Abstract
Sclerostin modulation is a novel therapeutic bone regulation strategy. The anti-sclerostin drugs, proposed in medicine for skeletal bone loss may be developed for jaw bone indications in dentistry. Alveolar bone responsible for housing dentition share common bone remodeling mechanisms with skeletal bone. Manipulating alveolar bone turnover can be used as a strategy to treat diseases such as periodontitis, where large bone defects from disease are a surgical treatment challenge and to control tooth position in orthodontic treatment, where moving teeth through bone in the treatment goal. Developing such therapeutics for dentistry is a future line for research and therapy. Furthermore, it underscores the interprofessional relationship that is the future of healthcare.
Highlights
The idea of pharmacologic alveolar bone modulation as a strategy to treat oral conditions is not new, nor is it a new concept to apply existing drugs for new indications Alveolar bone and skeletal bone remodeling share similar mechanisms
Destruction in periodontal disease occurs in the supporting structures of the teeth, namely: gingiva, periodontal ligament, cementum and alveolar bone, through a complex pathogenic process gingiva, periodontal ligament, cementum and alveolar bone, through a complex pathogenic process starting with the interaction between bacterial plaque biofilm and the host immune response
Sclerostin immunolocalization has been demonstrated in periodontal tissues other than bone. Both cementocytes and periodontal ligament cultures show increasing sclerostin protein when adjacent tissues were exposed to cells genetically capable of producing sclerostins. As such both periodontal ligament cells and cementocytes show the potential participate in bone turnover when modulating osteocytes through sclerostin binding [77]
Summary
The idea of pharmacologic alveolar bone modulation as a strategy to treat oral conditions is not new, nor is it a new concept to apply existing drugs for new indications Alveolar bone and skeletal bone remodeling share similar mechanisms. Both involve osteoblast and osteoclast balance regulated through signaling systems involving common hormones, cytokines and pathways. Since bone turnover modulation shares similar pathways and signaling systems not just in alveolar and skeletal bone, these drugs hold potential indications for several diseases/conditions including rheumatoid arthritis, bone health complications in diabetes and osteogenesis imperfecta. [41,42]
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