Comparative In Vitro Evaluation of Commercial Periodontal Gels on Antibacterial, Biocompatibility and Wound Healing Ability.

Marta Munar-Bestard,Marta Monjo,Maria Antonia Llopis-Grimalt,Joana Maria Ramis

doi:10.3390/pharmaceutics13091502

Abstract

In the last years, several studies testing commercial periodontal gels that contain chlorhexidine (CHX) or other antibacterial agents, have raised concerns regarding their cytotoxicity in periodontal tissues. We aimed at comparing the biocompatibility but also the efficacy as regards to the antibacterial and wound healing ability of different commercial periodontal gels. In vitro human gingival fibroblasts (GF) and a 3D model of human tissue equivalents of gingiva (GTE) were used under inflammatory conditions to evaluate wound closure, cytotoxicity and gene expression. Antibacterial effects were also investigated on Porphyromonas gingivalis growth, viability and gingipain activity. In GF and in the bacterial study, we found cytotoxic effects on GF and a high inhibition on bacterial growth rate in gels containing CHX, asiaticoside, enoxolone, cetylpyridinium chloride, propolis and eugenol. Of the two gels that were non-cytotoxic, Syntoss Biogel (containing chondrontin sulfate) and Emdogain (EMD, containing amelogenin and propylene glycol alginate), EMD showed the best wound closure, with no effect on P. gingivalis growth but decreased gingipain activity. On the other hand, Syntoss Biogel reduced viability and gingipain activity of P. gingivalis, but lack wound healing capacity. In the 3D GTE, Syntoss Biogel and EMD showed a good biocompatibility. Among all the tested gels, formulations containing CHX, asiaticoside, enoxolone, cetylpyridinium chloride, propolis and eugenol showed high antibacterial effect but also showed high cytotoxicity in eukaryotic cells. EMD was the one with the best biocompatibility and wound healing ability at the conditions tested.

Highlights

Periodontal disease (PD), which includes gingivitis and periodontitis, is one of the most common human diseases, being severe periodontitis the sixth most prevalent disease in the world [1]
The tissue damage induced in the PD is caused directly by certain bacteria present in the subgingival plaque and indirectly by an immune response against these bacteria and inflammation, which is mainly produced by macrophages and lymphocytes through a massive production of different cytokine subtypes, including tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β), IL-4, IL-6 and gamma interferon (IFN-γ), contributing to the progression of the disease and the death of periodontal tissues [2,3]
We evaluated the gingipain activity of the bacteria treated with the different periodontal gels (Figure 3D)

Summary

Introduction

Periodontal disease (PD), which includes gingivitis and periodontitis, is one of the most common human diseases, being severe periodontitis the sixth most prevalent disease in the world [1]. PD is characterized by the infection and inflammation of the gingiva that may lead to its destruction, and in severe cases, to the degradation of the alveolar bone and tooth loss. Pharmaceutics 2021, 13, 1502 and stimulate tissue regeneration, allowing bone formation and soft tissue attachment to the tooth. PD treatments allow active disease to be cured using mechanical and antimicrobial procedures. These procedures manage to stop the inflammation, eliminate bacteria and reduce the possible loss of tissue. They do not lead to a complete regeneration of the tissue [2,4]

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