Topical HPMC/S-Nitrosoglutathione Solution Decreases Inflammation and Bone Resorption in Experimental Periodontal Disease in Rats

S-nitrosoglutathione (GSNO) is a nitric oxide (NO) donor, which exerts antioxidant, anti-inflammatory, and microbicidal actions. Intragingival application of GSNO was already shown to decrease alveolar bone loss, inflammation and oxidative stress in an experimental periodontal disease (EPD) model. In the present study, we evaluated the potential therapeutic effect of topical applications of hydroxypropylmethylcellulose (HPMC)/GSNO solutions on EPD in Wistar rats. EPD was induced by placing a sterilized nylon (3.0) thread ligature around the cervix of the second left upper molar of the animals, which received topical applications of a HPMC solutions containing GSNO 2 or 10 mM or vehicle (HPMC solution), 1 h prior to the placement of the ligature and then twice daily until sacrifice on day 11. Treatment with HPMC/GSNO 10 mM solution significantly reduced alveolar bone loss, oxidative stress and TNF-α e IL-1β levels in the surrounding gingival tissue, and led to a decreased transcription of RANK and TNF-α genes and elevated bone alkaline phosphatase, compared to the HPMC group. In conclusion, topical application of HPMC/GSNO solution is a potential treatment to reduce inflammation and bone loss in periodontal disease.

Review of failed implant cases

Five Failed implant cases were presented and gained the following; 1) The use of computed tomography is recommended for treatment planning such as to ascertain the three-dimensional position of the mandibular canal, maxillary sinus and nasal floor, and also to decide the diameter, length and inclination of the implant placement. 2) The implant should be located for enough from mental foramen, mandibular canal, maxillary sinus and nasal floor. 3) The use of surgical stent is recommended for accurate drilling of the implant site. 4) Adequate number of implants and strategic arrangement of implants are required to equally distribute stress. 5) An implant abutment which is connected to natural teeth will be affected by the difference of micromobility of the natural teeth and the trouble of abutment of prosthesis.