Therapy Of Periodontitis Research Articles

Melatonin Engineering M2 Macrophage-Derived Exosomes Mediate Endoplasmic Reticulum Stress and Immune Reprogramming for Periodontitis Therapy.

Periodontitis is a chronic infectious disease caused by bacterial irritation. As an essential component of the host immunity, macrophages are highly plastic and play a crucial role in inflammatory response. An appropriate and timely transition from proinflammatory (M1) to anti-inflammatory (M2) macrophages is indispensable for treating periodontitis. As M2 macrophage-derived exosomes (M2-exos) can actively target inflammatory sites and modulate immune microenvironments, M2-exos can effectively treat periodontitis. Excessive endoplasmic reticulum stress (ER stress) and unfolded protein response (UPR) are highly destructive pathological characteristics during inflammatory periodontal bone loss. Although melatonin has antioxidant and anti-inflammatory effects, studies focusing on melatonin ER stress modulation remain limited. This study fabricates engineered M2-exos loading with melatonin (Mel@M2-exos) for treating periodontitis. As a result, M2-exos drive an appropriate and timely macrophage reprogramming from M1 to M2 type, which resolves chronic inflammation and accelerated periodontal healing. Melatonin released from Mel@M2-exos rescues the osteogenic and cementogenic differentiation capacity in inflammatory human periodontal ligament cells (hPDLCs) by reducing excessive ER stress and UPR. Injectable gelatin methacryloyl (GelMA) hydrogels with sustained-release Mel@M2-exos accelerate periodontal bone regeneration in rats with ligation-induced periodontitis. Taken together, melatonin engineering M2 macrophage-derived exosomes are promising candidates for inflammatory periodontal tissue regeneration.

Efek ekstrak etanol kelopak bunga rosella (hibiscus sabdariffa l.) Terhadap biofilm prevotella intermedia

Background: The prevalence of periodontal disease in Indonesia reaches 96,58%. Prevotella intermedia is an orange complex bacteria play an important role in periodontitis. One of the therapies for periodontitis disease is the use of antimicrobial mouthwash. Rosella flowers can be used for an alternative therapy for periodontal disease because Rosella flower had been widely used as herbal drink. Purpose: This study aims to find out how rosella flower ethanol extract adheres to prevotella intermedia biofilms. Methods: This research is a laboratory experimental study using the biofilm test method. Rosella flower petals were taken from Balitro in Bogor, West Java. This research was conducted at the FKG Usakti MiCore Laboratory. The ethanol extract of rosella petals was diluted to obtain concentrations of 100%, 50%, 25%, 12.5%, 6.25%, 3.12% and 1.5%. The wellplate was incubated for 1 hour, 6 hours and 24 hours under anaerobic conditions then read the OD (optical density) using a microplate reader at a wavelength of 49nm.Results: The normality test shows normal data distribution (p>0.05). The ANOVA test showed a significant difference (p>0.05). Post-Hoc test showed significant differences between the concentrations of the ethanol extract of rosella calyx. Conclusion: The ethanol extract of rosella calyx has an effect on inhibiting the attachment of the prevotella intermedia biofilm.

The Effect of Adjunctive Use of Hyaluronic Acid on Prevalence of Porphyromonas gingivalis in Subgingival Biofilm in Patients with Chronic Periodontitis: A Systematic Review.

Porphyromonas gingivalis (P. gingivalis) is a Gram-negative anaerobic bacterium that plays an important role in the development and progression of periodontitis. Hyaluronic acid (HA) is a naturally occurring glycosaminoglycan that has previously demonstrated antibacterial potential in vitro against multiple bacterial species, including P. gingivalis. The purpose of this systematic review is to evaluate the effectiveness of HA as an adjunctive topical antibacterial agent to non-surgical mechanical therapy of periodontitis in reducing the prevalence of P. gingivalis in subgingival biofilms. Five clinical studies were identified that satisfied the eligibility criteria. Only three trials were suitable for the meta-analysis as they provided data at three and six months. Data on the prevalence of P. gingivalis in each study were collected. The odds ratio (OR) for measuring the effect size with a 95% confidence interval (CI) was applied to the available data. The results did not favor the use of HA during non-surgical mechanical therapy to reduce the prevalence of P. gingivalis in subgingival biofilm (odd ratio = 0.95 and 1.11 at three and six months, consecutively). Within their limitations, the current data do not indicate an advantage for using HA during mechanical periodontal therapy to reduce the prevalence of P. gingivalis.

POTENSI PENGGUNAAN β-TRICALCIUM PHOSPHATE SEBAGAI BAHAN SUBSTIUSI TULANG

Calcium phosphate has been widely used in bone regeneration applications. Originalkalsium fosfat merupakan biomaterial yang sering diaplikasikan ke dalam defek tulang dengan tidak memberikan efek toksik pada jaringan sehat.The most commonly used calcium phosphate are hydroxyapatite and β-tricalcium phosphate (β-TCP). β-TCP is one of the bioceramic materials that has chemical structure of β-Ca3(PO4)2. The use of β-TCP is widely used in medicine and dentistry as bone graft due to bone loss. β-TCP is used to fill and repair bone deficiencies to regenerative new bone formation. In dentistry, β-TCP can be used for periodontal disease therapy, pre-implant surgery to fill a post-extraction socket before implant application, post-surgical removal of benign tumors, post-endodontic bone healing such as apicoectomy and drug delivery. Various studies have shown β-TCP has better osteoconductive, biocompatible, biodegradable and bonding strength to bone tissue properties than hydroxyapatite. This article reviews the use of β-TCP as a substitute for hydroxyapatite in medicine and dentistry for bone substitution materials.

УСОВЕРШЕНСТВОВАНИЕ КОМПЛЕКСНОЙ ТЕРАПИИ ГИПЕРТРОФИЧЕСКОГО ГИНГИВИТА У ПАЦИЕНТОВ С ПАТОЛОГИЕЙ ПРИКУСА

The prevalence of inflammatory periodontal diseases, and in particular hypertrophic gingivitis, among adolescents ranges from 50 - 99%, which is often combined with malocclusion and this combination is about 70% of cases, which is an urgent and unresolved problem of modern periodontology and orthodontics. Therefore, the study of the issues of correlation between the severity of morphological, functional and aesthetic disorders of the masticatory-speech apparatus and the severity of the inflammatory process in the tissues of the periodontal complex is important and necessary for the development of modern complexes for the treatment of adolescents with hypertrophic gingivitis and malocclusion class 1 according to Angle during the hormonal period. perestroika. The purpose of the study: to optimize the complex treatment of malocclusion in adolescents with hypertrophic gingivitis. 32 patients aged 14 to 17 years with E.H. class I malocclusion. ANGLE and mild edematous hypertrophic gingivitis were included in this study. All patients underwent orthodontic treatment using non-removable orthodontic equipment (brackets), but for periodontal treatment, patients were divided into 2 groups of 16 people, one group underwent traditional conservative periodontal treatment, and the other group of patients underwent removal of dental biofilm using GBT therapy on apparatus "PROPHYLAXIS MASTER". Before treatment, after 6 months and after the removal of orthodontic equipment, an index assessment of the state of periodontal tissues was carried out and a comparison of the average statistical data of teleradiography to study changes in the size of the facial part of the skull before and after orthodontic treatment, as well as a study of the correlation between the studied parameters was carried out for all patients. According to the results of the study, it was found that during orthodontic treatment of adolescents with malocclusion class I according to E.H. ANGLE and GBT-periodontal therapy increases the effectiveness of complex treatment for this category of patients by 40% compared to traditional therapy for inflammatory periodontal diseases at the stages of orthodontic treatment.

Sirt6 Activation Ameliorates Inflammatory Bone Loss in Ligature-Induced Periodontitis in Mice.

Periodontitis is an inflammatory disease caused by microorganisms that induce the destruction of periodontal tissue. Inflamed and damaged tissue produces various inflammatory cytokines, which activate osteoclasts and induce alveolar bone loss and, eventually, tooth loss. Sirt6 expression suppresses inflammation and bone resorption; however, its role in periodontitis remains unclear. We hypothesized that Sirt6 has a protective role in periodontitis. To understand the role of Sirt6 in periodontitis, we compared periodontitis with ligature placement around the maxillary left second molar in 8-week-old control (C57BL/6J) male mice to Sirt6-overexpressing Tg (Sirt6Tg) mice, and we observed the resulting phenotypes using micro-CT. MDL801, a Sirt6 activator, was used as a therapy for periodontitis through oral gavage. Pro-inflammatory cytokines and increased osteoclast numbers were observed in alveolar bone tissue under periodontitis surgery. In the same condition, interestingly, protein levels from Sirt6 were the most downregulated among sirtuins in alveolar bone tissue. Based on micro-CT and CEJ-ABC distance, Sirt6Tg was observed to resist bone loss against ligature-induced periodontitis. Furthermore, the number of osteoclasts was significantly reduced in Sirt6Tg-ligated mice compared with control-ligated mice, although systemic inflammatory cytokines did not change. Consistent with this observation, we confirmed that bone loss was significantly reduced when MDL801, a Sirt6 activator, was included in the ligation mouse model. Our findings demonstrate that Sirt6 activation prevents bone loss against ligature-induced periodontitis. Thus, a Sirt6 activator may provide a new therapeutic approach for periodontitis.

The Activities of Torch Ginger Flower (Etlingera elatior) Ethanol Extract on Degradation of Porphyromonas gingivalis Biofilm as Periodontal Pathogen


 Introduction: Porphyromonas gingivalis is bacteria that can form biofilms as the main cause of periodontitis. Mouthwash therapy in long term can cause mucositis and even oral cancer. Antibacterial potential of torch ginger flower (Etlingera elatior) can be developed as an alternative adjuvant therapy for periodontitis. Objective: Aims of this research was to determine the effect of torch ginger flower ethanol extract against degradation of P. gingivalis biofilm. Methods: This research used ethanolic extract of torch ginger flower with concentrations 1.56 mg/mL, 3.125 mg/mL, 6.25 mg/mL, 12.5 mg/mL, 25 mg/mL, and 50 mg/mL. Chlorhexidine gluconate 0.2% was used as positive control and DMSO 1% was used as negative control. Measurement of P. gingivalis biofilm degradation used microtiter plate assay with crystal violet 1% staining which reads its optical density at wavelength of 450 nm. Data were analyzed by one way ANOVA and Post hoc LSD. Results: The percentage of P. gingivalis biofilm degradation with torch ginger flower ethanol extract sequentially were 12.47%, 30.56%, 57.12%, 71.36%, and 74.83%. The analysis showed that there was a significant difference (p<0,05) between treatment groups torch ginger flower ethanol extract, as well as between torch ginger flower ethanol extract with DMSO 1% and chlorhexidine gluconate 0.2%. Optimum concentration of ethanol extract of torch ginger flower on P. gingivalis biofilm degradation was 25 mg/mL and showed no significant difference with chlorhexidine gluconate 0,2% (p>0,05). Conclusion: Conclusion of this research is torch ginger flower (Etlingera elatior) ethanol extract has P. gingivalis biofilm degradation activity.biofilm

The Impact of Covid-19 on The Incidence of Periodontitis Cases and its Therapeutic Management During The Pandemic

ABSTRACTIntroduction: Coronavirus Disease 2019 (COVID-19) is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2. Periodontitis is an infection of the periodontal tissue that causes inflammation with the potential for the spread of intravascular microorganisms throughout the body. According to Riskesdas, periodontitis cases in Indonesia reached 74.1%. The purpose of this study was to determine the impact of COVID-19 on the incidence of periodontitis cases and their therapeutic management during the pandemic. Methods: Descriptive qualitative research using primary and secondary data in three primary health care on Kediri Tabanan. Results: The incidence of Periodontitis is in the first rank with the most cases in two Puskesmas. Oral drug therapy and extraction are the treatment options used in the treatment of periodontitis cases during the pandemic. Discussion: The high incidence of periodontitis during the COVID-19 pandemic is caused by patients who are afraid to visit the dentist. Patients coming to the dentist when the condition of the teeth is damaged and experiencing mobility. In addition, the dental polyclinic only serves patients with medical emergencies. Tools in the dental polyclinic are damaged due to never being used during the pandemic. Transmission process that occurs through aerosols produced in the practice of dental services makes the therapy be limited. Drug administration and extraction are options in the management of periodontitis cases. Conclusion: The impact of the COVID-19 pandemic has resulted in a high number of periodontitis cases. Oral medication administration and extraction an option for periodontitis therapy in the dental polyclinic of primary health care.

Impact of Circulating Cell-Free DNA (cfDNA) as a Biomarker of the Development and Evolution of Periodontitis.

In the last few decades, circulating cell-free DNA (cfDNA) has been shown to have an important role in cell apoptosis or necrosis, including in the development and evolution of several tumors and inflammatory diseases in humans. In this regard, periodontitis, a chronic inflammatory disease that can induce the destruction of supporting components of the teeth, could represent a chronic inflammatory stimulus linked to a various range of systemic inflammatory diseases. Recently, a possible correlation between periodontal disease and cfDNA has been shown, representing new important diagnostic-therapeutic perspectives. During the development of periodontitis, cfDNA is released in biological fluids such as blood, saliva, urine and other body fluids and represents an important index of inflammation. Due to the possibility of withdrawing some of these liquids in a non-invasive way, cfDNA could be used as a possible biomarker for periodontal disease. In addition, discovering a proportional relationship between cfDNA levels and the severity of periodontitis, expressed through the disease extent, could open the prospect of using cfDNA as a possible therapeutic target. The aim of this article is to report what researchers have discovered in recent years about circulating cfDNA in the development, evolution and therapy of periodontitis. The analyzed literature review shows that cfDNA has considerable potential as a diagnostic, therapeutic biomarker and therapeutic target in periodontal disease; however, further studies are needed for cfDNA to be used in clinical practice.

Functional biomaterials for comprehensive periodontitis therapy

Periodontitis is an inflammatory disease caused by bacterial infection, and the dysregulation of host immune-inflammatory response finally destroys periodontal tissues. Current treatment strategies for periodontitis mainly involve mechanical scaling/root planing (SRP), surgical procedures, and systemic or localized delivery of antimicrobial agents. However, SRP or surgical treatment alone has unsatisfactory long-term effects and is easy to relapse. In addition, the existing drugs for local periodontal treatment do not stay in the periodontal pocket long enough and have difficulties in maintaining a steady, effective concentration to obtain a therapeutic effect, and continuous administration always causes drug resistance. Many recent studies have shown that adding bio-functional materials and drug delivery systems upregulates the therapeutic effectiveness of periodontitis. This review focuses on the role of biomaterials in periodontitis treatment and presents an overview of antibacterial therapy, host modulatory therapy, periodontal regeneration, and multifunctional regulation of periodontitis therapy. Biomaterials provide advanced approaches for periodontal therapy, and it is foreseeable that further understanding and application of biomaterials will promote the development of periodontal therapy. Various functional biomaterials are developed for comprehensive periodontitis therapy through antibacterial therapy, host modulation, periodontal regeneration, or their combinations.

Effects of combined application of fibroblast growth factor (FGF)-2 and carbonate apatite for tissue regeneration in a beagle dog model of one-wall periodontal defect

There has been an increasing desire for the development of predictive periodontal regenerative therapy for severe periodontitis. In this study, we investigated the effect of the combined use of fibroblast growth factor-2 (FGF-2), a drug for periodontal regeneration approved in Japan, and carbonated apatite (CO3Ap), bioresorbable and osteoconductive scaffold, on periodontal regeneration in beagle dog model of one-wall periodontal defect (severe intraosseous defect) for 24 weeks in comparison with CO3Ap or vehicle alone. One-wall periodontal defects were created (mesiodistal width×depth: 4×4mm) on the mesial portion of the mandibular first molar (M1) of beagle dogs on both side. Mixture of FGF-2 and CO3Ap, vehicle and CO3Ap, or vehicle alone were administered to the defects and designated as groups FGF-2+CO3Ap, CO3Ap, and control, respectively. To assess the periodontal regeneration, radiographic analysis over time for 24 weeks, and micro computed tomography (μCT) and histological evaluation at 6 and 24 weeks were performed. For the regenerated tissue in the defect site, the mineral content of the FGF-2+CO3Ap group was higher than that of the CO3Ap group in the radiographic analysis at 6-24 weeks. In the context of new bone formation and replacement, the FGF-2+CO3Ap group exhibited significantly greater new bone volume and smaller CO3Ap volume than the CO3Ap group in the μCT analysis at 6 and 24 weeks. Furthermore, the density of the new bone in the FGF-2+CO3Ap group at 24 weeks was similar to those in the control and CO3Ap groups. Histological evaluation revealed that the length of the new periodontal ligament and cementum in the FGF-2+CO3Ap group was greater than that in the CO3Ap group at 6 weeks. We also examined the effect of the combined use of the FGF-2 and CO3Ap on the existing bone adjacent to the defect and demonstrated that the existing bone height and volume in the FGF-2+CO3Ap group remained significantly greater than those in the CO3Ap group. This study demonstrated that the combination of FGF-2 and CO3Ap was effective not only in enhancing new bone formation and replacing scaffold but also in maintaining the existing bone adjacent to the defect site in a beagle dog model of one-wall periodontal defect. Additionally, new periodontal tissues induced by FGF-2 and CO3Ap may follow a maturation process similar to that formed by spontaneous healing. This suggests that the combined use of FGF-2 and CO3Ap would promote periodontal regeneration in severe bony defects of periodontitis patient.

Glycolytic reprogramming controls periodontitis-associated macrophage pyroptosis via AMPK/SIRT1/NF-κB signaling pathway

Glycolysis has been demonstrated as a crucial metabolic process in bacteria infected diseases via modulating the activity of pyroptosis. Macrophages are the most abundant immune cells that infiltrated in the infected periodontal tissues, which significantly influence the outcome of periodontitis (PD). However, the effect of glycolysis in regulating macrophage pyroptosis during PD development remains unknown. This study aimed to explore the role of glycolysis in PD-associated macrophage pyroptosis and periodontal degeneration. Clinical specimens were used to determine the emergence of macrophage pyroptosis and glycolysis in periodontal tissues by immunohistochemical analysis and western blot. For an in-depth understanding of the regulatory effect of glycolysis in the progression of macrophage pyroptosis associated periodontitis, both in vivo PD model and in vitro PD model were treated with 2-DG (2-Deoxy-d-glucose), a glycolysis inhibitor. The data showed that the blockade of glycolysis could significantly suppress the lipopolysaccharide (LPS) induced macrophage pyroptosis, resulting in an attenuation of the inflammatory response and bone resorption in periodontal lesions. Furthermore, we revealed that the regulatory effect of glycolysis on macrophage pyroptosis can be mediated via AMPK/SIRT1/NF-κB signaling pathway. Our study unveiled that suppressed glycolysis restrains the activity of PD-associated macrophage pyroptosis, osteoclastogenesis, and subsequent periodontal tissue destruction. These findings extend our knowledge of glycolysis in regulating PD-associated macrophage pyroptosis and provide a potential novel target for PD therapy.

Aspirin loaded extracellular vesicles inhibit inflammation of macrophages via switching metabolic phenotype in periodontitis

ObjectivesChanges of macrophage in the local immune microenvironment of periodontitis cause alveolar bone resorption. This study aims to investigate the effect of a new drug delivery method of aspirin on the immune microenvironment of periodontitis to promote alveolar bone repair, and to explore mechanism of aspirin's effect on macrophage. MethodsWe isolated extracellular vesicles (EVs) from periodontal stem cells (PDLSCs) and loaded with aspirin by sonication, and then evaluated the treatment efficacy of aspirin-loaded vesicles (EVs-ASP) in periodontitis model in mice. In vitro, we explored the role of EVs-ASP in the regulation of LPS-induced macrophages. The underlying mechanism by which EVs-ASP regulates phenotypic remodeling of macrophages in periodontitis was further investigated. ResultsEVs-ASP inhibited the inflammatory environment of LPS-induced macrophage, and promoted anti-inflammatory macrophages formation both in vivo and in vitro, and reduced bone loss in periodontitis models. Moreover, EVs-ASP enhanced oxidative phosphorylation and suppressed glycolysis in macrophages. ConclusionsConsequently, EVs-ASP improves the periodontal immune microenvironment by enhancing oxidative phosphorylation (OXPHOS) in macrophages, resulting in a certain degree of regeneration of alveolar bone height. Our study provides a new potential strategy for bone repair in periodontitis therapy.

Bibliometric analysis on research trends for contribution of photodynamic therapy in periodontitis

BackgroundThe objective of this bibliometric analysis was to ascertain the research trend regarding the application of photodynamic therapy as a treatment modality for periodontal disease. MethodsAn online search was administered using the Scopus database to retrieve all the relevant research literature published from 2003 till 26th Dec 2022. After applying the inclusion criteria articles pertinent to the topic were manually selected. Data was saved as CSV. Data was read using VOSviewer software and further analysis was performed using Microsoft excel. ResultsFrom a total of 545 articles, 117 scientific papers relevant to the field were evaluated. The keen interest of researchers was identified by an increase in the number of publications over the course of time, with the highest citations n = 827 attained during the year 2009. Brazil, India, and USA made significant contribution by publishing highest number of papers. Organizations from the USA produced the highest publications which attained high citations. Author Sculean A. published the highest number of papers. Journal of periodontology was the leading journal, by publishing highest number of papers (n = 15), followed by Journal of Clinical Periodontology. ConclusionThis bibliometric analysis provided detailed information regarding the total number of publications from 2003 to 2022 and the number of citations attained. Brazil has been identified as the leading country, whilst all the leading organizations which contributed significantly, were from USA. The Journal of Periodontology published the highest number of papers which had been highly cited. Sculean A, affiliated with University of Bern, Switzerland published the highest number of papers.

Combined Ferromagnetic Nanoparticles for Effective Periodontal Biofilm Eradication in Rat Model.

The critical challenge for periodontitis therapy is thoroughly eliminating the dental plaque biofilm, particularly penetrating the deep periodontal tissue. Regular therapeutic strategies are insufficient to penetrate the plaque without disturbing the commensal microflora of the oral cavity. Here, we constructed a Fe3O4 magnetic nanoparticle loading minocycline (FPM NPs) to penetrate the biofilm physically and effectively eliminate periodontal biofilm. In order to penetrate and remove the biofilm effectively, Fe3O4 magnetic nanoparticles were modified with minocycline using a co-precipitation method. The particle size and dispersion of the nanoparticles were characterized by transmission electron microscopy, scanning electron microscopy, and dynamic light scattering. The antibacterial effects were examined to verify the magnetic targeting of FPM NPs. Confocal laser scanning microscopy was employed to check the effect of FPM + MF and develop the best FPM NPs treatment strategy. Additionally, the therapeutic effect of FPM NPs was investigated in periodontitis rat models. The expression of IL-1β, IL-6, and TNF-α in periodontal tissues was measured by qRT-PCR and Western blot. The multifunctional nanoparticles exhibited intense anti-biofilm activity and good biocompatibility. The magnetic forces could pull FMP NPs against the biofilm mass and kill bacteria deep in the biofilms both in vivo and in vitro. The integrity of the bacterial biofilm is disrupted under the motivation of the magnetic field, allowing for improved drug penetration and antibacterial performance. The periodontal inflammation recovered well after FPM NPs treatment in rat models. Furthermore, FPM NPs could be monitored in real-time and have magnetic targeting potentials. FPM NPs exhibit good chemical stability and biocompatibility. The novel nanoparticle presents a new approach for treating periodontitis and provides experimental support for using magnetic-targeted nanoparticles in clinic applications.

Exploring the Streptococci Variants in Children’s Oral Cavity, Its Microbiome Diversity

This study aimed to identify the variants of the Streptococcus genus in the oral cavity of healthy individuals. Streptococcus is one of the normal flora, which is part of the lactic acid bacteria (LAB) in the oral cavity. LAB has the ability to produce antimicrobial agents, regulate the host's immune response, and inhibit the growth of pathogenic bacteria. The presence of LAB in the oral cavity is crucial in maintaining oral health and preventing periodontal diseases. This study used observational cross-sectional design with 40 healthy elementary school children as subjects. Swabs were taken from their oral cavities and sent to the laboratory for PCR and sequencing tests. The results revealed that isolates 3S, 4S, 9S, 10S, 14S, and 15S were identified as Streptococcus dysgalactiae, while isolates 1S, 8S, and 9S were identified as Streptococcus mitis. Additionally, isolates 2S, 5S, 7S, 11S, 12S, and 13S were identified as Streptococcus salivarius, isolate 6S was identified as Streptococcus agalactiae, and isolate 17S was identified as Streptococcus oralis. These findings provide valuable information on the identification of oral microbiota, particularly Streptococcus genus variants, which can potentially serve as an alternative therapy for periodontal diseases.

Local Delivery and Controlled Release Drugs Systems: A New Approach for the Clinical Treatment of Periodontitis Therapy.

Periodontitis is an inflammatory disease of the gums characterized by the degeneration of periodontal ligaments, the formation of periodontal pockets, and the resorption of the alveolar bone, which results in the destruction of the teeth's supporting structure. Periodontitis is caused by the growth of diverse microflora (particularly anaerobes) in the pockets, releasing toxins and enzymes and stimulating the immune system. Various approaches, both local and systemic, have been used to treat periodontitis effectively. Successful treatment depends on reducing bacterial biofilm, bleeding on probing (BOP), and reducing or eliminating pockets. Currently, the use of local drug delivery systems (LDDSs) as an adjunctive therapy to scaling and root planing (SRP) in periodontitis is a promising strategy, resulting in greater efficacy and fewer adverse effects by controlling drug release. Selecting an appropriate bioactive agent and route of administration is the cornerstone of a successful periodontitis treatment plan. In this context, this review focuses on applications of LDDSs with varying properties in treating periodontitis with or without systemic diseases to identify current challenges and future research directions.

The Role of Vitamin C and Vitamin D in the Pathogenesis and Therapy of Periodontitis-Narrative Review.

Periodontitis is a common disorder affecting the bone and soft tissues of the periodontal complex. When untreated, it may lead to severe mobility or even loss of teeth. The pathogenesis of periodontitis is complex, with crucial factors being chronic inflammation in gingival and periodontal tissues and oral microbiome alterations. However, recent studies highlight the alleged role of vitamins, such as vitamin C (VitC) and vitamin D (VitD), in the development of the disease. VitC regulates numerous biochemical reactions, but foremost, it is involved in synthesizing collagen. It was reported that VitC deficiency could lead to damage to the periodontal ligaments. VitC supplementation improves postoperative outcomes in patients with periodontitis. VitD is a steroid derivative that can be produced in the skin under ultraviolet radiation and later transformed into an active form in other tissues, such as the kidneys. VitD was established to decrease the expression of proinflammatory cytokines in gingiva and regulate the proper mineral density of teeth. Moreover, the supplementation of VitD was associated with better results in the nonsurgical treatment of periodontitis. In this review, we summarize recent knowledge on the role of vitamins C and D in the pathogenesis and treatment of periodontitis.

Periodontal Disease and Nonsurgical Periodontal Therapy on the OHRQoL of the Patient: A Pilot Study of Case Series

The objective of this prospective study was to assess oral health-related quality of life (OHR-QoL) in patients with periodontitis and nonsurgical periodontal treatment. A prospective, longitudinal case series study was carried out at the University Dental Clinic of the Morales Meseguer Hospital in Murcia. Eighty periodontal patients with periodontitis, aged 22 to 72 years, were included in this study. The Spanish version of the Oral Health Impact Profile 14 (OHIP-14sp) questionnaire was used on two occasions: at the first visit and one month after completing the nonsurgical periodontal treatment. Clinical measurements of probing depth, plaque index and bleeding on probing were performed at baseline and after periodontal therapy. Data were analyzed using Student's t-test and analysis of variance. We found statistically significant differences (p < 0.05) between the pre- and post-treatment in all the dimensions studied except disability. Similarly, statistically significant differences were also found according to the degree or stage of the disease. However, these differences were not observed with respect to the extent of periodontal disease. Periodontal disease has a negative impact on the OHRQoL of periodontal patients, especially in severe stages (III-IV). Basic periodontal treatment can improve the OHRQoL of periodontal patients one month after treatment.

Anti-Porphyromonas gingivalis nanotherapy for maintaining bacterial homeostasis in periodontitis

Periodontitis is caused by oral flora imbalance, which leads to immune imbalance. Porphyromonas gingivalis is a keystone pathogen in periodontitis, causing the blooming of inflammophilic microbes, and becoming dormant to resist antibiotics. Targeted interventions are needed to destroy this pathogen and collapse its inflammophilic flora. Therefore, a targeting nanoagent antibody-conjugated liposomal drug carrier with ginsenoside Rh2 (A-L-R) was developed for pleiotropic benefits. A-L-R showed high quality in high-performance liquid chromatography (HPLC), Fourier transform infrared (FTIR), and transmission electron microscope (TEM) detection. Only P. gingivalis was influenced by A-L-R, as shown by live/dead cell staining and a series of antimicrobial effects assays. With fluorescence in situ hybridization (FISH) staining and in propidium monoazide-quantitative polymerase chain reaction (PMA-qPCR), the clearance of P. gingivalis by A-L-R was more than for other groups, and only the proportion of P. gingivalis was reduced by A-L-R in monospecies culture. Moreover, in a periodontitis model, A-L-R targeted P. gingivalis with high efficiency and low toxicity, maintaining homeostasis with a relatively stable oral microflora. This targeting nanomedicine offers new strategies for periodontitis therapy, providing a foundation for the prevention and treatment of periodontitis.