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Ferrà-Cañellas MDM, Garcia-Sureda L. Exploring the Potential of Micro-Immunotherapy in the Treatment of Periodontitis. Life (Basel) 2024; 14:552. [PMID: 38792574 PMCID: PMC11122531 DOI: 10.3390/life14050552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 04/19/2024] [Accepted: 04/22/2024] [Indexed: 05/26/2024] Open
Abstract
Periodontitis, characterized by the progressive destruction of dental support tissues due to altered immune responses, poses a significant concern for public health. This condition involves intricate interactions between the immune response and oral microbiome, where innate and adaptive immune responses, with their diverse cell populations and inflammatory mediators, play crucial roles in this immunopathology. Indeed, cytokines, chemokines, growth factors, and immune cells perform key functions in tissue remodeling. Focusing on periodontal therapies, our attention turns to micro-immunotherapy (MI), employing low doses (LDs) and ultra-low doses (ULDs) of immunological signaling molecules like cytokines, growth factors, and hormones. Existing studies across various fields lay the groundwork for the application of MI in periodontitis, highlighting its anti-inflammatory and regenerative potential in soft tissue models based on in vitro research. In summary, this review underscores the versatility and potential of MI in managing periodontal health, urging further investigations to solidify its clinical integration. MI supports an innovative approach by modulating immune responses at low doses to address periodontitis.
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Affiliation(s)
- Maria del Mar Ferrà-Cañellas
- Preclinical Research Department, Labo’Life España, 07330 Consell, Spain
- Group of Cell Therapy and Tissue Engineering, Research Institute on Health Sciences (IUNICS), University of the Balearic Islands, 07122 Palma de Mallorca, Spain
- Health Research Institute of the Balearic Islands (IdISBa), 07122 Palma de Mallorca, Spain
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Micu IC, Muntean A, Roman A, Stratul ȘI, Pall E, Ciurea A, Soancă A, Negucioiu M, Barbu Tudoran L, Delean AG. A Local Desiccant Antimicrobial Agent as an Alternative to Adjunctive Antibiotics in the Treatment of Periodontitis: A Narrative Review. Antibiotics (Basel) 2023; 12:antibiotics12030456. [PMID: 36978324 PMCID: PMC10044681 DOI: 10.3390/antibiotics12030456] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/20/2023] [Accepted: 02/22/2023] [Indexed: 03/03/2023] Open
Abstract
Periodontitis is one of the most common oral polymicrobial infectious diseases induced by the complex interplay between the altered subgingival microbiota and the host’s dysregulated immune-inflammatory response, leading to the initiation of progressive and irreversible destruction of the periodontal tissues and eventually to tooth loss. The main goal of cause-related periodontal therapy is to eliminate the dysbiotic subgingival biofilm in order to arrest local inflammation and further periodontal tissue breakdown. Because, in some cases, subgingival mechanical instrumentation has limited efficiency in achieving those goals, various adjunctive therapies, mainly systemic and locally delivered antimicrobials, have been proposed to augment its effectiveness. However, most adjunctive antimicrobials carry side effects; therefore, their administration should be precociously considered. HybenX® (HY) is a commercial therapeutical agent with decontamination properties, which has been studied for its effects in treating various oral pathological conditions, including periodontitis. This review covers the current evidence regarding the treatment outcomes and limitations of conventional periodontal therapies and provides information based on the available experimental and clinical studies related to the HY mechanism of action and effects following its use associated with subgingival instrumentation and other types of dental treatments.
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Affiliation(s)
- Iulia C. Micu
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeş St., No. 15, 400012 Cluj-Napoca, Romania
| | - Alexandrina Muntean
- Department of Pedodontics, Faculty of Dental Medicine, Iuliu Hațieganu University of Medicine and Pharmacy Cluj-Napoca, Avram Iancu St., No. 31, 400117 Cluj-Napoca, Romania
- Correspondence: (A.M.); (A.S.)
| | - Alexandra Roman
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeş St., No. 15, 400012 Cluj-Napoca, Romania
| | - Ștefan I. Stratul
- Department of Periodontology, Anton Sculean Research Center of Periodontal and Peri-Implant Diseases, Faculty of Dental Medicine, Victor Babeș University of Medicine and Pharmacy Timișoara, Bulevardul Revoluției din 1989, No.9, 300230 Timișoara, Romania
| | - Emöke Pall
- Department of Infectious Disease, Faculty of Veterinary Medicine, University of Agricultural Sciences and Veterinary Medicine, Mănăștur St., No. 3-5, 400372 Cluj-Napoca, Romania
| | - Andreea Ciurea
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeş St., No. 15, 400012 Cluj-Napoca, Romania
| | - Andrada Soancă
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Victor Babeş St., No. 15, 400012 Cluj-Napoca, Romania
- Correspondence: (A.M.); (A.S.)
| | - Marius Negucioiu
- Department of Prosthodontics, Faculty of Dental Medicine, Iuliu Haţieganu University of Medicine and Pharmacy Cluj-Napoca, Clinicilor St., No. 32, 400006 Cluj-Napoca, Romania
| | - Lucian Barbu Tudoran
- Electron Microscopy Center, Department of Molecular Biology and Biotechnologies, Faculty of Biology and Geology, Babeş-Bolyai University, Clinicilor St., No. 5-7, 400006 Cluj-Napoca, Romania
- Electron Microscopy Integrated Laboratory (LIME), National Institute for Research and Development of Isotopic and Molecular Technologies, Institutul Național de Cercetare-Dezvoltare pentru Tehnologii Izotopice și Moleculare, 67-103 Donath St., 400293 Cluj-Napoca, Romania
| | - Ada G. Delean
- Department of Cariology, Endodontics and Oral Pathology, “Iuliu Hațieganu” University of Medicine and Pharmacy, Moților St., No. 33, 400001 Cluj-Napoca, Romania
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The Effectiveness of a Bioactive Healing Abutment as a Local Drug Delivery System to Impact Peri-Implant Mucositis: A Prospective Case Series Study. Pharmaceutics 2022; 15:pharmaceutics15010138. [PMID: 36678767 PMCID: PMC9866183 DOI: 10.3390/pharmaceutics15010138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/17/2022] [Accepted: 12/21/2022] [Indexed: 01/03/2023] Open
Abstract
Modern dental therapy makes use of prosthetic implant reconstructions, which are supported or retained on dental implants. The most frequent, long-term complications associated with these prosthetic implants include mucositis and peri-implantitis. Since mucositis is the initial inflammation of tissues supporting the dental implant, the management of this condition is thus crucial. The aim of the present study was to assess the effects of the placement of bioactive healing abutment for 48 h, in patients diagnosed with peri-implant mucositis. Moreover, the quantitative and qualitative shift in the bacterial profile of the biofilm present in the peri-implant pockets, was assessed by means of RT-PCR genotyping. Each patient was examined using a commercially available PET test protocol: the first sample was taken upon diagnosis (after which the bioactive healing abutment, with clindamycin at a dose of 30 mg, was used for 48 h and replaced with the prosthetic superstructure used so far by a patient); the second sample was taken two weeks after removal of the bioactive healing abutment. The effects of the intervention were clinically assessed using the PET test after the two weeks. A significant reduction in mucositis was observed following treatment, as measured by periodontal indices: modified Sulcus Bleeding Index—mBI (p < 0.001), modified Plaque Index—PLI (r = 0.69, Z= −4.43; p < 0.001) and probing depth—PD (Z = −4.61; p < 0.001). Significant differences in the occurrence of periopathogenic bacteria were also observed: Aggregatibacter actinomycetemcomitans (p < 0.014; Z = −2.45; r = 0.38), Treponema denticola (p < 0.005; Z = −2.83; r = 0.44), Tannerella forsythia (p < 0.001; Z = −4.47; r = 0.69) and Porphyromonas gingivalis (p < 0.132; Z = −1.51).
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Cytotoxic Effects on Gingival Mesenchymal Stromal Cells and Root Surface Modifications Induced by Some Local Antimicrobial Products Used in Periodontitis Treatment. MATERIALS 2021; 14:ma14175049. [PMID: 34501140 PMCID: PMC8434495 DOI: 10.3390/ma14175049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/30/2021] [Accepted: 08/31/2021] [Indexed: 12/12/2022]
Abstract
(1) Background: this study aims to test the cytotoxicity of three antimicrobial products used in periodontitis treatment on gingival mesenchymal stem cells (gMSCs) and their influence on root surfaces and gMSC adhesion. We tested the null hypothesis that the effects of the antimicrobials did not differ. (2) Methods: the commercial products based on sulphonic/sulphuric acids, sodium hypochlorite and silver nanoparticles, in five different concentrations, were added to culture medium for growing gMSCs. Cell proliferation capacity was tested using the Cell Counting Kit-8 (CCK8) and their viability was determined by succinate dehydrogenase activity (MTT) assay. Scanning electron microscopy evaluated the adhesion of gMSCs on root samples treated mechanically and with commercial products. (3) Results: the products induced a dose-dependent cytotoxicity in terms of reduced proliferation and viability of gMSCs, as well as cell shape modifications. Significant differences in CCK8 values between the different commercial products were observed. Based on proliferation tests, the null hypothesis was rejected. When MTT values of the three products were compared with each other, no significant differences were observed for any of the five concentrations (p = 0.065, p = 0.067, p = 0.172, p = 0.256, p = 0.060). (4) Conclusions: the three antimicrobials had a certain degree of cytotoxicity on gMSCs. gMSCs repopulated treated root surfaces.
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Wychowański P, Starzyńska A, Adamska P, Słupecka-Ziemilska M, Sobocki BK, Chmielewska A, Wysocki B, Alterio D, Marvaso G, Jereczek-Fossa BA, Kowalski J. Methods of Topical Administration of Drugs and Biological Active Substances for Dental Implants-A Narrative Review. Antibiotics (Basel) 2021; 10:919. [PMID: 34438969 PMCID: PMC8388631 DOI: 10.3390/antibiotics10080919] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/20/2021] [Accepted: 07/26/2021] [Indexed: 12/15/2022] Open
Abstract
Dental implants are, nowadays, established surgical devices for the restoration of lost teeth. Considered as an alternative for traditional prosthetic appliances, dental implants surpass them in reliability and patient feedback. Local drug delivery around the implants promotes osseointegration and reduces peri-implantitis. However, there are currently no methods of a multiple, precise topical administration of drugs to the implant area. Engineering coatings on the implants, drug application on carriers during implantation, or gingival pockets do not meet all requirements of dental surgeons. Therefore, there is a need to create porous implants and other medical devices that will allow a multiple drug delivery at a controlled dose and release profile without traumatic treatment. Due to the growing demand for the use of biologically active agents to support dental implant treatment at its various stages (implant placement, long-term use of dental superstructures, treatment of the peri-implant conditions) and due to the proven effectiveness of the topical application of pharmacological biologically active agents to the implant area, the authors would like to present a review and show the methods and devices that can be used by clinicians for local drug administration to facilitate dental implant treatment. Our review concludes that there is a need for research in the field of inventions such as new medical devices or implants with gradient solid-porous structures. These devices, in the future, will enable to perform repeatable, controllable, atraumatic, and repeatable injections of active factors that may affect the improvement of osteointegration and the longer survival of implants, as well as the treatment of peri-implantitis.
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Affiliation(s)
- Piotr Wychowański
- Department of Oral Surgery, Medical University of Warsaw, 6 St. Binieckiego Street, 02-097 Warsaw, Poland;
| | - Anna Starzyńska
- Department of Oral Surgery, Medical University of Gdańsk, 7 Dębinki Street, 80-211 Gdańsk, Poland; (P.A.); (B.K.S.)
| | - Paulina Adamska
- Department of Oral Surgery, Medical University of Gdańsk, 7 Dębinki Street, 80-211 Gdańsk, Poland; (P.A.); (B.K.S.)
| | - Monika Słupecka-Ziemilska
- Department of Human Epigenetics, Mossakowski Medical Research Center, Polish Academy of Sciences, 5 Pawińskiego Street, 02-106 Warsaw, Poland;
| | - Bartosz Kamil Sobocki
- Department of Oral Surgery, Medical University of Gdańsk, 7 Dębinki Street, 80-211 Gdańsk, Poland; (P.A.); (B.K.S.)
- International Research Agenda 3P—Medicine Laboratory, Medical University of Gdańsk, 3a Marii Skłodowskiej-Curie Street, 80-210 Gdańsk, Poland
| | - Agnieszka Chmielewska
- Faculty of Material Science and Engineering, Warsaw University of Technology, 141 Wołoska Street, 02-507 Warsaw, Poland;
- Department of Materials Science and Engineering, The Ohio State University, 140 W 19th Ave, Columbus, OH 43210, USA
| | - Bartłomiej Wysocki
- Center of Digital Science and Technology, Cardinal Stefan Wyszyński University in Warsaw, Woycickiego 1/3 Street, 01-938 Warsaw, Poland;
- Additive Manufacturing Research Center, College of Engineering, Youngstown State University, Youngstown, OH 44555, USA
| | - Daniela Alterio
- Division of Radiotherapy, IEO European Institute of Oncology, IRCCS, 435 Ripamonti Street, 20141 Milan, Italy; (D.A.); (G.M.); (B.A.J.-F.)
| | - Giulia Marvaso
- Division of Radiotherapy, IEO European Institute of Oncology, IRCCS, 435 Ripamonti Street, 20141 Milan, Italy; (D.A.); (G.M.); (B.A.J.-F.)
- Department of Oncology and Hemato-Oncology, University of Milan, 7 Festa del Perdono Street, 20112 Milan, Italy
| | - Barbara Alicja Jereczek-Fossa
- Division of Radiotherapy, IEO European Institute of Oncology, IRCCS, 435 Ripamonti Street, 20141 Milan, Italy; (D.A.); (G.M.); (B.A.J.-F.)
- Department of Oncology and Hemato-Oncology, University of Milan, 7 Festa del Perdono Street, 20112 Milan, Italy
| | - Jan Kowalski
- Department of Periodontology and Oral Medicine, Medical University of Warsaw, 6 St. Binieckiego Street, 02-097 Warsaw, Poland;
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