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Ramos F, Willart JF, Neut C, Agossa K, Siepmann J, Siepmann F. In-situ forming PLGA implants: Towards less toxic solvents. Int J Pharm 2024; 657:124121. [PMID: 38621617 DOI: 10.1016/j.ijpharm.2024.124121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 04/11/2024] [Accepted: 04/12/2024] [Indexed: 04/17/2024]
Abstract
In-situ forming poly(lactic-co-glycolic acid) (PLGA) implants offer a great potential for controlled drug delivery for a variety of applications, e.g. periodontitis treatment. The polymer is dissolved in a water-miscible solvent. The drug is dissolved or dispersed in this solution. Upon contact with aqueous body fluids, the solvent diffuses into the surrounding tissue and water penetrates into the formulation. Consequently, PLGA precipitates, trapping the drug. Often, N-methyl-2-pyrrolidine (NMP) is used as a water-miscible solvent. However, parenteral administration of NMP raises toxicity concerns. The aim of this study was to identify less toxic alternative solvent systems for in-situ forming PLGA implants. Various blends of polyethylene glycol 400 (PEG 400), triethyl citrate (TEC) and ethanol were used to prepare liquid formulations containing PLGA, ibuprofen (as an anti-inflammatory drug) and/or chlorhexidine dihydrochloride (as an antiseptic agent). Implant formation and drug release kinetics were monitored upon exposure to phosphate buffer pH 6.8 at 37 °C. Furthermore, the syringeability of the liquids, antimicrobial activity of the implants, and dynamic changes in the latter's wet mass and pH of the release medium were studied. Importantly, 85:10:5 and 60:30:10 PEG 400:TEC:ethanol blends provided good syringeability and allowed for rapid implant formation. The latter controlled ibuprofen and chlorhexidine release over several weeks and assured efficient antimicrobial activity. Interestingly, fundamental differences were observed concerning the underlying release mechanisms of the two drugs: Ibuprofen was dissolved in the solvent mixtures and partially leached out together with the solvents during implant formation, resulting in relatively pronounced burst effects. In contrast, chlorhexidine dihydrochloride was dispersed in the liquids in the form of tiny particles, which were effectively trapped by precipitating PLGA during implant formation, leading to initial lag-phases for drug release.
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Affiliation(s)
- F Ramos
- Univ. Lille, Inserm, CHU Lille, U1008, F-59000 Lille, France; Univ. Lille, CNRS, INRAE, Centrale Lille, UMR 8207 UMET, F-59000 Lille, France
| | - J-F Willart
- Univ. Lille, CNRS, INRAE, Centrale Lille, UMR 8207 UMET, F-59000 Lille, France
| | - C Neut
- Univ. Lille, Inserm, CHU Lille, U1286, F-59000 Lille, France
| | - K Agossa
- Univ. Lille, Inserm, CHU Lille, U1008, F-59000 Lille, France
| | - J Siepmann
- Univ. Lille, Inserm, CHU Lille, U1008, F-59000 Lille, France.
| | - F Siepmann
- Univ. Lille, Inserm, CHU Lille, U1008, F-59000 Lille, France
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Diarra A, Agossa K, Youl ENH. The Potential of Cochlospermum tinctorium, Flueggea virosa, and Waltheria indica Traditional Plants From Burkina Faso in Treating Periodontitis: A Systematic Review. Cureus 2024; 16:e52471. [PMID: 38371022 PMCID: PMC10873538 DOI: 10.7759/cureus.52471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2024] [Indexed: 02/20/2024] Open
Abstract
Periodontitis is a chronic, infectious, and inflammatory oral disease with a high prevalence in developing countries, where limited access to modern dental care curtails its treatment. This review is dedicated to examining three indigenous botanical species frequently recommended by traditional therapists for the treatment of periodontal disease, namely, Cochlospermum tinctorium, Flueggea virosa, and Waltheria indica, with the aim of elucidating their chemical constituents and pharmacological properties that may support their empirical use. This review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines extension for scoping reviews. An electronic search was conducted in three databases (PubMed, Science Direct, and Google Scholar) up to July 2022. Out of 700 articles initially identified, only 11 were deemed eligible for inclusion; a substantial majority (80%) of these comprised in vitro studies. Among the trio of botanicals considered, Waltheria indica emerged as the most extensively investigated (65% of the studies). The administration of these plants was predominantly in the form of decoctions or macerations, with extraction methods employing alcoholic agents (ethanolic and methanolic), hydroalcoholic solutions, or aqueous solvents. The selected plants exhibited notable richness in polyphenolic compounds, particularly flavonoids, and demonstrated anti-inflammatory effects, as indicated in 60% of the studies, along with antibacterial properties (against Streptococcus aureus and Helicobacter pylori). None of the studies reported antibacterial activity against periodontal pathogens. The pharmacological properties of these plants may hold promise for the management of oral inflammatory and infectious conditions. Nevertheless, further comprehensive investigations are imperative to establish their safety and efficacy for periodontitis treatment before conclusive recommendations can be formulated.
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Affiliation(s)
- Abdoulaziz Diarra
- Periodontology, Training and Research Unit in Health Sciences (UFR/SDS) University of Ouaga I, Pr. Joseph Ki-Zerbo, Ouagadougou, BFA
| | - Kevimy Agossa
- Periodontology, Lille University Hospital, Lille, FRA
| | - Estelle Noëla Hoho Youl
- Pharmacology, Training and Research Unit in Health Sciences (UFR/SDS) University of Ouaga I, Pr. Joseph Ki-Zerbo, Ouagadougou, BFA
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Sy K, Chevalier C, Maton M, Mokbel I, Mahieux S, Houcke I, Neut C, Grosgogeat B, Deveaux E, Gritsch K, Agossa K. Therapeutic Potential of Chlorhexidine-Loaded Calcium Hydroxide-Based Intracanal Medications in Endo-Periodontal Lesions: An Ex Vivo and In Vitro Study. Antibiotics (Basel) 2023; 12:1416. [PMID: 37760713 PMCID: PMC10525524 DOI: 10.3390/antibiotics12091416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/21/2023] [Accepted: 08/31/2023] [Indexed: 09/29/2023] Open
Abstract
Endo-periodontal lesions are challenging clinical situations where both the supporting tissues and the root canal of the same tooth are infected. In the present study, chlorhexidine (CHX)-loaded calcium hydroxide (CH) pastes were used as intracanal medications (ICMs). They were prepared and tested on pathogens found in both the root canal and the periodontal pocket. Exposure to 0.5% and 1% CHX-loaded ICMs decreased the growth of Porphyromonas gingivalis and was effective in eradicating or inhibiting an Enterococcus faecalis biofilm. CH was injected into the root canal of extracted human teeth immersed in deionized water. CHX-loaded ICMs resulted in the transradicular diffusion of active components outside the tooth through the apex and the lateral dentinal tubules, as shown by the release of CHX (from 3.99 µg/mL to 51.28 µg/mL) and changes in pH (from 6.63 to 8.18) and calcium concentrations (from 2.42 ppm to 14.67 ppm) after 7 days. The 0.5% CHX-loaded ICM was non-toxic and reduced the release of IL-6 by periodontal cells stimulated by P. gingivalis lipopolysaccharides. Results indicate that the root canal may serve as a reservoir for periodontal drug delivery and that CHX-based ICMs can be an adjuvant for the control of infections and inflammation in endo-periodontal lesions.
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Affiliation(s)
- Kadiatou Sy
- U1008, Controlled Drug Delivery Systems and Biomaterials, Inserm, CHU Lille, Université de Lille, 59000 Lille, France; (M.M.); (E.D.); (K.A.)
- Faculté d’Odontologie, Hospices Civils de Lyon, Pôle d′Odontologie, Université Lyon 1, Université de Lyon, 69372 Lyon Cedex 08, France; (B.G.); (K.G.)
| | - Charlène Chevalier
- UMR CNRS 5615 Laboratoire des Multimatériaux et Interfaces, Université Lyon 1, 69100 Villeurbanne, France; (C.C.); (I.M.)
| | - Mickaël Maton
- U1008, Controlled Drug Delivery Systems and Biomaterials, Inserm, CHU Lille, Université de Lille, 59000 Lille, France; (M.M.); (E.D.); (K.A.)
| | - Ilham Mokbel
- UMR CNRS 5615 Laboratoire des Multimatériaux et Interfaces, Université Lyon 1, 69100 Villeurbanne, France; (C.C.); (I.M.)
| | - Séverine Mahieux
- U1286 Infinite, Institute for Translational Research in Inflammation, Inserm, CHU Lille, Université de Lille, 59000 Lille, France; (S.M.); (I.H.); (C.N.)
| | - Isabelle Houcke
- U1286 Infinite, Institute for Translational Research in Inflammation, Inserm, CHU Lille, Université de Lille, 59000 Lille, France; (S.M.); (I.H.); (C.N.)
| | - Christel Neut
- U1286 Infinite, Institute for Translational Research in Inflammation, Inserm, CHU Lille, Université de Lille, 59000 Lille, France; (S.M.); (I.H.); (C.N.)
| | - Brigitte Grosgogeat
- Faculté d’Odontologie, Hospices Civils de Lyon, Pôle d′Odontologie, Université Lyon 1, Université de Lyon, 69372 Lyon Cedex 08, France; (B.G.); (K.G.)
| | - Etienne Deveaux
- U1008, Controlled Drug Delivery Systems and Biomaterials, Inserm, CHU Lille, Université de Lille, 59000 Lille, France; (M.M.); (E.D.); (K.A.)
| | - Kerstin Gritsch
- Faculté d’Odontologie, Hospices Civils de Lyon, Pôle d′Odontologie, Université Lyon 1, Université de Lyon, 69372 Lyon Cedex 08, France; (B.G.); (K.G.)
| | - Kevimy Agossa
- U1008, Controlled Drug Delivery Systems and Biomaterials, Inserm, CHU Lille, Université de Lille, 59000 Lille, France; (M.M.); (E.D.); (K.A.)
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Bourgoin A, Agossa K, Seror R, Fumery M, Radoi L, Gosset M. Management of dental care of patients on immunosuppressive drugs for chronic immune-related inflammatory diseases: a survey of French dentists' practices. BMC Oral Health 2023; 23:545. [PMID: 37559031 PMCID: PMC10411020 DOI: 10.1186/s12903-023-03258-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 07/27/2023] [Indexed: 08/11/2023] Open
Abstract
OBJECTIVES The aim of the study was to provide an overview of the practices of French general dentists (GDs) and specialists (SDs) concerning the management of patients with inflammatory bowel diseases (IBDs), rheumatic inflammatory diseases (IRDs), and vasculitis on biologic disease-modifying antirheumatic drugs (bDMARDs), conventional DMARDs, or immunosuppressants (ISs). MATERIALS AND METHODS An online national cross-sectional survey with 53 questions was developed by a multidisciplinary team including rheumatologists, gastroenterologists and dentists based on their clinical experience. It was refined following a test with nine dentists in private practice and in hospital before being disseminated to the members of French scientific societies and colleges of dentistry teachers over 3 months. Responses of general dentists versus specialists were compared with respect to their experience in managing patients with IRDs or IBDs, knowledge/training, type of invasive procedure performed, management of medical treatment, perioperative oral-care protocols, and frequency of postoperative complications after invasive dental care procedures. RESULT In total, 105 practitioners fully completed the survey (participation rate 11.1%). SDs more frequently performed invasive surgical procedures and were more aware of the recommendations of learned societies than GDs. They encountered more post-operative complications for patients on bDMARDs. For both SDs and GDs, most patients were managed without stopping treatment and pre- and postoperative antibiotics were prescribed to more than 75% of patients. When medical treatment was stopped, the decision was made by the prescribing physician. CONCLUSION Complications were reported more frequently by SDs when highly invasive procedures were performed on patients under active drug therapy. Certain common procedures, such as scaling and root planing, appear to be safe, regardless of treatment management. However, adapted guidelines for the practice of dentistry are needed to standardize the management of patients on bDMARDS, conventional DMARDs, or ISs. CLINICAL RELEVANCE French dentists perform a wide range of oral procedures on patients on bDMARDS, conventional DMARDs, or ISs under antibiotic coverage and antiseptic mouthwashes. SDs reported more postoperative complications after extensive invasive procedures for patients under active drug therapy, despite their greater knowledge of recommendations on how to manage such patients.
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Affiliation(s)
- Alice Bourgoin
- Service de Médecine Bucco-Dentaire, AP-HP, Hôpital Charles Foix, Ivry/Seine, F-94200, France
| | - Kevimy Agossa
- Université de Lille, Inserm, CHU Lille, U1008, Lille, F-59000, France
- Department of Periodontology, Faculty of Dentistry, University of Lille, Place De Verdun, Lille, France
| | - Raphaele Seror
- Department of Rheumatology, Université Paris-Saclay, Assistance Publique-Hôpitaux de Paris (AP-HP), CHU Bicêtre, Le Kremlin-Bicêtre, France
| | - Mathurin Fumery
- Department of Gastroenterology, Amiens University Hospital, Picardie University, Amiens, France
- Department of GastroenterologyPériTox Laboratory, Périnatalité & Risques Toxiques, UMR-I 01 INERIS, Picardie Jules Verne University, Amiens, France
| | - Loredana Radoi
- Service de Médecine Bucco-Dentaire, AP-HP, Hôpital Louis Mourier, Colombes, F-92700, France
- CESP, INSERM, Exposome and Heredity Group, Université Paris-Saclay, Villejuif, France
| | - Marjolaine Gosset
- Service de Médecine Bucco-Dentaire, AP-HP, Hôpital Charles Foix, Ivry/Seine, F-94200, France.
- Laboratoire d'Excellence INFLAMEX, Paris, France.
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Bravard M, Agossa K. Combination Therapy with Connective Tissue Graft, Amelogenins, and Bone Substitutes for Treatment of Deep Intrabony Defects Associated with Gingival Recession: 1-Year Follow-up of 12 Cases. INT J PERIODONT REST 2022; 42:321-329. [PMID: 35472108 DOI: 10.11607/prd.5479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Combined surgical procedures have been introduced that combine periodontal regenerative/reconstructive procedures in intrabony defects with a connective tissue graft to compensate for a deficient bone wall and limit soft tissue shrinkage, but little is known about the reproducibility of these advanced surgical techniques. This 12-case series applies a combined surgical procedure, combining amelogenins, bone substitutes, and connective tissue graft to treat deep intrabony defects associated with gingival recession. Twelve deep intrabony defects with a mean clinical attachment loss of 9.9 ± 2.1 mm, mean probing depth (PPD) of 7.8 ± 1.5 mm, mean recession of the tip of the interdental papilla (TP) of 2.1 ± 1.5 mm, and mean buccal recession (REC) of 2.3 ± 1.8 mm were treated. At 1 year, the average attachment gain was 5.1 ± 1.8 mm (P < .001), the residual PPD was 2.9 ± 0.7 mm (P < .001), no change was observed in the TP (-0.4 ± 0.8 mm, P = .078), and the REC slightly decreased to 1.7 ± 1.5 mm (P = .047). These results suggest that the proposed technique led to predictable clinical outcomes that support regeneration while maintaining or improving the position of the soft tissue margin for the interdental and buccal aspects in deep intrabony defects associated with gingival recession.
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Agossa K, Sy K, Pinçon C, Nicolas T, Catteau C, Blaizot A, Dubar M. Knowledge, Attitude, Access and Confidence in Evidence-based practice amongst French dental undergraduates: A transcultural adaptation and psychometrics analysis of French version of the KACE questionnaire. Eur J Dent Educ 2022; 26:106-115. [PMID: 33548112 DOI: 10.1111/eje.12677] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 01/09/2021] [Accepted: 01/30/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE The aim of this study was to provide a reliable instrument to assess evidence-based practice (EBP) dimensions in French-speaking dental students. To do so, a transcultural adaptation into French of the self-administered KACE questionnaire (Knowledge, Attitude, Access and Confidence Evaluation) and the evaluation of its psychometric properties in a sample of French dental students and teachers were performed. The effects of individual and academic factors on student performance in the KACE were also investigated. METHOD Teachers and fourth-year students completed once the translated KACE and fifth-year students completed twice the questionnaire before and after an epidemiology course. Cronbach's alpha coefficient analysis, Kruskal-Wallis and post hoc Dunn's tests, paired samples Wilcoxon tests and a generalised linear mixed model were performed to assess the psychometric properties (reliability, internal consistency, discriminant validity and responsiveness) of the questionnaire and to identify the factors associated with KACE scores, respectively. RESULTS 186 participants completed the survey. Cronbach's alpha ranged from 0.06 to 0.48 for Knowledge, 0.21 to 0.59 for Attitude, 0.42 to 0.76 for Access and 0.82 to 0.93 for Confidence. The discriminant value and sensitivity of the French KACE revealed significant differences amongst students and teachers and accurately identified the effect the training course had on the students who had completed it. Preparing for a residency programme or having received add-on modules in science improved the students' performance in the test. Being female negatively impacted the KACE Confidence score. CONCLUSION This version of the KACE is appropriate to assess EBP dimensions in French dental students. Academic background and gender may affect test performance.
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Affiliation(s)
- Kevimy Agossa
- Department of Periodontology, School of Dentistry, CHU Lille, Univ. Lille, Lille, France
| | - Kadiatou Sy
- Department of Restorative Dentistry and Endodontics, School of Dentistry, CHU Lille, Univ. Lille, Lille, France
| | - Claire Pinçon
- EA 2694 - Public Health: Epidemiology and Quality of Care, CHU Lille, Univ. Lille, Lille, France
| | | | - Céline Catteau
- Department of Dental Public Health, School of Dentistry, CHU Lille, Univ. Lille, Lille, France
| | - Alessandra Blaizot
- Department of Dental Public Health, School of Dentistry, CHU Lille, Univ. Lille, Lille, France
| | - Marie Dubar
- Department of Periodontology, School of Dentistry, CHU Lille, Univ. Lille, Lille, France
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Agossa K, Dubar M, Lemaire G, Blaizot A, Catteau C, Bocquet E, Nawrocki L, Boyer E, Meuric V, Siepmann F. Effect of Lactobacillus reuteri on Gingival Inflammation and Composition of the Oral Microbiota in Patients Undergoing Treatment with Fixed Orthodontic Appliances: Study Protocol of a Randomized Control Trial. Pathogens 2022; 11:pathogens11020112. [PMID: 35215057 PMCID: PMC8878988 DOI: 10.3390/pathogens11020112] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/08/2022] [Accepted: 01/14/2022] [Indexed: 12/12/2022] Open
Abstract
The effect of probiotics in improving or maintaining oral health in orthodontic patients is understudied. The aim of this study is to evaluate the effect of probiotic administration in addition to tooth brushing on clinical gingival inflammation, plaque formation, subgingival microbiota composition, and salivary biomarkers of inflammation in adolescents with fixed orthodontic appliances. The present study is a 6-month, double-blind, two-arm, placebo-controlled, single-center trial, in which 116 adolescent volunteers aged 12–16 years will be recruited from the patients of the orthodontics clinic of the University Hospital of Lille, France. Subjects who meet the eligibility criteria will be allocated to one of the following groups: (i) control: two placebo lozenges per day for 90 days together with regular oral hygiene, (ii) test: two probiotic lozenges per day for 90 days together with regular oral hygiene. Clinical assessment and biological sample collection will be performed at baseline, 3 and 6 months. In addition, compliance outcomes and adverse events will be monitored.
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Affiliation(s)
- Kevimy Agossa
- Univ. Lille, Inserm, CHU Lille, U1008—Controlled Drug Delivery Systems and Biomaterials, F-59000 Lille, France;
- Department of Periodontology, School of Dentistry, University of Lille, Place de Verdun, F-59000 Lille, France; (M.D.); (G.L.)
- Correspondence:
| | - Marie Dubar
- Department of Periodontology, School of Dentistry, University of Lille, Place de Verdun, F-59000 Lille, France; (M.D.); (G.L.)
- Univ. Lille, Inserm, CHU Lille, UMR-S 1172, F-59000 Lille, France
| | - Grégoire Lemaire
- Department of Periodontology, School of Dentistry, University of Lille, Place de Verdun, F-59000 Lille, France; (M.D.); (G.L.)
| | - Alessandra Blaizot
- Department of Dental Public Health, School of Dentistry, CHU Lille, Univ. Lille, F-59000 Lille, France; (A.B.); (C.C.)
| | - Céline Catteau
- Department of Dental Public Health, School of Dentistry, CHU Lille, Univ. Lille, F-59000 Lille, France; (A.B.); (C.C.)
| | - Emmanuël Bocquet
- Department of Orthodontics, School of Dentistry, CHU Lille, Univ. Lille, F-59037 Lille, France;
| | - Laurent Nawrocki
- Department of Oral Surgery, School of Dentistry, CHU Lille, Univ. Lille, F-59037 Lille, France;
| | - Emile Boyer
- INSERM, INRAE, Université de Rennes 1, CHU de Rennes, Nutrition Metabolisms and Cancer, F-35000 Rennes, France; (E.B.); (V.M.)
- Teaching Hospital Pontchaillou, 2 rue Henri le Guilloux, F-35033 Rennes, France
| | - Vincent Meuric
- INSERM, INRAE, Université de Rennes 1, CHU de Rennes, Nutrition Metabolisms and Cancer, F-35000 Rennes, France; (E.B.); (V.M.)
- Teaching Hospital Pontchaillou, 2 rue Henri le Guilloux, F-35033 Rennes, France
| | - Florence Siepmann
- Univ. Lille, Inserm, CHU Lille, U1008—Controlled Drug Delivery Systems and Biomaterials, F-59000 Lille, France;
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Sy K, Agossa K, Maton M, Chijcheapaza-Flores H, Martel B, Siepmann F, Deveaux E, Blanchemain N, Neut C. How Adding Chlorhexidine or Metallic Nanoparticles Affects the Antimicrobial Performance of Calcium Hydroxide Paste as an Intracanal Medication: An In Vitro Study. Antibiotics (Basel) 2021; 10:antibiotics10111352. [PMID: 34827289 PMCID: PMC8614750 DOI: 10.3390/antibiotics10111352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 10/30/2021] [Accepted: 11/02/2021] [Indexed: 11/16/2022] Open
Abstract
The aim of our study was to explore the potential value of metallic (Ag, Cu, and Zn) salts, polymer/metallic nanoparticles, and chlorhexidine (CHX) for improving the antimicrobial activity of calcium hydroxide (CH) against E. faecalis and C. albicans, associated with persistent endodontic infections. A first screening was performed by determining minimum inhibitory/bactericidal concentrations (MIC/MBC). Antimicrobial activity of the CH paste mixed with metallic salts, chitosan or cyclodextrin polymer metallic nanoparticles was compared to the antimicrobial activity of CH paste alone and CH + CHX using a time-kill kinetics assay. The effect of the antimicrobials on the rheological and the key mechanical properties were also examined. Copper and zinc were discarded because of their MIC/MBC values and silver because of its kill time curve profile. Except for a slower setting time after 24 h and a higher weight loss after 1 week of incubation, the mechanical behavior of the CH paste was unaffected by the addition of CHX. Polymeric/metallic nanoparticles failed to potentiate the antimicrobial effect of CH. By contrast, CHX increased this effect and thus could help eradicate E. faecalis associated with persistent root canal infections without altering the desired key physical properties of the CH paste.
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Affiliation(s)
- Kadiatou Sy
- U1008—Controlled Drug Delivery Systems and Biomaterials, Inserm, CHU Lille, University of Lille, 59000 Lille, France; (K.A.); (M.M.); (H.C.-F.); (F.S.); (E.D.); (N.B.)
- Correspondence:
| | - Kevimy Agossa
- U1008—Controlled Drug Delivery Systems and Biomaterials, Inserm, CHU Lille, University of Lille, 59000 Lille, France; (K.A.); (M.M.); (H.C.-F.); (F.S.); (E.D.); (N.B.)
| | - Mickaël Maton
- U1008—Controlled Drug Delivery Systems and Biomaterials, Inserm, CHU Lille, University of Lille, 59000 Lille, France; (K.A.); (M.M.); (H.C.-F.); (F.S.); (E.D.); (N.B.)
| | - Henry Chijcheapaza-Flores
- U1008—Controlled Drug Delivery Systems and Biomaterials, Inserm, CHU Lille, University of Lille, 59000 Lille, France; (K.A.); (M.M.); (H.C.-F.); (F.S.); (E.D.); (N.B.)
| | - Bernard Martel
- UMR 8207, UMET—Unité Matériaux et Transformations, CNRS—Centre National de la Recherche Scientifique, INRA—Institut National de la Recherche Agronomique, ENSCL—Ecole Nationale Supérieure de Chimie de Lille, University of Lille, 59655 Lille, France;
| | - Florence Siepmann
- U1008—Controlled Drug Delivery Systems and Biomaterials, Inserm, CHU Lille, University of Lille, 59000 Lille, France; (K.A.); (M.M.); (H.C.-F.); (F.S.); (E.D.); (N.B.)
| | - Etienne Deveaux
- U1008—Controlled Drug Delivery Systems and Biomaterials, Inserm, CHU Lille, University of Lille, 59000 Lille, France; (K.A.); (M.M.); (H.C.-F.); (F.S.); (E.D.); (N.B.)
| | - Nicolas Blanchemain
- U1008—Controlled Drug Delivery Systems and Biomaterials, Inserm, CHU Lille, University of Lille, 59000 Lille, France; (K.A.); (M.M.); (H.C.-F.); (F.S.); (E.D.); (N.B.)
| | - Christel Neut
- U1286 Infinite—Institute for Translational Research in Inflammation, Inserm, CHU Lille, University of Lille, 59000 Lille, France;
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Dubar M, Lizambard M, Delcourt-Debruyne E, Batool F, Huck O, Siepmann F, Agossa K. In-situforming drug-delivery systems for periodontal treatment: current knowledge and perspectives. Biomed Mater 2021; 16. [PMID: 34500442 DOI: 10.1088/1748-605x/ac254c] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 09/09/2021] [Indexed: 02/07/2023]
Abstract
Several chemical compounds are considered to be promising as adjuvants in the treatment of periodontitis. Antimicrobials, anti-inflammatory drugs or, more recently, pro-regenerative or antioxidant molecules have shown a very interesting potential to improve the outcomes of mechanical biofilm removal and promote the healing of the damaged tissues. However, their clinical effect is often limited by the challenge of achieving effective and prolonged drug delivery within the periodontal lesion, while limiting the risk of toxicity.In-situforming implants (ISFI) are 'implantable' drug-delivery systems that have gained considerable attention over the last few decades due to their multiple biomedical applications. They are liquids that, when injected at the site to be treated, form a semi-solid or solid dosage form that provides safe and locally controlled drug release. This review discusses current data and future prospects for the use of ISFI in periodontal treatment.
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Affiliation(s)
- Marie Dubar
- University Lille, Inserm, CHU Lille, U1008-Advanced Drug Delivery Systems, F-59000 Lille, France
| | - Martin Lizambard
- University Lille, Inserm, CHU Lille, U1008-Advanced Drug Delivery Systems, F-59000 Lille, France
| | | | - Fareeha Batool
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France.,Université de Strasbourg, Faculté de Chirurgie-dentaire, 8 rue Sainte-Elisabeth, 67000 Strasbourg, France
| | - Olivier Huck
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France.,Université de Strasbourg, Faculté de Chirurgie-dentaire, 8 rue Sainte-Elisabeth, 67000 Strasbourg, France
| | - Florence Siepmann
- University Lille, Inserm, CHU Lille, U1008-Advanced Drug Delivery Systems, F-59000 Lille, France
| | - Kevimy Agossa
- University Lille, Inserm, CHU Lille, U1008-Advanced Drug Delivery Systems, F-59000 Lille, France
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Petit J, Huon C, Nicolas T, Sy K, Dubar M, Agossa K. How to select proper interdental brush size in periodontitis patients: Comparison of the reliability of two methods among novice and expert users. Am J Dent 2021; 34:186-189. [PMID: 34370909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE To compare two methods used by novice and expert operators for selecting interdental brush (IDB) size for periodontitis patients: (1) sequential testing or (2) using a color-coded taper tip device (CTD) corresponding to color-coded brush sizes. METHODS Six operators, one experienced and five dental students, employed both methods to determine the IDB with best fit for 204 interdental spaces in 34 periodontitis patients. The percentage of agreement and the inter-methods reliability was evaluated. The influence of anatomical features on differences between the operators or method was also investigated. RESULTS Moderate to substantial correlation was found between the two methods but the reliability was stronger when different operators used the same method, irrespective of the method, than when they used a different method. Among the anatomical factors studied, only sites in molar regions were associated with significant differences. CLINICAL SIGNIFICANCE Use of a dedicated color-coded taper tip may be an alternative to the fastidious sequential testing of different IDB in selecting best-fit IDB diameter for periodontal patients with moderate to broad interdental spaces.
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Affiliation(s)
- Jérome Petit
- Department of Periodontology, School of Dentistry, University of Lille - CHU Lille, Lille, France
| | - Christopher Huon
- Department of Periodontology, School of Dentistry, University of Lille - CHU Lille, Lille, France
| | - Thomas Nicolas
- Department of Periodontology, School of Dentistry, University of Lille - CHU Lille, Lille, France
| | - Kadiatou Sy
- Department of Restorative Dentistry and Endodontics, School of Dentistry, University of Lille - CHU Lille, Lille, France
| | - Marie Dubar
- Department of Periodontology, School of Dentistry, University of Lille - CHU Lille, Lille, France
| | - Kevimy Agossa
- Department of Periodontology, School of Dentistry, University of Lille - CHU Lille, Lille, France,
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Agossa K, Roman L, Gosset M, Yzet C, Fumery M. Periodontal and dental health in inflammatory bowel diseases: a systematic review. Expert Rev Gastroenterol Hepatol 2021:1-15. [PMID: 34227446 DOI: 10.1080/17474124.2021.1952866] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 07/05/2021] [Indexed: 12/17/2022]
Abstract
Introduction: An increased risk of dental caries and periodontal diseases has been reported for inflammatory bowel disease (IBD) patients and are challenging conditions to manage.Areas covered: The authors searched international databases to find all studies assessing dental/periodontal outcomes in patients with IBD and other immune-mediated inflammatory disease (IMID), as well as the association between IMID medications and dental/periodontal status.Expert opinion: IBD are associated with a higher risk of both periodontitis and caries. Some evidence from rheumatoid arthritis suggests that periodontitis may be associated with a lower response to anti-TNF. There is no reliable evidence that IBD patients may be at greater risk of complications during routine dental care. On the basis of current data, guidelines can be proposed for the dental management focusing on the detection and eradication of infectious foci prior to the implementation of immunosuppressants/biologics and modified dental treatment protocol for invasive dental procedures that includes antibiotic prophylaxis.
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Affiliation(s)
- Kevimy Agossa
- Univ. Lille, Inserm, CHU Lille, U1008 - Controlled Drug Delivery Systems and Biomaterials, Lille, France
- Department of Periodontology, Faculty of Dentistry, University of Lille, Place De Verdun, Lille, France
| | - Lidia Roman
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille France
| | - Marjolaine Gosset
- Department of Odontology, Assistance Publique-Hôpitaux De Paris, Hôpital Charles Foix, Hôpitaux Universitaires La Pitié Salpétrière - Charles Foix Ivry-sur-SeineFaculty of Dental Surgery, University Paris Descartes PRES Sorbonne Paris Cité, University of Paris, EA 2496
| | - Clara Yzet
- Department of Gastroenterology, Amiens University Hospital, Picardie University, Amiens, France
| | - Mathurin Fumery
- Department of Gastroenterology, Amiens University Hospital, Picardie University, Amiens, France
- Department of Gastroenterology, PériTox Laboratory, Périnatalité & Risques Toxiques, UMR-I 01 INERIS, Picardie Jules Verne University, Amiens, France
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12
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Routier A, Blaizot A, Agossa K, Dubar M. What do we know about the mechanisms of action of probiotics on factors involved in the pathogenesis of periodontitis? A scoping review of in vitro studies. Arch Oral Biol 2021; 129:105196. [PMID: 34153538 DOI: 10.1016/j.archoralbio.2021.105196] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 06/03/2021] [Accepted: 06/07/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Probiotics are increasingly used in oral prevention and treatment conditions, but little is known about their abilities. The aim of this review is to clarify, summarize and disseminate current knowledge about the mode of action of in vitro probiotics on factors involved in the pathogenesis of periodontitis. METHOD 2495 articles were identified in three databases (Medline, Web of Science, SpringerLink) and 26 studies included in this scoping review. RESULTS Twenty-three probiotic species were identified, the majority of which were Lactobacilli or Bifidobacteria. Lactobacillus rhamnosus (30.8 %) and Lactobacillus reuteri (42.3 %) were found to be the two predominantly studied probiotic species and three main mechanisms of action of probiotics could be classified as: (i) modulation of the immuno-inflammatory response, (ii) direct actions of probiotics on periodontopathogens by adhesion or nutritive competitions and/or the secretion of antimicrobial molecules and (iii) indirect actions through environmental modifications. A combination of several probiotic strains seems to be beneficial via synergistic action amplifying the functions of each strain used. However, heterogeneity of the methodologies and probiotic species included in studies leads us to consider the following avenues for future research: (i) implementation of standardized periodontal models as close as possible to in vivo periodontal conditions to identify the functions of each strain for appropriate medication, (ii) updating data about interactions within oral biofilms to identify new candidates and to predict then analyze their behavior within these biofilms. CONCLUSION Probiotics may have their place in the response to inter-individual variability in periodontitis, provided that the choice of the probiotic strain or combination of them will be personalized and optimal for each patient.
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Affiliation(s)
- Arthur Routier
- School of Dentistry, Lille University Hospital, Lille, France.
| | - Alessandra Blaizot
- Department of Public Health, Faculty of Dental Surgery, Lille University Hospital, Lille, France.
| | - Kevimy Agossa
- Department of Periodontology, Faculty of Dental Surgery, Lille University Hospital, Lille, France; University of Lille, Inserm, Lille University Hospital, U1008, F-59000 Lille, France.
| | - Marie Dubar
- Department of Periodontology, Faculty of Dental Surgery, Lille University Hospital, Lille, France; University of Lille, Inserm, Lille University Hospital, UMR-S 1172, F-59000 Lille, France.
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Agossa K, Sy K, Mainville T, Gosset M, Jeanne S, Grosgogeat B, Siepmann F, Loingeville F, Dubar M. Antibiotic Use in Periodontal Therapy among French Dentists and Factors Which Influence Prescribing Practices. Antibiotics (Basel) 2021; 10:303. [PMID: 33804145 PMCID: PMC8001084 DOI: 10.3390/antibiotics10030303] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/10/2021] [Accepted: 03/12/2021] [Indexed: 01/21/2023] Open
Abstract
The aim of the present survey is to investigate the use of antibiotics during periodontal therapy among French dentists with a focus on exploring potential differences between various groups of practitioners. A self-administered questionnaire was distributed to different groups of practitioners including members of (i) the French Society of Periodontology and Implantology; (ii) the College of University Teachers in Periodontology and, (iii) private practitioners participating in the French general dental practice-based research network. 272 questionnaires were included in the analysis. Prescription patterns were globally in line with the current recommendations. Systemic antibiotics are most frequently used as a first-line therapy in necrotizing periodontitis (92%) and aggressive periodontitis (53.3% to 66.1%). However, malpractice still exists, including in the management of periodontal abscesses. Antibiotics are prescribed (i) less frequently for periodontal abscesses and (ii) more frequently for generalized aggressive periodontitis by members of the periodontal society and University college (p < 0.05). Amoxicillin (59.9%) and the amoxicillin + metronidazole (59.6%) combination were the most frequently prescribed molecules. Providing a high number of periodontal treatments per week, being more recently graduated, having a post-graduate certificate in periodontology and holding or having held an academic position/hospital practice were all factors associated with a better knowledge of and/or more adequate antibiotic use.
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Affiliation(s)
- Kevimy Agossa
- University of Lille, Inserm, CHU Lille, U1008—Controlled Drug Delivery Systems and Biomaterials, F-59000 Lille, France; (K.S.); (F.S.)
- Department of Periodontology, School of Dentistry, University of Lille, Place de Verdun, 59000 Lille, France; (T.M.); (M.D.)
| | - Kadiatou Sy
- University of Lille, Inserm, CHU Lille, U1008—Controlled Drug Delivery Systems and Biomaterials, F-59000 Lille, France; (K.S.); (F.S.)
- Faculté d’Odontologie, Université de Lyon, Université Claude Bernard Lyon 1, 69008 Lyon, France;
- Hospices Civils de Lyon, Service d’Odontologie, 69007 Lyon, France
| | - Théo Mainville
- Department of Periodontology, School of Dentistry, University of Lille, Place de Verdun, 59000 Lille, France; (T.M.); (M.D.)
| | - Marjolaine Gosset
- Laboratory Orofacial Pathologies, Imaging and Biotherapies URP2496, Université de Paris, F-92120 Montrouge, France;
- Service de Médecine Bucco-Dentaire, AP-HP, Hôpital Charles Foix, F-94200 Ivry-sur-Seine, France
- SFPIO—French Society of Periodontology and Oral Implantology, 44000 Nantes, France
| | - Sylvie Jeanne
- UFR d’Odontologie de Rennes, Bâtiment 15, 2 Avenue du Professeur Léon Bernard, Campus Santé, 35043 Rennes, France;
- Pôle Odontologie, CHU Rennes, 2 Rue Henri Le Guilloux, 35000 Rennes, France
- CNEP—French College of Teachers in Periodontology, 35000 Rennes, France
| | - Brigitte Grosgogeat
- Faculté d’Odontologie, Université de Lyon, Université Claude Bernard Lyon 1, 69008 Lyon, France;
- Hospices Civils de Lyon, Service d’Odontologie, 69007 Lyon, France
- Laboratoire des Multimatériaux et Interfaces, Université de Lyon—Claude Bernard Lyon 1, UMR CNRS 5615, F-69622 Villeurbanne, France
- ReCOL—French Private Dental Practice-Based Research Network, 69007 Lyon, France
| | - Florence Siepmann
- University of Lille, Inserm, CHU Lille, U1008—Controlled Drug Delivery Systems and Biomaterials, F-59000 Lille, France; (K.S.); (F.S.)
| | - Florence Loingeville
- University of Lille, CHU Lille, ULR 2694—METRICS: Evaluation of Health Technologies and Medical Practices, F-59000 Lille, France;
| | - Marie Dubar
- Department of Periodontology, School of Dentistry, University of Lille, Place de Verdun, 59000 Lille, France; (T.M.); (M.D.)
- University of Lille, Inserm, CHU Lille, UMR-S 1172 JPArc, F-59000 Lille, France
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Sy K, Flamme J, Maquet H, Chai F, Neut C, Siepmann F, Agossa K. Antimicrobial effect and physical properties of an injectable "active oxygen" gel for the treatment of periodontitis. Am J Dent 2020; 33:305-309. [PMID: 33439559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
PURPOSE To evaluate an injectable gel, recently proposed for the controlled release of "active oxygen" in periodontal pockets, compared to an antibiotic or an antiseptic gel, respectively. METHODS The antimicrobial activity, injectability, texture properties, swelling and water uptake of the gels were studied. RESULTS The "active oxygen" gel showed a bactericidal effect comparable to the two commercially available drug products (containing minocycline or chlorhexidine) on anaerobic periodontal pathogens and did not seem to affect aerobic strains. The gel was easy to inject and stable in an aqueous medium for several days. Texture analysis revealed potential gel fragility. CLINICAL SIGNIFICANCE The investigated gel for local delivery of oxygen can help to selectively eradicate anaerobic bacteria associated with periodontitis and promote the recovery of a healthy-compatible oral flora.
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Affiliation(s)
- Kadiatou Sy
- Controlled Drug Delivery Systems and Biomaterials, University of Lille, Inserm, Lille, France
| | - Joséphine Flamme
- Controlled Drug Delivery Systems and Biomaterials, University of Lille, Inserm, Lille, France
| | - Héloïse Maquet
- Controlled Drug Delivery Systems and Biomaterials, University of Lille, Inserm, Lille, France
| | - Feng Chai
- Controlled Drug Delivery Systems and Biomaterials, University of Lille, Inserm, Lille, France
| | - Christel Neut
- LIRIC - Lille Inflammation Research International Center, University of Lille, Inserm, Lille, France
| | - Florence Siepmann
- Controlled Drug Delivery Systems and Biomaterials, University of Lille, Inserm, Lille, France
| | - Kevimy Agossa
- Controlled Drug Delivery Systems and Biomaterials, University of Lille, Inserm, Lille, France,
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Agossa K, Delepierre A, Lizambard M, Delcourt-Debruyne E, Siepmann J, Siepmann F, Neut C. In-situ forming implants for dual controlled release of chlorhexidine and ibuprofen for periodontitis treatment: Microbiological and mechanical key properties. J Drug Deliv Sci Technol 2020. [DOI: 10.1016/j.jddst.2020.101956] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Dubar M, Delatre V, Moutier C, Sy K, Agossa K. Awareness and practices of general practitioners towards the oral-systemic disease relationship: A regionwide survey in France. J Eval Clin Pract 2020; 26:1722-1730. [PMID: 31876066 DOI: 10.1111/jep.13343] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 12/10/2019] [Accepted: 12/11/2019] [Indexed: 12/12/2022]
Abstract
UNLABELLED RATIONALE, AIM, AND OBJECTIVE: "Periodontal medicine" is based on evidence of interactions between periodontal disease and overall health. The aim of the present study was to assess awareness of oral-systemic disease relationship among French general practitioners (GPs) and clarify how this influences their practices in a wider effort to better integrate oral health concerns into global health care delivery. METHOD GPs registered in the north of France were invited to complete an online self-administered questionnaire through local divisions of the French Medical Board. The questionnaire was divided into four sections: socio-demographic aspects, knowledge, practices, and an overview. RESULTS The questionnaire was completed by 253 GPs. Among these, 75% were aware of the association between periodontitis (PD) and diabetes, and 53% to 59% were aware of the impact of PD on cardiovascular diseases, inflammatory bowel diseases, and respiratory infections. Few GPs identified PD as a possible risk factor of rheumatoid arthritis and Alzheimer disease (35.18% and <15%, respectively); 74.31% of GPs reported never asking their patients about their periodontal health. However, a personal history of PD and professional experiences seem to influence the medical practices of GPs to include oral examination. GPs largely self-rated their knowledge of the oral-systemic disease connection as being insufficient and were favourable to completing an up-to-date training course (86.56%). CONCLUSION French GPs' knowledge about the association of PD with systemic diseases seems to be fair, but discrepancies in their daily clinical routine were found. Promisingly, a positive attitude was observed towards improving their knowledge of oral-systemic diseases link. These results indicate the importance to reinforce collaboration between medical doctors and oral health care specialists.
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Affiliation(s)
- Marie Dubar
- Department of Periodontology, School of Dentistry, Lille University Hospital, University of Lille, Lille, France
| | - Vincent Delatre
- Private Practice, School of Dentistry, University of Lille, Lille, France
| | - Cassandre Moutier
- Department of Public Health, School of Dentistry, Lille University Hospital, University of Lille, Lille, France
| | - Kadiatou Sy
- Department of Restorative Dentistry and Endodontics, School of Dentistry, Lille University Hospital, University of Lille, Lille, France
| | - Kevimy Agossa
- Department of Periodontology, School of Dentistry, Lille University Hospital, University of Lille, Lille, France
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Lizambard M, Menu T, Fossart M, Bassand C, Agossa K, Huck O, Neut C, Siepmann F. In-situ forming implants for the treatment of periodontal diseases: Simultaneous controlled release of an antiseptic and an anti-inflammatory drug. Int J Pharm 2019; 572:118833. [PMID: 31715363 DOI: 10.1016/j.ijpharm.2019.118833] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 10/23/2019] [Accepted: 10/28/2019] [Indexed: 01/16/2023]
Abstract
Different types of in-situ forming implants based on poly(lactic-co-glycolic acid) (PLGA) for the controlled dual release of an antiseptic drug (chlorhexidine) and an anti-inflammatory drug (ibuprofen) were prepared and thoroughly characterized in vitro. N-methyl-pyrrolidone (NMP) was used as water-miscible solvent, acetyltributyl citrate (ATBC) as plasticizer and hydroxypropyl methylcellulose (HPMC) was added to enhance the implants' stickiness/bioadhesion upon formation within the periodontal pocket. Different drug forms exhibiting substantially different solubilities were used: chlorhexidine dihydrochloride and digluconate as well as ibuprofen free acid and lysinate. The initial drug loadings were varied from 1.5 to 16.1%. In vitro drug release, dynamic changes in the pH of the surrounding bulk fluid and in the systems' wet mass as well as polymer degradation were monitored. Importantly, the release of both drugs, chlorhexidine and ibuprofen, could effectively be controlled simultaneously during several weeks. Interestingly, the tremendous differences in the drug forms' solubilities (e.g., factor >5000) did not translate into major differences in the resulting release kinetics. In the case of ibuprofen, this can likely (at least in part) be attributed to significant drug-polymer interactions (ibuprofen acts as a plasticizer for PLGA). In the case of chlorhexidine, the release of the much less soluble dihydrochloride was even faster compared to the more soluble digluconate (when combined with ibuprofen free acid). In the case of ibuprofen, at higher initial drug loadings also limited solubility effects within the implants seem to play a role, in contrast to chlorhexidine. In the latter case, instead, increased system porosity effects likely dominate at higher drug loadings.
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Affiliation(s)
- M Lizambard
- Univ. Lille, Inserm, CHU Lille, U1008, F-59000 Lille, France
| | - T Menu
- Univ. Lille, Inserm, CHU Lille, U1008, F-59000 Lille, France
| | - M Fossart
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - C Bassand
- Univ. Lille, Inserm, CHU Lille, U1008, F-59000 Lille, France
| | - K Agossa
- Univ. Lille, Inserm, CHU Lille, U1008, F-59000 Lille, France
| | - O Huck
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France; Université de Strasbourg, Faculté de Chirurgie-dentaire, 8 rue Sainte-Elisabeth, 67000 Strasbourg, France
| | - C Neut
- Univ. Lille, Inserm, CHU Lille, U995-LIRIC, F-59000 Lille, France
| | - F Siepmann
- Univ. Lille, Inserm, CHU Lille, U1008, F-59000 Lille, France.
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Batool F, Agossa K, Lizambard M, Petit C, Bugueno IM, Delcourt-Debruyne E, Benkirane-Jessel N, Tenenbaum H, Siepmann J, Siepmann F, Huck O. In-situ forming implants loaded with chlorhexidine and ibuprofen for periodontal treatment: Proof of concept study in vivo. Int J Pharm 2019; 569:118564. [PMID: 31352049 DOI: 10.1016/j.ijpharm.2019.118564] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 07/23/2019] [Accepted: 07/24/2019] [Indexed: 12/12/2022]
Abstract
Control of infection and inflammation is crucial for the success of periodontal treatment. In this study, in-situ forming implants (ISFI) loaded with chlorhexidine dihydrochloride (CHX) and ibuprofen (IBU) were developed and tested to optimize periodontal treatment outcomes. Release profiles were promising. Exposure to 1.5% and 5.3% CHX-IBU loaded ISFI's release media decreased significantly the P. gingivalis growth up to 20-fold and 35-fold, respectively, after 48 h (p < 0.05). The metabolic activity assay of gingival epithelial cells (EC) demonstrated 1.5% CHX-IBU-loaded ISFI to be non-toxic, therefore, it was selected for further experimentation. Furthermore, significant down-regulation of TNF-α release (34% at 6 h and 43% at 24 h, p < 0.05) in P. gingivalis lipopolysaccharide (Pg-LPS) stimulated EC exposed to 1.5% CHX-IBU ISFI release medium was demonstrated by ELISA. In vivo, 1.5% CHX-IBU ISFI was injected into the periodontal pocket in an experimental periodontitis mouse model and the reduction in inflammation and improvement in periodontal wound healing was evaluated through inflammatory cell scoring and histomorphometry at 7- and 15-days post-treatment. The results indicate that CHX-IBU loaded ISFI could be efficient as adjuvant to periodontal therapy for the control of infection and inflammation. Moreover, other (e.g., pro-regenerative) drugs could be incorporated into ISFI to further improve periodontal treatment outcomes.
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Affiliation(s)
- Fareeha Batool
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France; Université de Strasbourg, Faculté de Chirurgie-dentaire, 8 rue Sainte-Elisabeth, 67000 Strasbourg, France
| | - Kevimy Agossa
- Univ. Lille, Inserm, CHU Lille, U1008 - Controlled Drug Delivery Systems and Biomaterials, F-59000 Lille, France
| | - Martin Lizambard
- Univ. Lille, Inserm, CHU Lille, U1008 - Controlled Drug Delivery Systems and Biomaterials, F-59000 Lille, France
| | - Catherine Petit
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France; Université de Strasbourg, Faculté de Chirurgie-dentaire, 8 rue Sainte-Elisabeth, 67000 Strasbourg, France
| | - Isaac Maximiliano Bugueno
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France; Université de Strasbourg, Faculté de Chirurgie-dentaire, 8 rue Sainte-Elisabeth, 67000 Strasbourg, France
| | - Elisabeth Delcourt-Debruyne
- Univ. Lille, Inserm, CHU Lille, U1008 - Controlled Drug Delivery Systems and Biomaterials, F-59000 Lille, France
| | - Nadia Benkirane-Jessel
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Henri Tenenbaum
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France; Université de Strasbourg, Faculté de Chirurgie-dentaire, 8 rue Sainte-Elisabeth, 67000 Strasbourg, France
| | - Juergen Siepmann
- Univ. Lille, Inserm, CHU Lille, U1008 - Controlled Drug Delivery Systems and Biomaterials, F-59000 Lille, France
| | - Florence Siepmann
- Univ. Lille, Inserm, CHU Lille, U1008 - Controlled Drug Delivery Systems and Biomaterials, F-59000 Lille, France
| | - Olivier Huck
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France; Université de Strasbourg, Faculté de Chirurgie-dentaire, 8 rue Sainte-Elisabeth, 67000 Strasbourg, France.
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Feuillet D, Keller JF, Agossa K. Interproximal Tunneling with a Customized Connective Tissue Graft: A Microsurgical Technique for Interdental Papilla Reconstruction. INT J PERIODONT REST 2019; 38:833-839. [PMID: 30304073 DOI: 10.11607/prd.3549] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Interdental papilla reconstruction is one of the most challenging clinical procedures in periodontal plastic surgery. Several surgical approaches have been proposed but have varying degrees of success. It has long been acknowledged that the narrowness of the interdental papilla and the limited blood supply are major impediments to achieving predictable outcomes. Advances in microsurgery could offer an opportunity to overcome these anatomic and biologic barriers. The authors propose an original microsurgical technique based on interproximal tunneling combined with utilization of a customized tissue graft for interdental papilla reconstruction.
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Agossa K, Godel G, Dubar M, S Y K, Behin P, Delcourt-Debruyne E. Does Evidence Support a Combined Restorative Surgical Approach for the Treatment of Gingival Recessions Associated With Noncarious Cervical Lesions? J Evid Based Dent Pract 2017; 17:226-238. [PMID: 28865819 DOI: 10.1016/j.jebdp.2017.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 04/01/2017] [Accepted: 04/03/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Gingival recessions are frequently associated with noncarious cervical lesions. Combined restorative surgical approaches have been suggested for the management of these combined defects. The aim of this review was to analyze the current evidence on the effectiveness of these combined restorative surgical approaches. METHODS A systematic review of randomized controlled studies published from January 2006 to June 2016 was performed. RESULTS Ten articles comparing combined restorative surgical approaches to surgery alone were included. Both the procedures showed similar outcomes in term of root coverage but the combined restorative surgical approach achieved better result in the reduction of dentin hypersensitivity. In combined restorative surgical treatments, resin-modified glass ionomers showed better antimicrobial properties but poorer esthetic outcome than resin composites. CONCLUSION Data to support or refute definitely the interest of combined approaches for the treatment of gingival recessions associated with noncarious cervical lesions are limited.
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Affiliation(s)
- Kevimy Agossa
- Univ. Lille, Inserm, CHU Lille, U1008, Controlled Drug Delivery Systems and Biomaterials, Lille, France; Department of Periodontology, School of Dentistry, University of Lille, Lille, France.
| | | | - Marie Dubar
- Department of Periodontology, Lorraine University, Nancy, France
| | - Kadiatou S Y
- Department of Restorative Dentistry and Endodontics, School of Dentistry, University of Lille, Lille, France
| | - Pascal Behin
- Department of Prosthodontics, School of Dentistry, University of Lille, Lille, France
| | - Elisabeth Delcourt-Debruyne
- Univ. Lille, Inserm, CHU Lille, U1008, Controlled Drug Delivery Systems and Biomaterials, Lille, France; Department of Periodontology, School of Dentistry, University of Lille, Lille, France
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Agossa K, Dendooven A, Dubuquoy L, Gower-Rousseau C, Delcourt-Debruyne E, Capron M. Periodontal manifestations of inflammatory bowel disease: emerging epidemiologic and biologic evidence. J Periodontal Res 2016; 52:313-324. [PMID: 27663744 DOI: 10.1111/jre.12422] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2016] [Indexed: 12/27/2022]
Abstract
Inflammatory bowel disease and periodontitis are both described as a disproportionate mucosal inflammatory response to a microbial environment in susceptible patients. Moreover, these two conditions share major environmental and lifestyle-related risk factors. Despite this intriguing pathogenic parallel, large-scale studies and basic research have only recently considered periodontal outcomes as relevant data. There are mounting and consistent arguments, from recent epidemiologic studies and animal models, that these two conditions might be related. This article is a comprehensive and critical up-to-date review of the current evidence and future prospects in understanding the biologic and epidemiologic relationships between periodontal status and inflammatory bowel disease.
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Affiliation(s)
- K Agossa
- Univ. Lille, Inserm, CHU Lille, U1008 - Controlled Drug Delivery Systems and Biomaterials, Lille, France.,Department of Periodontology, School of Dentistry, University of Lille, Lille, France
| | - A Dendooven
- Univ. Lille, Inserm, CHU Lille, U995 - LIRIC - Lille Inflammation Research International Center, Lille, France
| | - L Dubuquoy
- Univ. Lille, Inserm, CHU Lille, U995 - LIRIC - Lille Inflammation Research International Center, Lille, France
| | - C Gower-Rousseau
- Univ. Lille, Inserm, CHU Lille, U995 - LIRIC - Lille Inflammation Research International Center, Lille, France.,Public Health, Epidemiology and Economic Health, Registre Epimad, Maison Régionale de la Recherche Clinique, Centre Hospitalier Universitaire Régional, Lille Cedex, France
| | - E Delcourt-Debruyne
- Univ. Lille, Inserm, CHU Lille, U1008 - Controlled Drug Delivery Systems and Biomaterials, Lille, France.,Department of Periodontology, School of Dentistry, University of Lille, Lille, France
| | - M Capron
- Univ. Lille, Inserm, CHU Lille, U995 - LIRIC - Lille Inflammation Research International Center, Lille, France
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