiving once-yearly zoledronic acid: a randomized clinical trial. Menopause 2019; 26:1277-1283. [PMID: 31688575 DOI: 10.1097/gme.0000000000001393] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This randomized, clinical trial investigated whether zoledronic acid combined with oral health maintenance can improve periodontal disease associated with osteoporosis, thus reducing the risk of tooth loss. METHODS Participants were those of the ZONE (ZOledroNate treatment in efficacy to osteoporosis) study. None of the participants had symptomatic periodontal disease at baseline. Participants received either zoledronic acid (5 mg; n = 333 [male 21, female 312]) or placebo (n = 332 [male 19, female 313]) once yearly for 2 years, and their age was 74.0 ± 5.3 (65-88) and 74.3 ± 5.4 (65-87) years, respectively. Participants were instructed to maintain good oral hygiene at baseline and every 3 months. Participants with signs or symptoms involving their oral cavity at the monthly visit with their physician were referred to dentists for examination of oral disease. All cases were included to analyze adverse events in this study. Testing for significance was conducted using Fisher exact test (P < 0.05). RESULTS The incidence of oral adverse events was significantly higher in the control group (67 cases, 20.2%) than in the zoledronic acid group (47 cases, 14.1%; P = 0.04). The frequency of symptomatic periodontal disease observed during the study was significantly higher in the control group (40 cases, 12.0%) than in the zoledronic acid group (18 cases, 5.4%; P = 0.002). Loss of teeth was more frequent in the control group (36 cases, 10.8%) than in the zoledronic acid group (24 cases, 7.2%), although the difference was not significant. CONCLUSIONS Zoledronic acid effectively prevented symptomatic periodontal disease in patients with osteoporosis who maintained good oral hygiene. : Video Summary: Supplemental Digital Content 1, http://links.lww.com/MENO/A438.
Collapse
Affiliation(s)
- Akira Taguchi
- Department of Oral and Maxillofacial Radiology, Matsumoto Dental University, Nagano, Japan
| | - Masataka Shiraki
- Research Institute and Practice for Involutional Diseases, Nagano, Japan
| | | | | | | |
Collapse
|
12
|
Kato CN, Barra SG, Tavares NP, Amaral TM, Brasileiro CB, Mesquita RA, Abreu LG. Use of fractal analysis in dental images: a systematic review. Dentomaxillofac Radiol 2019; 49:20180457. [PMID: 31429597 DOI: 10.1259/dmfr.20180457] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES This study reviewed the use of fractal analysis (FA) in dental images. METHODS A search was performed using PubMed, MEDLINE, LILACS, Web of Science and SCOPUS databases. The inclusion criteria were human studies in the English language, with no date restriction. RESULTS 78 articles were found in which FA was applied to panoramic radiographs (34), periapical radiographs (21), bitewing radiographs (4), cephalometric radiograph (1), cone beam CT (15), micro-CT (3), sialography (2), and ultrasound (2). Low bone mineral density (21) and systemic or local diseases (22) around the bone of dental implants were the main subjects of the study of FA. Various sizes and sites of the regions of interest were used to evaluate the bone structure. Different ways were used to treat the image and to calculate FA. FA of 43 articles showed significant differences in the comparison of groups, mainly between healthy and sick patients. CONCLUSIONS FA in Dentistry has been widely applied to the study of images. Panoramic and periapical radiographs were those most frequently used. The Image J software and the box-counting method were extensively adopted in the studies reviewed herein. Further studies are encouraged to improve clarification of the parameters that directly influence FA.
Collapse
Affiliation(s)
- Camila Nao Kato
- Department of Oral Pathology and Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Sâmila G Barra
- Department of Oral Pathology and Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Núbia Pk Tavares
- Department of Oral Pathology and Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Tânia Mp Amaral
- Department of Oral Pathology and Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Cláudia B Brasileiro
- Department of Oral Pathology and Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Ricardo A Mesquita
- Department of Oral Pathology and Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Lucas G Abreu
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| |
Collapse
|
13
|
Carvalho Dutra B, Oliveira AMSD, Oliveira PAD, Miranda Cota LO, Silveira JO, Costa FO. Effects of topical application of 1% sodium alendronate gel in the surgical treatment of periodontal intrabony defects: A 6-month randomized controlled clinical trial. J Periodontol 2019; 90:1079-1087. [PMID: 31071760 DOI: 10.1002/jper.19-0160] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 04/29/2019] [Accepted: 05/01/2019] [Indexed: 01/26/2023]
Abstract
BACKGROUND Sodium alendronate (ALN) is an aminobisphosphonate and potent inhibitor of bone resorption. It has been suggested that ALN might be a promising carrier of biomolecules for periodontal bone repair. The aim of this randomized split-mouth clinical trial was to evaluate the effects of the topical application of 1% ALN gel in intrabony defects during the surgical treatment of patients with periodontitis. METHODS Sixty-four intrabony defects from 32 patients with periodontitis were randomly treated with either 1% ALN gel or placebo gel during periodontal surgeries. Full-mouth periodontal examination was performed at baseline and at 3 and 6 months after surgical treatment. Clinical attachment level (CAL), probing depth (PD), and bleeding on probing (BOP) were recorded as the clinical outcomes. Bone defects were evaluated by digital subtraction radiography (DSR) at baseline and 6 months post-treatment. Analyses were performed through Fisher, Kruskal-Wallis, and ANOVA tests and a generalized estimation equations method. RESULTS Both ALN and placebo groups showed significant improvements in BOP, PD, and CAL after periodontal surgical procedures (P < 0.001). Intergroup analysis showed significantly better outcomes in the ALN group with higher PD reduction and clinical attachment gain. DSR showed positive effects on periodontal bone repair strongly associated in the ALN group (P < 0.001). CONCLUSION Topical application of 1% ALN may be a promising and beneficial adjuvant for the treatment of intrabony defects during surgical periodontal therapy.
Collapse
Affiliation(s)
- Bernardo Carvalho Dutra
- Department of Dental Clinics, Oral Surgery and Oral Pathology, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | | | - Luís Otávio Miranda Cota
- Department of Dental Clinics, Oral Surgery and Oral Pathology, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Juliana Oliveira Silveira
- Department of Dental Clinics, Oral Surgery and Oral Pathology, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Fernando Oliveira Costa
- Department of Dental Clinics, Oral Surgery and Oral Pathology, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| |
Collapse
|
14
|
Local administration of Tiludronic Acid downregulates important mediators involved in periodontal tissue destruction in experimental periodontitis in rats. Arch Oral Biol 2018; 88:1-9. [DOI: 10.1016/j.archoralbio.2018.01.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 12/30/2017] [Accepted: 01/09/2018] [Indexed: 11/18/2022]
|
15
|
Swidi AJ, Taylor RW, Tadlock LP, Buschang PH. Recent Advances in Orthodontic Retention Methods: A Review article. J World Fed Orthod 2018. [DOI: 10.1016/j.ejwf.2018.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
16
|
Sharma A, Raman A, Pradeep AR. Role of 1% alendronate gel as adjunct to mechanical therapy in the treatment of chronic periodontitis among smokers. J Appl Oral Sci 2017; 25:243-249. [PMID: 28678942 PMCID: PMC5482246 DOI: 10.1590/1678-7757-2016-0201] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 08/22/2016] [Indexed: 02/06/2023] Open
Abstract
Objective Alendronate (ALN) inhibits osteoclastic bone resorption and triggers osteostimulative properties both in vivo and in vitro, as shown by increase in matrix formation. This study aimed to explore the efficacy of 1% ALN gel as local drug delivery (LDD) in adjunct to scaling and root planing (SRP) for the treatment of chronic periodontitis among smokers. Material and Methods 75 intrabony defects were treated in 46 male smokers either with 1% ALN gel or placebo gel. ALN gel was prepared by adding ALN into carbopol-distilled water mixture. Clinical parameters [modified sulcus bleeding index, plaque index, probing depth (PD), and periodontal attachment level (PAL)] were recorded at baseline, at 2 months, and at 6 months, while radiographic parameters were recorded at baseline and at 6 months. Defect fill at baseline and at 6 months was calculated on standardized radiographs by using the image analysis software. Results Mean PD reduction and mean PAL gain were found to be greater in the ALN group than in the placebo group, both at 2 and 6 months. Furthermore, a significantly greater mean percentage of bone fill was found in the ALN group (41.05±11.40%) compared to the placebo group (2.5±0.93%). Conclusions The results of this study showed 1% ALN stimulated a significant increase in PD reduction, PAL gain, and an improved bone fill compared to placebo gel in chronic periodontitis among smokers. Thus, 1% ALN, along with SRP, is effective in the treatment of chronic periodontitis in smokers.
Collapse
Affiliation(s)
| | | | - Avani Raju Pradeep
- Government Dental College and Research Institute, Department of Periodontics, Bangalore, Karnataka, India
| |
Collapse
|
17
|
Dutra BC, Oliveira AMSD, Oliveira PAD, Manzi FR, Cortelli SC, Cota LODM, Costa FO. Effect of 1% sodium alendronate in the non-surgical treatment of periodontal intraosseous defects: a 6-month clinical trial. J Appl Oral Sci 2017; 25:310-317. [PMID: 28678950 PMCID: PMC5482254 DOI: 10.1590/1678-7757-2016-0252] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 12/06/2016] [Indexed: 12/04/2022] Open
Abstract
Background and objectives Few studies have evaluated the effect of the topical application of sodium alendronate (ALN) on the treatment of intrabuccal bone defects, especially those caused by periodontitis. This 6-month randomized placebo controlled clinical trial aimed at evaluating the effect of non-surgical periodontal treatment associated with the use of 1% ALN, through clinical evaluations and cone-beam computed tomography (CBCT). Material and Methods Twenty individuals with chronic periodontitis underwent periodontal examination at the baseline as well as 3 and 6 months after periodontal treatment, registering clinical attachment level (CAL), periodontal probing depth (PPD), and bleeding on probing (BOP) as the clinical outcomes. After manual scaling and root planing, 40 bilateral sites with interproximal vertical bone defects were randomly treated with either 1% ALN gel or a placebo. Bone defects were evaluated through CBCT at the baseline and 6 months post-treatment. The clinical and CBCT parameters were compared using the Wilcoxon and Friedman tests (p<0.05). Results Although ALN produced a greater CAL gain when compared to the placebo at 6 months post-treatment (p=0.021), both treatments produced similar effects on the PPD, BOP, and bone height. Significant differences in bone fill were observed only in patients of the ALN group (4.5 to 3.8 mm; p=0.003) at 6 months post-treatment. Conclusions Topical application of 1% ALN might be a beneficial adjuvant to non-surgical periodontal therapy.
Collapse
Affiliation(s)
- Bernardo Carvalho Dutra
- Universidade Federal de Minas Gerais, Faculdade de Odontologia, Departamento de Patologia e Cirurgia. Belo Horizonte, MG, Brasil
| | | | | | - Flavio Ricardo Manzi
- Pontífica Universidade Católica of Minas Gerais, Departamento de Periodontia. Belo Horizonte, MG, Brasil
| | - Sheila Cavalca Cortelli
- Universidade de Taubaté, Departamento de Odontologia, Divisão de Pesquisa Periodontal. Taubaté, SP, Brasil
| | - Luís Otávio de Miranda Cota
- Universidade Federal de Minas Gerais, Faculdade de Odontologia, Departamento de Patologia e Cirurgia. Belo Horizonte, MG, Brasil
| | - Fernando Oliveira Costa
- Universidade Federal de Minas Gerais, Faculdade de Odontologia, Departamento de Patologia e Cirurgia. Belo Horizonte, MG, Brasil
| |
Collapse
|
18
|
Shah NP, Nayee S, Pazianas M, Sproat C. Beyond ONJ – A review of the potential uses of bisphosphonates in dentistry. Br Dent J 2017; 222:727-730. [DOI: 10.1038/sj.bdj.2017.412] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2017] [Indexed: 01/06/2023]
|
19
|
Oliveira GJPLD, Paula LGFD, Souza JACD, Spin-Neto R, Stavropoulos A, Marcantonio RAC. Effects of avocado/soybean unsaponifiables (ASU) on the treatment of ligature-induced periodontitis in rats. Braz Oral Res 2017; 31:e28. [PMID: 28403331 DOI: 10.1590/1807-3107bor-2017.vol31.0028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 03/13/2017] [Indexed: 12/30/2022] Open
Abstract
The purpose of this study is to evaluate the effect of the avocado/soybean unsaponifiables (ASU) on the treatment of induced periodontitis in rats. Periodontitis was induced in 84 rats via ligature placement around the second upper molar, which was removed after 7 days, and scaling and root planning (SRP) was performed at this time. Subsequently, the rats were randomly allocated to four groups with 21 animals each: One SRP group in which saline solution was administered (SS), and three groups in which ASU was administered (0.6 g/kg/day), beginning either 7 days before the induction of periodontitis (SRP/ASU-7), on the day of periodontitis induction (SRP/ASU0), or on the day of treatment (SRP/ASU+7). ASU and SS were administered daily by gavage until the sacrifice of the animals (7, 15, and 30 days after SRP). The % bone in the furcation area was evaluated by histomorphometry and micro-CT. The expression of proteins (TRAP, RANKL, and alkaline phosphatase) and mRNA (IL-1β, TNF-α, IL-6, RANKL, and alkaline phosphatase) were evaluated by immunohistochemistry and qPCR. The SRP/ASU+7 group presented a higher percentage of bone fill in the furcation area and higher expression of alkaline phosphatase than in the SRP group (at 7 and 30 days, respectively). The SRP/ASU0 and SRP/ASU+7 groups presented lower expression levels of RANKL mRNA than the SRP and SRP/ASU-7 groups at 15 days. ASU administration on the day of the SRP treatment of the ligature-induced periodontitis promoted subtle beneficial effects on periodontal repair following the treatment of induced periodontitis within the experimental period of 7 days.
Collapse
Affiliation(s)
| | | | | | - Rubens Spin-Neto
- Aarhus University, Department of Dentistry, Section of Oral Radiology, Aarhus, Denmark
| | - Andreas Stavropoulos
- Malmo University, Faculty of Odontology, Department of Periodontology and Community Dentistry, Malmo, Sweden
| | | |
Collapse
|
20
|
Taguchi A, Shiraki M, Morrison A, Khan AA. Antiresorptive agent-related osteonecrosis of the jaw in osteoporosis patients from Asian countries. Osteoporos Sarcopenia 2017; 3:64-74. [PMID: 30775507 PMCID: PMC6372774 DOI: 10.1016/j.afos.2017.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 02/27/2017] [Accepted: 03/04/2017] [Indexed: 11/05/2022] Open
Abstract
Bisphosphonate (BP)-associated osteonecrosis of the jaw (ONJ) was first reported in oncology patients in 2003 and subsequently in osteoporosis patients in 2004. Since oral surgical procedures, such as tooth extraction, are also considered one of the major risk factors for ONJ, there is confusion among physicians, dentists, and patients—particularly osteoporosis patients currently taking BPs—regarding the safety of remaining on therapy surrounding these procedures. Many papers about BP-related ONJ (BRONJ) have been published to date. In addition to BRONJ, recent studies have reported an association between ONJ and the antiresorptive therapy denosumab (Dmab; a RANKL-inhibitor). BRONJ and Dmab-related ONJ are together referred to as antiresorptive agent-related ONJ (ARONJ). The pathogenesis of ARONJ still remains unknown. It is forecasted that there will be an increased incidence of patients with osteoporotic fractures and an increased number of prescriptions for antiresorptive agents in Asia in the future. However, prescriptions for antiresorptives for osteoporosis may be restricted in the Asian population as the occurrence of ARONJ may be higher as compared with those in other countries. In this review, we focused on the following topics as it pertains to the Asian osteoporotic population: the oral condition specific for osteoporosis patients; definition, staging, prevalence and incidence of ARONJ; imaging modalities for ARONJ; specific risk factors for ARONJ; prevention strategies for ARONJ, and; cooperation between physicians and dentists in the prevention of ARONJ. Ideally, the Asian Federation of Osteoporosis Societies would cooperate with one another and find more population-specific evidence for the prevention of ARONJ.
Collapse
Affiliation(s)
- Akira Taguchi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Matsumoto Dental University, Shiojiri, Japan
| | - Masataka Shiraki
- Research Institute and Practice for Involutional Diseases, Nagano, Japan
| | | | - Aliya A Khan
- Divisions of Endocrinology and Metabolism and Geriatrics, Department of Medicine, McMaster University, Hamilton, ON, Canada
| |
Collapse
|
21
|
Pan J, Wang J, Hao L, Zhu G, Nguyen DN, Li Q, Liu Y, Zhao Z, Li YP, Chen W. The Triple Functions of D2 Silencing in Treatment of Periapical Disease. J Endod 2017; 43:272-278. [DOI: 10.1016/j.joen.2016.07.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 06/30/2016] [Accepted: 07/18/2016] [Indexed: 10/20/2022]
|
22
|
Özden FO, Sakallioğlu EE, Demir E, Bilgici B, Tunçel ÖK, Gökosmanoğlu F, Atmaca A. Effect of bisphosphonate as an adjunct treatment for chronic periodontitis on gingival crevicuar fluid levels of nuclear factor-κB ligand (RANKL) and osteoprotegerin in postmenopausal osteoporosis. J Oral Sci 2017; 59:147-155. [DOI: 10.2334/josnusd.16-0241] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Feyza O. Özden
- Department of Periodontology, School of Dentistry, Ondokuz Mayis University
| | | | - Esra Demir
- Department of Periodontology, School of Dentistry, Ondokuz Mayis University
| | - Birşen Bilgici
- Department of Biochemistry, School of Medicine, Ondokuz Mayis University
| | - Özgür K. Tunçel
- Department of Biochemistry, School of Medicine, Ondokuz Mayis University
| | - Feyzi Gökosmanoğlu
- Department of Internal Medicine, Division of Endocrinology and Metabolism, School of Medicine, Ondokuz Mayis University
| | - Ayşegül Atmaca
- Department of Internal Medicine, Division of Endocrinology and Metabolism, School of Medicine, Ondokuz Mayis University
| |
Collapse
|
23
|
Chen J, Chen Q, Hu B, Wang Y, Song J. Effectiveness of alendronate as an adjunct to scaling and root planing in the treatment of periodontitis: a meta-analysis of randomized controlled clinical trials. J Periodontal Implant Sci 2016; 46:382-395. [PMID: 28050316 PMCID: PMC5200864 DOI: 10.5051/jpis.2016.46.6.382] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 11/01/2016] [Indexed: 11/08/2022] Open
Abstract
Purpose Alendronate has been proposed as a local and systemic drug treatment used as an adjunct to scaling and root planing (SRP) for the treatment of periodontitis. However, its effectiveness has yet to be conclusively established. The purpose of the present meta-analysis was to assess the effectiveness of SRP with alendronate on periodontitis compared to SRP alone. Methods Five electronic databases were used by 2 independent reviewers to identify relevant articles from the earliest records up to September 2016. Randomized controlled trials (RCTs) comparing SRP with alendronate to SRP with placebo in the treatment of periodontitis were included. The outcome measures were changes in bone defect fill, probing depth (PD), and clinical attachment level (CAL) from baseline to 6 months. A fixed-effect or random-effect model was used to pool the extracted data, as appropriate. Mean differences (MDs) with 95% confidence intervals (CIs) were calculated. Heterogeneity was assessed using the Cochrane χ2 and I2 tests. Results After the selection process, 8 articles were included in the meta-analysis. Compared with SRP alone, the adjunctive mean benefits of locally delivered alendronate were 38.25% for bone defect fill increase (95% CI=33.05–43.45; P<0.001; I2=94.0%), 2.29 mm for PD reduction (95% CI=2.07–2.52 mm; P<0.001; I2=0.0%) and 1.92 mm for CAL gain (95% CI=1.55–2.30 mm; P<0.001; I2=66.0%). In addition, systemically administered alendronate with SRP significantly reduced PD by 0.36 mm (95% CI=0.18–0.55 mm; P<0.001; I2=0.0%) and increased CAL by 0.39 mm (95% CI=0.11–0.68 mm; P=0.006; I2=6.0%). Conclusions The collective evidence regarding the adjunctive use of alendronate locally and systemically with SRP indicates that the combined treatment can improve the efficacy of non-surgical periodontal therapy on increasing CAL and bone defect fill and reducing PD. However, precautions must be exercised in interpreting these results, and multicenter studies evaluating this specific application should be carried out.
Collapse
Affiliation(s)
- Jin Chen
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University College of Stomatology, Chongqing, China
| | - Qian Chen
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University College of Stomatology, Chongqing, China
| | - Bo Hu
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University College of Stomatology, Chongqing, China
| | - Yunji Wang
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University College of Stomatology, Chongqing, China
| | - Jinlin Song
- Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University College of Stomatology, Chongqing, China
| |
Collapse
|
24
|
Takahashi M, Uchida K, Yamada S, Sugino N, Higashi Y, Yamada K, Taguchi A. Association between number of teeth present and mandibular cortical erosion in Japanese men and women aged 40 years and older: A cross-sectional study. Osteoporos Sarcopenia 2016; 2:250-255. [PMID: 30775494 PMCID: PMC6372764 DOI: 10.1016/j.afos.2016.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 10/03/2016] [Accepted: 10/04/2016] [Indexed: 11/28/2022] Open
Abstract
Mandibular cortical erosion detected on dental panoramic radiographs is associated with increased risk of osteoporosis in older adults. Additionally, many reports have demonstrated an association between decreased number of teeth present and osteoporosis. However, whether mandibular cortical erosion is associated with a decreased number of teeth remains unclear. The purpose of this study, therefore, was to clarify the association between mandibular cortical erosion and number of teeth present in Japanese men and women aged 40 years and older. Among patients who visited our university hospital and underwent dental panoramic radiography for the diagnosis of dental diseases, 839 patients (293 men and 546 women) aged 40–89 years (mean [SD], 63.7 [10.6] years) participated in this study. Multiple regression analysis revealed that mildly to moderately eroded cortex (p = 0.007) and severe eroded cortex (p < 0.001) were significantly associated with a decreased number of teeth present. Analysis of covariance adjusted for covariates revealed a significant association between mandibular cortical erosion category and number of teeth present (p < 0.001). Subjects with a severely eroded cortex had significantly fewer teeth present than those with a normal cortex (mean [SE], 20.7 [0.5] vs. 23.4 [0.3], p < 0.001) or mildly to moderately eroded cortex (22.2 [0.4], p = 0.04). Subjects with a mildly to moderately eroded cortex had significantly fewer teeth present than those with a normal cortex (p = 0.033). Our results suggest the significant association between mandibular cortical erosion and number of teeth present in Japanese men and women aged 40 years and older.
Collapse
Affiliation(s)
- Mizuna Takahashi
- Department of Hard Tissue Research, Graduate School of Oral Medicine, Matsumoto Dental University, 1170 Gobara, Hirooka, Shiojiri 399-0781, Japan.,Department of Orthodontics, School of Dentistry, Matsumoto Dental University, 1170 Gobara, Hirooka, Shiojiri 399-0781, Japan
| | - Keiichi Uchida
- Department of Hard Tissue Research, Graduate School of Oral Medicine, Matsumoto Dental University, 1170 Gobara, Hirooka, Shiojiri 399-0781, Japan.,Department of Oral and Maxillofacial Radiology, School of Dentistry, Matsumoto Dental University, 1170 Gobara, Hirooka, Shiojiri 399-0781, Japan
| | - Shinichiro Yamada
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Matsumoto Dental University, 1170 Gobara, Hirooka, Shiojiri 399-0781, Japan
| | - Noriyuki Sugino
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Matsumoto Dental University, 1170 Gobara, Hirooka, Shiojiri 399-0781, Japan
| | - Yukihito Higashi
- Department of Regeneration and Medicine, Research Center for Radiation Genome Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima 734-8553, Japan
| | - Kazuhiro Yamada
- Department of Hard Tissue Research, Graduate School of Oral Medicine, Matsumoto Dental University, 1170 Gobara, Hirooka, Shiojiri 399-0781, Japan.,Department of Orthodontics, School of Dentistry, Matsumoto Dental University, 1170 Gobara, Hirooka, Shiojiri 399-0781, Japan
| | - Akira Taguchi
- Department of Hard Tissue Research, Graduate School of Oral Medicine, Matsumoto Dental University, 1170 Gobara, Hirooka, Shiojiri 399-0781, Japan.,Department of Oral and Maxillofacial Radiology, School of Dentistry, Matsumoto Dental University, 1170 Gobara, Hirooka, Shiojiri 399-0781, Japan
| |
Collapse
|
25
|
Taguchi A, Kamimura M, Nakamura Y, Sugino N, Ichinose A, Maezumi H, Fukuzawa T, Ashizawa R, Takahara K, Gushiken S, Mukaiyama K, Ikegami S, Uchiyama S, Kato H. Delayed wound healing after tooth extraction and self-reported kyphosis in Japanese men and women. Sci Rep 2016; 6:36309. [PMID: 27848958 PMCID: PMC5111072 DOI: 10.1038/srep36309] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 10/13/2016] [Indexed: 11/09/2022] Open
Abstract
It is unclear whether osteoporosis itself is a main risk factor for delayed wound healing after tooth extraction in humans. In this study, we evaluated the association between experience of delayed wound healing after last tooth extraction and self-reported kyphosis, with the possibility of having vertebral fractures, in Japanese patients. Among the 1,504 patients who responded to the structured questionnaire survey, 518 patients (134 men and 384 women) aged 55-97 years finally participated in this study. Patients who self-reported mild-moderate kyphosis were more likely to have problematic delayed wound healing after last tooth extraction than those who reported severe kyphosis (odds ratio [OR] 4.98; 95% confidence interval [CI], 1.86-13.38 and OR 2.30; 95% CI, 0.52-10.22, respectively) (p for trend = 0.005). Japanese patients with vertebral fractures may have a higher risk of having problematic delayed wound healing after tooth extraction.
Collapse
Affiliation(s)
- Akira Taguchi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Matsumoto Dental University, 1780 Gobara, Hirooka, Shiojiri, Nagano 399-0781, Japan
| | - Mikio Kamimura
- Center of Osteoporosis and Spinal Disorders, Kamimura Orthopedic Clinic, 595-17 Ippommatsu, Kotobukitoyooka, Matsumoto, Nagano 399-0021, Japan
| | - Yukio Nakamura
- Department of Orthopedic Surgery, Showa-Inan General Hospital, Akaho 3230, Komagane 399-4117, Japan
- Department of Orthopedic Surgery, Shinshu University School of Medicine, 33-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
| | - Noriyuki Sugino
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Matsumoto Dental University, 1780 Gobara, Hirooka, Shiojiri, Nagano 399-0781, Japan
| | - Akira Ichinose
- Department of Orthopedic Surgery, Ichise Hospital, 4824 Nishitakano-cho, Shimosuwa, Suwa-gun, Nagano 393-0087, Japan
| | - Hisayoshi Maezumi
- Maezumi Orthopedic Clinic, 8263-1 Hodaka, Azumino, Nagano 399-8303, Japan
| | - Takashi Fukuzawa
- Department of Orthopedic Surgery, Shiojiri Hospital, 6-4-36 Daimon, Shiojiri, Nagano 399-0731, Japan
| | - Ryouhei Ashizawa
- Ashizawa Orthopedic Clinic, 12205-2 Nakaminowa, Minowacho, Kamiina-gun, Nagano 399-4601 Japan
| | - Kenji Takahara
- Takahara Clinic, 5586-2, Minami-Minowa, Kamiina-gun, Nagano, 399-4511 Japan
| | - Susumu Gushiken
- Department of Surgery, Matsumoto Kyoritsu Hospital, 9-26 Habaue, Matsumoto, Nagano 390-8505, Japan
| | - Keijiro Mukaiyama
- Department of Orthopedic Surgery, North Alps Medical Center Azumi Hospital, 3207-1 Oaza-Ikeda, Ikeda, Kitaazumi-gun, Nagano 399-8695, Japan
| | - Shota Ikegami
- Department of Orthopedic Surgery, Shinshu University School of Medicine, 33-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
| | - Shigeharu Uchiyama
- Department of Orthopedic Surgery, Shinshu University School of Medicine, 33-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
| | - Hiroyuki Kato
- Department of Orthopedic Surgery, Shinshu University School of Medicine, 33-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
| |
Collapse
|
26
|
Akram Z, Abduljabbar T, Kellesarian SV, Abu Hassan MI, Javed F, Vohra F. Efficacy of bisphosphonate as an adjunct to nonsurgical periodontal therapy in the management of periodontal disease: a systematic review. Br J Clin Pharmacol 2016; 83:444-454. [PMID: 27718252 DOI: 10.1111/bcp.13147] [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] [Received: 08/22/2016] [Revised: 10/03/2016] [Accepted: 10/04/2016] [Indexed: 12/31/2022] Open
Abstract
AIMS The aim of this systematic review was to assess the efficacy of bisphosphonate therapy as an adjunct to scaling and root planing (SRP) in the management of periodontitis. METHODS Databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and Cochrane Oral Health Group Trials Register databases) were searched up to and including July 2016. The primary outcome was probing depth (PD), and the secondary outcomes were changes in clinical attachment level (CAL) and bone defect (BD) fill. The mean differences (MD) of outcomes and 95% confidence intervals (CI) for each variable were calculated using random effect model. RESULTS Eight clinical studies were included. Seven studies used alendronate as an adjunct to SRP; of these, four studies used topical application and three used oral alendronate. Considering the effects of adjunctive bisphosphonates as compared to SRP alone, a high degree of heterogeneity for PD (Q value = 39.6, P < 0.0001, I2 = 87.38%), CAL (Q value = 13.65, P = 0.008, I2 = 70.71%), and BD fill (Q value = 53.26, P < 0.0001, I2 = 92.49%) was noticed among both the groups. Meta-analysis showed a statistically significant PD reduction (MD = -1.18, 95% CI = -1.91 to -0.44, P = 0.002), CAL gain (MD = -0.69, 95% CI = -1.20 to -0.18, P = 0.008) and BD fill (MD = -2.36, 95% CI = -3.64 to -1.08, P < 0.001) for SRP + bisphosphonate treatment vs. SRP alone. CONCLUSIONS Adjunctive bisphosphonate therapy appears to be effective in managing periodontitis, however, due to the potential risk of osteonecrosis of the jaws and short-term follow-up of the studies, their clinical application is debatable.
Collapse
Affiliation(s)
- Zohaib Akram
- Department of Periodontology, Faculty of Dentistry, Ziauddin University, Karachi, 75600, Pakistan
| | - Tariq Abduljabbar
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Sergio Varela Kellesarian
- Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, New York, 14620, USA
| | | | - Fawad Javed
- Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, New York, 14620, USA
| | - Fahim Vohra
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
27
|
Li H, Ji Q, Chen X, Sun Y, Xu Q, Deng P, Hu F, Yang J. Accelerated bony defect healing based on chitosan thermosensitive hydrogel scaffolds embedded with chitosan nanoparticles for the delivery of BMP2 plasmid DNA. J Biomed Mater Res A 2016; 105:265-273. [PMID: 27636714 DOI: 10.1002/jbm.a.35900] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 08/27/2016] [Accepted: 09/13/2016] [Indexed: 01/13/2023]
Affiliation(s)
- Hui Li
- Department of Stomatology; The Affiliated Hospital of Qingdao University; Qingdao Shandong 266001 China
- School of Stomatology; Qingdao University; Qingdao Shandong 266001 China
- Department of Stomatology; Beijing Tongzhou Xinhua Hospital; Tongzhou Beijing 101100 China
| | - Qiuxia Ji
- Department of Stomatology; The Affiliated Hospital of Qingdao University; Qingdao Shandong 266001 China
- School of Stomatology; Qingdao University; Qingdao Shandong 266001 China
| | - Ximin Chen
- Orthopedic Center; Qilu Hospital of Shandong University; Qingdao Shandong 266035 China
| | - Yan Sun
- Department of Stomatology; The Affiliated Hospital of Qingdao University; Qingdao Shandong 266001 China
- School of Stomatology; Qingdao University; Qingdao Shandong 266001 China
| | - Quanchen Xu
- Department of Stomatology; The Affiliated Hospital of Qingdao University; Qingdao Shandong 266001 China
- School of Stomatology; Qingdao University; Qingdao Shandong 266001 China
| | - Panpan Deng
- Department of Stomatology; The Affiliated Hospital of Qingdao University; Qingdao Shandong 266001 China
- School of Stomatology; Qingdao University; Qingdao Shandong 266001 China
| | - Fang Hu
- Department of Stomatology; The Affiliated Hospital of Qingdao University; Qingdao Shandong 266001 China
- School of Stomatology; Qingdao University; Qingdao Shandong 266001 China
| | - Jianjun Yang
- Department of Stomatology; The Affiliated Hospital of Qingdao University; Qingdao Shandong 266001 China
- School of Stomatology; Qingdao University; Qingdao Shandong 266001 China
| |
Collapse
|
28
|
Kanoriya D, Pradeep AR, Singhal S, Garg V, Guruprasad CN. Synergistic Approach Using Platelet-Rich Fibrin and 1% Alendronate for Intrabony Defect Treatment in Chronic Periodontitis: A Randomized Clinical Trial. J Periodontol 2016; 87:1427-1435. [PMID: 27562221 DOI: 10.1902/jop.2016.150698] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Platelet-rich fibrin (PRF) is a reservoir of concentrated platelets that provides a pool of biologic growth-promoting factors and cytokines, which help in mediating regeneration of lost bone and soft tissue maturation. Alendronate (ALN), a member of the amino-bisphosphonate group, is known to enhance periodontal tissue regeneration by inhibiting osteoclast-mediated bone resorption and promoting osteoblast-mediated osteogenesis. The current intervention aims to assess combined effectiveness of PRF and 1% ALN with access therapy in intrabony defect (IBD) treatment in patients with chronic periodontitis (CP). METHODS Single IBDs in 90 patients were categorized into three groups: 1) group 1 had access therapy alone; 2) group 2 had access therapy with PRF; and 3) group 3 had access therapy with PRF + 1% ALN. Site-specific plaque index, modified sulcus bleeding index, probing depth (PD), clinical attachment level (CAL), and gingival marginal level, included as parameters for clinical assessment, were evaluated before surgery at baseline and 9 months postoperatively. Percentage IBD depth reduction, assessed using radiographs, was evaluated at baseline and postoperatively. RESULTS Compared with groups 1 and 2, group 3 exhibited significantly greater reduction in PD and gain in CAL postoperatively. Significantly greater IBD depth reduction was shown in group 3 (54.05% ± 2.88%) compared with group 2 (46% ± 1.89%) and group 1 (7.33% ± 4.86%) postoperatively. CONCLUSION Combined approach therapy of PRF + 1% ALN for IBD treatment in patients with CP showed better clinical parameter outcomes with greater IBD depth reduction compared with PRF and access therapy alone.
Collapse
Affiliation(s)
- Dharmendra Kanoriya
- Department of Periodontology, Government Dental College and Research Institute, Bengaluru, Karnataka, India
| | - A R Pradeep
- Department of Periodontology, Government Dental College and Research Institute, Bengaluru, Karnataka, India
| | - Sandeep Singhal
- Department of Periodontology, Government Dental College and Research Institute, Bengaluru, Karnataka, India
| | - Vibhuti Garg
- Department of Periodontology, Government Dental College and Research Institute, Bengaluru, Karnataka, India
| | - C N Guruprasad
- Department of Periodontology, Government Dental College and Research Institute, Bengaluru, Karnataka, India
| |
Collapse
|
29
|
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.
Collapse
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
| |
Collapse
|
30
|
Penoni DC, Torres SR, Farias MLF, Fernandes TM, Luiz RR, Leão ATT. Association of osteoporosis and bone medication with the periodontal condition in elderly women. Osteoporos Int 2016; 27:1887-96. [PMID: 26626187 DOI: 10.1007/s00198-015-3437-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Accepted: 11/18/2015] [Indexed: 12/20/2022]
Abstract
UNLABELLED This study investigated whether osteoporosis and its treatment may affect periodontal condition in elderly women. The findings highlighted that women with osteoporosis had a higher chance to present severe periodontitis than women with normal bone mineral density (BMD), particularly those who were not treated for osteoporosis. INTRODUCTION This study investigated whether osteoporosis increases the frequency and severity of chronic periodontitis in elderly women and evaluated the influence of vitamin D and osteoporosis treatment in the periodontal condition. METHODS In this cross-sectional study, elderly women were selected among 1266 subjects evaluated for lumbar spine and proximal femur bone mineral density (BMD) using dual energy X-ray absorptiometry. Sociodemographic, clinical characteristics, and complete periodontal examination were recorded. Serum 25-hydroxyvitamin D levels were measured by chemiluminescence. RESULTS Forty-eight elderly women with normal BMD and 86 with osteoporosis were selected. Women with osteoporosis presented higher frequency of sites with clinical attachment level ≥6 mm (p = 0.003) and gingival recession ≥3 mm (p = 0.002) than those with normal BMD and were more than twice as likely to present severe periodontitis (odds ratio (OR) = 2.49, 95 % CI [1.14 to 5.43]). Osteoporotic women who were not treated for the condition had more chance to present severe periodontitis (OR = 3.16, 95 % CI [1.28 to 7.82]) than those who did use bisphosphonates (OR = 2.04, 95 % CI [0.85 to 4.89]). Among the participants who presented low levels of vitamin D, those with osteoporosis exhibited a higher chance to present severe periodontitis than those with normal BMD (p = 0.027), but the association between vitamin D levels and osteoporosis was not statistically significant after adjustment (p = 0.198). CONCLUSIONS Elderly women with osteoporosis have a greater chance to present periodontitis, with higher severity than those with normal BMD. Osteoporosis treatment provides protection for periodontitis.
Collapse
Affiliation(s)
- D C Penoni
- Periodontics Department, Odontoclínica Central da Marinha, Rio de Janeiro, Brazil
- Department of Dental Clinic, Division of Periodontics, Dental School, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - S R Torres
- Department of Oral Pathology and Diagnosis, Dental School, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - M L F Farias
- Division of Endocrinology, Department of Internal Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - T M Fernandes
- Rheumatology Department, School of Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Rheumatology Department, Hospital Naval Marcilio Dias, Rio de Janeiro, Brazil
| | - R R Luiz
- Institute of Public Health Studies, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - A T T Leão
- Department of Dental Clinic, Division of Periodontics, Dental School, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
| |
Collapse
|
31
|
Pradeep AR, Kanoriya D, Singhal S, Garg V, Manohar B, Chatterjee A. Comparative evaluation of subgingivally delivered 1% alendronate versus 1.2% atorvastatin gel in treatment of chronic periodontitis: a randomized placebo-controlled clinical trial. ACTA ACUST UNITED AC 2016; 8. [PMID: 27091596 DOI: 10.1111/jicd.12215] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 02/13/2016] [Indexed: 01/22/2023]
Abstract
AIM Alendronate (ALN) and atorvastatin (ATV) are known to inhibit osteoclastic bone resorption and were proposed to have osteostimulative properties. The aim of the study was to evaluate and compare the efficacy of 1% ALN and 1.2% ATV gel as a local drug-delivery system in adjunct to scaling and root planning (SRP) for the treatment of intrabony defects in chronic periodontitis patients. METHODS A total of 90 intrabony defects were treated with either 1% ALN, 1.2% ATV, or placebo gel. Clinical parameters (plaque index, modified sulcus bleeding index, probing depth (PD), and clinical attachment level (CAL)) were recorded at baseline, 3, 6, and 9 months. Intrabony defect depth (IBD) and defect depth reduction (DDR%) was calculated on standardized radiographs at 6 and 9 months. RESULTS The mean PD reduction, CAL gain, and DDR% were greater in the ALN and ATV group than in the placebo group at 3, 6, and 9 months. Furthermore, a significantly greater DDR% was found in the ALN group at 6 and 9 months than in the ATV and placebo groups. CONCLUSION Local delivery of 1% ALN results in significantly greater improvement in PD, CAL, IBD depth, and DDR% as compared to 1.2% ATV gel.
Collapse
Affiliation(s)
- Avani R Pradeep
- Department of Periodontology, Government Dental College and Research Institute, Bangalore, Karnataka, India
| | - Dharmendra Kanoriya
- Department of Periodontology, Government Dental College and Research Institute, Bangalore, Karnataka, India
| | - Sandeep Singhal
- Department of Periodontology, Government Dental College and Research Institute, Bangalore, Karnataka, India
| | - Vibhuti Garg
- Department of Periodontology, Government Dental College and Research Institute, Bangalore, Karnataka, India
| | - Balaji Manohar
- Department of Periodontology, Pacific Dental College, Jaipur, India
| | - Anirban Chatterjee
- Department of Periodontology, The Oxford Dental College and Hospital, Bangalore, Karnataka, India
| |
Collapse
|
32
|
Knight ET, Liu J, Seymour GJ, Faggion CM, Cullinan MP. Risk factors that may modify the innate and adaptive immune responses in periodontal diseases. Periodontol 2000 2016; 71:22-51. [DOI: 10.1111/prd.12110] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2015] [Indexed: 12/31/2022]
|
33
|
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.
Collapse
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.
| |
Collapse
|
34
|
Shah NP, Katsarelis H, Pazianas M, Dhariwal DK. Periodontal disease, dental implants, extractions and medications related to osteonecrosis of the jaws. ACTA ACUST UNITED AC 2015; 42:878-80, 883-4, 887-89. [DOI: 10.12968/denu.2015.42.9.878] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Neha P Shah
- Specialty Dentist, Department of Oral Surgery, Guy's Hospital, London
| | - Helen Katsarelis
- Specialty Registrar, Department of Oral and Maxillofacial Surgery, Royal County Surrey Hospital Surrey
| | - Michael Pazianas
- Visiting Scholar, Institute of Musculoskeletal Sciences, Oxford University, Oxford
| | - Daljit K Dhariwal
- Consultant, Department of Oral and Maxillofacial Surgery, John Radcliffe Hospital, Oxford, UK
| |
Collapse
|
35
|
Kornman KS. Commentary: Periodontitis severity and progression are modified by various host and environmental factors. J Periodontol 2015; 85:1642-5. [PMID: 25434780 DOI: 10.1902/jop.2014.140430] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Kenneth S Kornman
- Chief Executive Officer, President, and Chief Scientific Officer, Interleukin Genetics, Inc., Waltham, MA
| |
Collapse
|
36
|
Calciolari E, Donos N, Park JC, Petrie A, Mardas N. A systematic review on the correlation between skeletal and jawbone mineral density in osteoporotic subjects. Clin Oral Implants Res 2015; 27:433-42. [DOI: 10.1111/clr.12597] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Elena Calciolari
- Periodontology Unit; UCL Eastman Dental Institute; London UK
- Section of Periodontology, Implantology and Gnathology; Centre of Dentistry; University of Parma; Parma Italy
| | - Nikolaos Donos
- Periodontology Unit; UCL Eastman Dental Institute; London UK
| | - Jung-Chul Park
- Department of Periodontology; College of Dentistry; Dankook University; Cheonan South Korea
| | - Aviva Petrie
- Biostatistics Unit; UCL Eastman Dental Institute; London UK
| | - Nikos Mardas
- Periodontology Unit; UCL Eastman Dental Institute; London UK
| |
Collapse
|
37
|
Elwakeel NM, Hazaa HH. Effect of omega 3 fatty acids plus low-dose aspirin on both clinical and biochemical profiles of patients with chronic periodontitis and type 2 diabetes: a randomized double blind placebo-controlled study. J Periodontal Res 2015; 50:721-9. [DOI: 10.1111/jre.12257] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2014] [Indexed: 12/18/2022]
Affiliation(s)
- N. M. Elwakeel
- Department of Oral Medicine and Periodontology; Faculty of Dentistry; Al-Azhar University (Girls Branch); Cairo Egypt
| | - H. H. Hazaa
- Department of Oral Medicine and Periodontology; Faculty of Dentistry; Al-Azhar University (Girls Branch); Cairo Egypt
| |
Collapse
|
38
|
Bhansali RS. Non-surgical periodontal therapy: An update on current evidence. World J Stomatol 2014; 3:38-51. [DOI: 10.5321/wjs.v3.i4.38] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 11/06/2014] [Accepted: 11/19/2014] [Indexed: 02/06/2023] Open
Abstract
Periodontal disease is an inflammatory condition that involves a complex interaction between pathogenic bacteria, environmental and acquired factors and host related factors. Till recently periodontal treatment was directed primarily towards reduction of bacterial load by subgingival debridement of root surfaces and modification of environmental risk factors. The current paradigm of periodontal disease stresses greater role of host-mediated inflammatory response in tissue destruction characteristic of periodontal disease. Various therapeutic modalities have been developed adjuvant to mechanical periodontal therapy. The use of laser and photodynamic therapy show great promise but their effectiveness has still not been conclusively proven. Chemotherapeutic agents, either systemic and local antimicrobials or host modulating drugs, played pivotal role in better and more predictable management of periodontal disease. The present review focuses on the best available evidence, for the current management of the chronic periodontal patients, gathered from systematic reviews and meta-analysis of mechanical non surgical periodontal therapy (NSPT) (subgingival debridement, laser therapy and photodynamic therapy) and the adjunctive chemotherapeutic approaches such as systematic and local antibiotics and antiseptics, subgingival pocket irrigation and host modulation therapies. The review also attempts to briefly introduce future developments in some of these modalities. At the end, the review summarizes the analysis of the current evidence that suggests that thorough subgingival debridement remains the mainstay of NSPT and that adjunct use of chemotherapeutic agents may offer better management of clinical parameters in periodontitis patients.
Collapse
|
39
|
Li CL, Lu WW, Seneviratne CJ, Leung WK, Zwahlen RA, Zheng LW. Role of periodontal disease in bisphosphonate-related osteonecrosis of the jaws in ovariectomized rats. Clin Oral Implants Res 2014; 27:1-6. [PMID: 25371026 DOI: 10.1111/clr.12502] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study aimed to investigate the role of progressive periodontal disease in inducing bisphosphonate-related osteonecrosis of the jaws (BRONJ) using an ovariectomized (OVX) rat model mimicking human intracortical remodeling process. MATERIALS AND METHODS Thirty 12-week-old Spraque-Dawly (SD) female rats were randomly assigned into two groups. All rats underwent bilateral ovariectomy. Six weeks after surgery, zoledronic acid (ZA) or vehicle control was administered intraperitoneally for 12 weeks. On the same day of injection, a cotton ligature was placed subgingivally around the first left lower molar to induce periodontitis. All animals were sacrificed 12 weeks after injection. The entire mandibles were harvested for micro-computed tomography (micro-CT) and histological examinations. RESULTS Micro-CT examination showed that ligature placement caused significant alveolar bone loss both in ZA (0.63 ± 0.13 vs. 0.38 ± 0.06 mm, P < 0.001) and in control (0.88 ± 0.19 vs. 0.40 ± 0.06 mm, P < 0.001) groups. Whereas in the ZA group, bone loss was attenuated compared with the control group (P < 0.01); the bone mineral density in the ZA group (1.00 ± 0.02 g/cm(3)) was significantly higher than that in vehicle control group (0.96 ± 0.03 g/cm(3), P < 0.001). Histological examination found necrotic bone tissue with extensive, empty lacunae in two of 15 rats in ZA group, but in none of the control group. CONCLUSION Bisphosphonates inhibit alveolar bone resorption in progressive periodontal disease, which might benefit the management of periodontitis, but increase the risk of developing BRONJ.
Collapse
Affiliation(s)
- Chun Lei Li
- Discipline of Oral Diagnosis & Polyclinics, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Weijia William Lu
- Department of Orthopaedics & Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | | | - Wai Keung Leung
- Discipline of Oral Diagnosis & Polyclinics, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Roger A Zwahlen
- Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Li Wu Zheng
- Discipline of Oral Diagnosis & Polyclinics, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| |
Collapse
|
40
|
Eastham JE, Seymour RA. Local drug delivery in the management of periodontal diseases part 2: specific agents. ACTA ACUST UNITED AC 2014. [DOI: 10.12968/denu.2014.41.9.796] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Jane E Eastham
- Research Assistant, School of Dental Sciences, Newcastle University, Framlington Place, Newcastle Upon Tyne, NE2 4BW, UK
| | - Robin A Seymour
- Emeritus Professor of Restorative Dentistry, School of Dental Sciences, Newcastle University, Framlington Place, Newcastle Upon Tyne, NE2 4BW, UK
| |
Collapse
|
41
|
|
42
|
Abstract
Different phases of a woman's life: Puberty, menses, pregnancy, and menopause have varied influence on her oral health. During the menopause, women go through biological and endocrine changes, particularly in their sex steroid hormone production, affecting their health. Because the oral mucosa contains estrogen receptors, variations in hormone levels directly affect the oral cavity. A few oral conditions and or diseases are seen more frequently during post menopausal years. Role of hormones affecting the health of oro-dental tissues, as well as treatment by HRT in ameliorating these conditions is not clear. There is paucity of randomized controlled trials in this field and more data is needed, before the recommendations for oral health care in post menopausal women can be made. A gynecologist sitting in menopausal clinic should be aware of oral changes happening during this period, and dental needs of these women and should refer them to the dental specialists accordingly. On the other hand, a dentist should also be sensitized about the menopausal status of the woman, her HRT status and special preventive and treatment needs.
Collapse
Affiliation(s)
- Vanita Suri
- Department of Obstetrics and Gynecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Varun Suri
- Department of Public Health Dentistry, Swami Devi Dyal Hospital and Dental College, Barwala, Panchkula, Haryana, India
| |
Collapse
|
43
|
Furlaneto FA, Nunes NL, Oliveira Filho IL, Frota NP, Yamamoto KO, Lisboa MR, Ervolino E, Taba M, Rêgo RO, Messora MR. Effects of Locally Administered Tiludronic Acid on Experimental Periodontitis in Rats. J Periodontol 2014; 85:1291-301. [DOI: 10.1902/jop.2014.130581] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
44
|
Tilakaratne A, Soory M. Anti-inflammatory Actions of Adjunctive Tetracyclines and Other Agents in Periodontitis and Associated Comorbidities. Open Dent J 2014; 8:109-24. [PMID: 24976875 PMCID: PMC4073587 DOI: 10.2174/1874210601408010109] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 04/08/2014] [Accepted: 05/12/2014] [Indexed: 02/08/2023] Open
Abstract
The non-antimicrobial properties of tetracyclines such as anti-inflammatory, proanabolic and anti-catabolic actions make them effective pharmaceuticals for the adjunctive management of chronic inflammatory diseases. An over-exuberant inflammatory response to an antigenic trigger in periodontitis and other chronic inflammatory diseases could contribute to an autoimmune element in disease progression. Their adjunctive use in managing periodontitis could have beneficial effects in curbing excessive inflammatory loading from commonly associated comorbidities such as CHD, DM and arthritis. Actions of tetracyclines and their derivatives include interactions with MMPs, tissue inhibitors of MMPs, growth factors and cytokines. They affect the sequence of inflammation with implications on immunomodulation, cell proliferation and angiogenesis; these actions enhance their scope, in treating a range of disease entities. Non-antimicrobial chemically modified tetracyclines (CMTs) sustain their diverse actions in organ systems which include anti-inflammatory, anti-apoptotic, anti-proteolytic actions, inhibition of angiogenesis and tumor metastasis. A spectrum of biological actions in dermatitis, periodontitis, atherosclerosis, diabetes, arthritis, inflammatory bowel disease, malignancy and prevention of bone resorption is particularly relevant to minocycline. Experimental models of ischemia indicate their specific beneficial effects. Parallel molecules with similar functions, improved Zn binding and solubility have been developed for reducing excessive MMP activity. Curbing excessive MMP activity is particularly relevant to periodontitis, and comorbidities addressed here, where specificity is paramount. Unique actions of tetracyclines in a milieu of excessive inflammatory stimuli make them effective therapeutic adjuncts in the management of chronic inflammatory disorders. These beneficial actions of tetracyclines are relevant to the adjunctive management of periodontitis subjects presenting with commonly prevalent comorbidities addressed here.
Collapse
Affiliation(s)
- Aruni Tilakaratne
- Department of Oral Medicine and Periodontology, Faculty of Dental Science, University of Peradeniya, Sri-Lanka
| | - Mena Soory
- Periodontology King's College London Dental Institute, Denmark Hill, London SE5 9RW, UKB
| |
Collapse
|
45
|
Allen MR, Chen NX, Gattone VH, Moe SM. Adverse mandibular bone effects associated with kidney disease are only partially corrected with bisphosphonate and/or calcium treatment. Am J Nephrol 2013; 38:458-64. [PMID: 24280830 DOI: 10.1159/000356335] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Accepted: 10/14/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS Patients with chronic kidney disease (CKD) have a high prevalence of periodontal disease that may predispose to tooth loss and inflammation. The goal of this study was to test the hypotheses that a genetic rat model of progressive CKD would exhibit altered oral bone properties and that treatment with either bisphosphonates or calcium could attenuate these adverse changes. METHODS At 25 weeks of age, rats were treated with zoledronate (ZOL), calcium gluconate, or their combination for 5 or 10 weeks. Mandible bone properties were assessed using micro-computed tomography to determine bone volume (BV/TV) and cementum-enamel junction to alveolar crest distance (CEJ-AC). RESULTS Untreated CKD animals had significantly lower BV/TV at both 30 (-5%) and 35 (-14%) weeks of age and higher CEJ-AC (+27 and 29%) compared to normal animals. CKD animals had a significantly higher parathyroid hormone (PTH) compared to normal animals, yet similar levels of C-reactive protein (CRP). ZOL treatment normalized BV/TV over the first 5 weeks but this benefit was lost by 10 weeks. Calcium treatment, alone or in combination with ZOL, was effective in normalizing BV/TV at both time points. Neither ZOL nor calcium was able to correct the higher CEJ-AC caused by CKD. Calcium, but not ZOL, significantly reduced serum PTH, while neither treatment affected CRP. CONCLUSIONS (i) This progressive animal model of CKD shows a clear mandibular skeletal phenotype consistent with periodontitis, (ii) the periodontitis is not associated with systemic inflammation as measured by CRP, and (iii) reducing PTH has positive effects on the mandible phenotype.
Collapse
Affiliation(s)
- Matthew R Allen
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Ind., USA
| | | | | | | |
Collapse
|
46
|
Thumbigere-Math V, Michalowicz BS, Hodges JS, Tsai ML, Swenson KK, Rockwell L, Gopalakrishnan R. Periodontal disease as a risk factor for bisphosphonate-related osteonecrosis of the jaw. J Periodontol 2013; 85:226-33. [PMID: 23786404 DOI: 10.1902/jop.2013.130017] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Previous case reports and animal studies suggest that periodontitis is associated with bisphosphonate-related osteonecrosis of the jaw (BRONJ). This case-control study is conducted to evaluate the association between clinical and radiographic measures of periodontal disease and BRONJ. METHODS Twenty-five patients with BRONJ were matched with 48 controls. Trained examiners measured probing depth, clinical attachment level (CAL), and bleeding on probing on all teeth except third molars and gingival and plaque indices on six index teeth. Alveolar bone height was measured from orthopantomograms. Most patients with BRONJ were using antibiotics (48%) or a chlorhexidine mouthrinse (84%) at enrollment. Adjusted comparisons of patients with BRONJ versus controls used multiple linear regression. RESULTS The average number of bisphosphonate (BP) infusions was significantly higher in patients with BRONJ compared with controls (38.4 versus 18.8, P = 0.0001). In unadjusted analyses, patients with BRONJ had more missing teeth (7.8 versus 3.1, P = 0.002) and higher average CAL (2.18 versus 1.56 mm, P = 0.047) and percentage of sites with CAL ≥3 mm (39.0 versus 23.3, P = 0.039) than controls. Also, patients with BRONJ had lower average bone height (as a fraction of tooth length, 0.59 versus 0.62, P = 0.004) and more teeth with bone height less than half of tooth length (20% versus 6%, P = 0.001). These differences remained significant after adjusting for age, sex, smoking, and number of BP infusions. CONCLUSIONS BRONJ patients have fewer teeth, greater CAL, and less alveolar bone support compared with controls after adjusting for number of BP infusions. Group differences in antibiotics and chlorhexidine rinse usage may have masked differences in the other clinical measures.
Collapse
Affiliation(s)
- Vivek Thumbigere-Math
- Division of Periodontology, University of Minnesota School of Dentistry, Minneapolis, MN
| | | | | | | | | | | | | |
Collapse
|
47
|
Abela S, Chotai M, Bister D. What you need to know about bisphosphonates: an overview and general recommendations for orthodontic treatment. J Orthod 2013; 39:186-92. [PMID: 22984103 DOI: 10.1179/1465312512z.00000000022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
The orthodontic treatment of patients on bisphosphonates is becoming an increasing aspect of contemporary practice. This article will draw attention to the chemical structure and effects of these drugs on bone and will provide the latest recommendations to avoid potential sequelae.
Collapse
Affiliation(s)
- Stefan Abela
- Department of Oral Health, Norfolk and Norwich University Hospital, Norwich, UK.
| | | | | |
Collapse
|
48
|
Bonnet N, Lesclous P, Saffar JL, Ferrari S. Zoledronate effects on systemic and jaw osteopenias in ovariectomized periostin-deficient mice. PLoS One 2013; 8:e58726. [PMID: 23505553 PMCID: PMC3591374 DOI: 10.1371/journal.pone.0058726] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Accepted: 02/05/2013] [Indexed: 12/21/2022] Open
Abstract
Osteoporosis and periodontal disease (PD) are frequently associated in the elderly, both concurring to the loss of jaw alveolar bone and finally of teeth. Bisphosphonates improve alveolar bone loss but have also been associated with osteonecrosis of the jaw (ONJ), particularly using oncological doses of zoledronate. The effects and therapeutic margin of zoledronate on jaw bone therefore remain uncertain. We reappraised the efficacy and safety of Zoledronate (Zol) in ovariectomized (OVX) periostin (Postn)-deficient mice, a unique genetic model of systemic and jaw osteopenia. Compared to vehicle, Zol 1M (100 µg/kg/month) and Zol 1W (100 µg/kg/week) for 3 months both significantly improved femur BMD, trabecular bone volume on tissue volume (BV/TV) and cortical bone volume in both OVX Postn+/+ and Postn−/− (all p<0.01). Zol 1M and Zol 1W also improved jaw alveolar and basal BV/TV, although the highest dose (Zol 1W) was less efficient, particularly in Postn−/−. Zol decreased osteoclast number and bone formation indices, i.e. MAR, MPm/BPm and BFR, independently in Postn−/− and Postn+/+, both in the long bones and in deep jaw alveolar bone, without differences between Zol doses. Zol 1M and Zol 1W did not reactivate inflammation nor increase fibrous tissue in the bone marrow of the jaw, whereas the distance between the root and the enamel of the incisor (DRI) remained high in Postn−/− vs Postn+/+ confirming latent inflammation and lack of crestal alveolar bone. Zol 1W and Zol 1M decreased osteocyte numbers in Postn−/− and Postn+/+ mandible, and Zol 1W increased the number of empty lacunae in Postn−/−, however no areas of necrotic bone were observed. These results demonstrate that zoledronate improves jaw osteopenia and suggest that in Postn−/− mice, zoledronate is not sufficient to induce bone necrosis.
Collapse
Affiliation(s)
- Nicolas Bonnet
- Division of Bone Diseases, Department of Internal Medicine Specialties, Geneva University Hospital, Geneva, Switzerland.
| | | | | | | |
Collapse
|
49
|
Tanna NK, Jeffcoat MK. Actonel<sup>®</sup> (risedronate) therapy for the maintenance of alveolar bone in adult chronic periodontitis. Health (London) 2013. [DOI: 10.4236/health.2013.57a2002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
50
|
Forced eruption as an alternative to tooth extraction in long-term use of oral bisphosphonates. J Am Dent Assoc 2012. [DOI: 10.14219/jada.archive.2012.0091] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
|