•aPDT is similar compared to AMX + MTZ in the treatment of periodontitis.•Local adjuvant therapies should be considered.•aPDT or AMX + MTZ promoted similar clinical periodontal benefices.
...Periodontitis is one of the most prevalent inflammatory diseases in humans. It is associated with the presence of bacteria and is mediated by the host's immune response This study represents a systematic review and meta-analysis trying to answer the following question: “What is the effect of antimicrobial photodynamic therapy (aPDT) as an adjunct to scaling and root planing (SRP) compared to systemic antibiotic therapy with amoxicillin plus metronidazole (AMX+MTZ) on the non-surgical treatment of periodontitis?”.
Clinical studies comparing aPDT with systemic use of AMX+MTZ were searched until January of 2020 using the databases: PubMed, MEDLINE, SCOPUS, EMBASE, Cochrane Central, Web of Science and Scielo, as well manual searches in related journals. Periodontal clinical parameters such as probing depth (PD), clinical attachment level (CAL) and bleeding on probing (BOP) were statistically analyzed.
Five randomized clinical studies (RCTs) were included within the eligibility criteria, and served as a basis for qualitative and quantitative analyzes. All the studies reported an improvement in the clinical parameters with both therapies, although in a direct comparison, our analyzes did not find statistical differences that indicate the superiority of one supporting treatment in relation to the other.
Although the limited number of RCTs and the great heterogeneity between them, it can be concluded that aPDT presents similar clinical results compared to antibiotic therapy with AMX+MTZ as adjuvants in the non-surgical treatment of periodontitis.
Aim
This study evaluated the effects of 5‐fluorouracil (5‐FU) and cisplatin (CIS) in healthy periodontal tissues and in the early stages of experimental periodontitis (EP) in rats.
Methods
One ...hundred and eighty male rats were divided into three groups, which were submitted to the following systemic treatments: physiological saline solution (PSS); CIS and 5FU. Each group was subdivided into two subgroups: without (NEP) and with (EP) induction of EP. Animals were euthanized at 3, 5 and 7 days post‐treatment. Histological, histometric (percentage of bone in the furcation PBF) and immunohistochemical (for tumour necrosis factor‐α, interleukin‐1β and receptor activator of nuclear factor‐κB ligand) analyses were performed. Data were statistically analysed.
Results
CIS‐NEP and 5FU‐NEP showed more inflammation than PSS‐NEP at 3, 5 and 7 days. CIS‐EP and 5FU‐EP showed more inflammation and lower PBF than PSS‐EP at all periods of evaluation. 5FU‐EP showed lower PBF than CIS‐EP at 5 and 7 days.
Conclusion
5‐FU and CIS exacerbated periodontal inflammation and aggravated the progression of EP in its early stages.
This study evaluated the peri-implant tissues under normal conditions and under the influence of experimental peri-implantitis (EPI) in osseointegrated implants installed in the maxillae of rats ...treated with oncologic dosage of zoledronate. Twenty-eight senescent female rats underwent the extraction of the upper incisor and placement of a titanium dental implant (DI). After eight weeks was installated a transmucosal healing screw on DI. After nine weeks, the following groups were formed: VEH, ZOL, VEH-EPI and ZOL-EPI. From the 9th until the 19th, VEH and VEH-EPI groups received vehicle and ZOL and ZOL-EPI groups received zoledronate. At the 14th week, a cotton ligature was installed around the DI in VEH-EPI and ZOL-EPI groups to induce the EPI. At the 19th week, euthanasia was performed, and the maxillae were processed so that at the implanted sites were analyzed: histological aspects and the percentage of total bone tissue (PTBT) and non-vital bone tissue (PNVBT), along with TNFα, IL-1β, VEGF, OCN and TRAP immunolabeling. ZOL group presented mild persistent peri-implant inflammation, higher PNVBT and TNFα and IL-1β immunolabeling, but lower for VEGF, OCN and TRAP in comparison with VEH group. ZOL-EPI group exhibited exuberant peri-implant inflammation, higher PNVBT and TNFα and IL-1β immunolabeling when compared with ZOL and VEH-EPI groups. Zoledronate disrupted peri-implant environment, causing mild persistent inflammation and increasing the quantity of non-vital bone tissue. Besides, associated with the EPI there were an exacerbated inflammation and even greater increase in the quantity of non-vital bone around the DI, which makes this condition a risk factor for medication-related osteonecrosis of the jaws.
•All aPDT groups obtained great control of the extent and intensity of inflammation.•Only the aPDT-0.5 group demonstrated total resolution of the local inflammation.•The aPDT-0.5 group showed ...presence of bone neoformation areas at 30 days.•The aPDT-05 group had better control of the inflammatory response and tissue repair.
This study evaluated three concentrations of butyl toluidine blue (BuTB) for antimicrobial photodynamic therapy (aPDT) in experimental periodontitis (EP) in rats.
EP was ligature-induced at the first mandibular molar in 105 rats. Ligature was removed after 7 days and animals were distributed into the following treatments: SRP, scaling and root planing (SRP) plus saline solution; BuTB-0.1, SRP plus BuTB at 0.1 mg/mL; aPDT-0.1, SRP plus BuTB at 0.1 mg/mL and InGaAlP diode laser (DL) irradiation; BuTB-0.5, SRP plus BuTB at 0.5 mg/mL; aPDT-0.5, SRP plus BuTB at 0.5 mg/mL and DL irradiation; BuTB-2.0, SRP plus BuTB at 2 mg/mL; aPDT-2.0, SRP plus BuTB at 2 mg/mL and DL irradiation. Five animals from each group were submitted to euthanasia at 7, 15 and 30 days post-treatment. The furcation area was submitted to histological, histometric and immunohistochemical (TGF-ß1, OCN and TRAP) analyses.
aPDT-0.5 group presented a better tissue remodeling in all periods, resolution of the inflammatory response and bone neoformation areas at 30 days. aPDT-0.5 also resulted in higher immunolabeling patterns of TGF-ß1 at all periods (p < 0.05) and of OCN at 30 days (p < 0.05).
aPDT-0.5 showed the best benefits for inflammatory response and periodontal repair process.
Objectives
This study assessed the influence of obesity on the progression of ligature-induced periodontitis in rats.
Materials and methods
Forty-eight adult Wistar rats were randomly divided into ...two groups: the HL group (
n
= 24) was fed high-fat animal food to induce obesity, and the NL group (
n
= 24) was fed normolipidic animal food. Obesity was induced within a period of 120 days, and the induction of experimental periodontitis (EP) was subsequently performed for 30 days. The animals were euthanized after 7, 15, and 30 days, and the jaws were removed for histopathological, histometric, and immunohistochemical analyses. Tartrate-resistant acid phosphatase (TRAP), receptor activator of nuclear factor kappa beta ligand (RANKL), and osteoprotegerin (OPG) were analyzed via immunolabeling.
Results
Histological findings indicated that the inflammation was more extensive and lasted longer in the HL⁄EP; however, advanced destruction also occurred in the NL/EP. Greater bone loss was verified in the HL/EP group (2.28 ± 0.35) in the period of 7 days than in the NL/EP group (1.2 ± 0.29). High immunolabeling was identified in the HL/EP group in the initial periods for RANKL and TRAP, whereas the NL⁄EP group presented with moderate immunolabeling for both factors. The HL/EP and NL/EP groups showed low immunolabeling for OPG.
Conclusions
Obesity induced by a high-fat diet influenced alveolar bone metabolism when associated with experimental periodontitis and caused a more severe local inflammatory response and alveolar bone loss.
Clinical relevance
Obesity is related to greater alveolar bone loss and an accentuated local inflammatory response, which may be reflected in the clinical severity of periodontitis and dental loss.
The aim of this study was to compare the clinical effects of Metronidazole (MTZ) combined with Amoxicillin (AMX) and repeated applications of antimicrobial photodynamic therapy (aPDT) as an adjuvant ...for the treatment of chronic periodontitis.
A double-blind controlled and randomized clinical trial was conducted in 34 patients. All of the patients were treated with scaling and root planing (SRP) and separated into 2 groups: the MTZ+AMX Group (n=17), who received SRP and the systemic use of MTZ (400mg 3×per day for 7days) and AMX (500mg 3×per day for 7days), and the aPDT Group (n=17), who received SRP and three aPDT applications at all sites with a probing depth≥5mm immediately, at 48 and 96h after scaling and placebo pills over the span of 7days. Clinical examinations were performed at baseline and 90days post-therapy. The clinical parameters of bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL) were measured. The aPDT was conducted using methylene blue and a low-level laser (GaAlAs 660nm, 100mW, 48s, and 160J/cm2) in all sites with a probing depth≥5mm. A statistical analysis was also performed (α=5%).
There was a significant improvement in CAL only in the intermediate pocket in the aPDT group compared to the MTZ+AMX group between baseline and 90days post-treatment (p=0.01). There was a reduction of both BOP and the percentage of residual pockets at 90days after treatment compared with baseline in both groups (p<0.05).
Both proposed adjuvant therapies associated with conventional mechanical treatment in patients with chronic periodontitis were equally effective in terms of the gain of clinical insertion, control of inflammation and elimination of residual pockets.
•The aPDT treatment resulted in a significant improvement of CAL in moderate pockets.•aPDT and AMX/MTZ were equally effective adjuvant therapy for chronic periodontitis.•All clinical parameters had an improvement after aPDT and antibiotic therapy.
The dento-gingival junction comprises multiple epithelia including the junctional epithelium (JE), which is the most coronally-located structural element of the dento-gingival junction that ...demarcates external from internal periodontal environments. After tooth eruption into the oral cavity, a specialized basal lamina is formed that provides a firm attachment of the JE to the enamel. This attachment prevents microbial species and oral debris from entering subjacent periodontal tissues. Here we discuss the expression of certain JE adhesion molecules and enamel proteins that maintain the health of the dento-gingival junction but that are perturbed in the pathogenesis of periodontitis. We also consider how evolutionary processes have influenced the development of the JE as a specialized adhesion that is well-suited for protection of the dento-gingival junction. A detailed understanding of the biology of the JE will deepen current models of dento-gingival adhesion, potentially clarify inter-patient variability of susceptibility to periodontitis and help to identify new roles of enamel proteins in periodontal regeneration.
Studies have highlighted numerous benefits of ozone therapy in the field of medicine and dentistry, including its antimicrobial efficacy against various pathogenic microorganisms, its ability to ...modulate the immune system effectively, reduce inflammation, prevent hypoxia, and support tissue regeneration. However, its effects on dental extraction healing remain to be elucidated. .Therefore, this study aimed to evaluate the effects of systemically administered ozone (O3) at different doses in the healing of dental extraction sockets in rats.
To this end, 72 Wistar rats were randomly divided into four groups after extraction of the right upper central incisor: Group C - control, no systemic treatment; Group OZ0.3 - animals received a single dose of 0.3 mg/kg O3; Group OZ0.7 - a single dose of 0.7 mg/kg O3; and Group OZ1.0 - a single dose of 1.0 mg/kg O3, intraperitoneally. In total, six animals from each group were euthanized at 7, 14, and 21 days after the commencement of treatment. Bone samples were harvested and further analyzed by descriptive histology, histomorphometry, and immunohistochemistry for osteocalcin (OCN) and tartrate-resistant acid phosphatase (TRAP) protein expression.
All applied doses of O3 were shown to increase the percentage of bone tissue (PBT) after 21 days compared to group C. After 14 days, the OZ0.7 and OZ1.0 groups showed significantly higher PBT when compared to group C. The OZ1.0 group presented the most beneficial results regarding PBT among groups, which denotes a dose-dependent response. OCN immunostaining was higher in all groups at 21 days. However, after seven and 14 days, the OZ1.0 group showed a significant increase in OCN immunostaining compared to C group. No differences in TRAP+ osteoclasts were found between groups and time points.
Therefore, O3 therapy at higher doses might be beneficial for bone repair of the alveolar socket following tooth extraction.
This study assessed the effect of curcumin as a photosensitizer in antimicrobial photodynamic therapy (aPDT) for the treatment of induced periodontitis in rats. Periodontitis was induced via a ...ligature around the mandibular first molar on the left side of 96 rats. The ligature was removed 7 days later, and the animals were randomized into four groups: NT, no local treatment; CUR, irrigation with curcumin solution (40 μM); LED, irradiation with a light-emitting diode (LED, InGaN, 465–485 nm, 200 mW/cm
2
, 60 s); and aPDT, irrigation with curcumin solution (40 μM) followed by irradiation with LED. Eight animals from each group were euthanized at 7, 15, and 30 days post-treatment. Treatments were assessed using alveolar bone loss (ABL) in the furcation region using histological, histometric, and immunohistochemical analyses. Rats treated with aPDT exhibited less ABL at 7 days compared to the NT group, moderate pattern immunolabeling for osteoprotegerin at 30 days, and a pattern of immunolabeling for RANKL from moderate to low. Treatments resulted in smaller numbers of TRAP-positive cells compared to the NT group. aPDT as monotherapy using curcumin as a photosensitizer and LED as the light source was effective in the treatment of induced periodontitis in rats.
This study evaluated the effects of local application of autologous platelet-rich plasma (PRP) on the tooth extraction site of rats presenting the main risk factors for medication-related ...osteonecrosis of the jaw (MRONJ). For seven weeks, senile rats were submitted to systemic treatment with vehicle (VEH and VEH-PRP) or 100 μg/Kg of zoledronate (ZOL and ZOL-PRP) every three days. After three weeks, the first lower molar was extracted. VEH-PRP and ZOL-PRP received PRP at the tooth extraction site. Euthanasia was performed at 28 days postoperatively. Clinical, histopathological, histometric and immunohistochemical analyses were carried out in histological sections from the tooth extraction site. ZOL showed lower percentage of newly formed bone tissue (NFBT), higher percentage of non-vital bone tissue (NVBT), as well as higher immunolabeling for TNFα and IL-1β. In addition, ZOL presented lower immunolabeling for PCNA, VEGF, BMP2/4, OCN and TRAP. VEH and ZOL-PRP showed improvement in the tooth extraction site wound healing and comparable percentage of NFBT, VEGF, BMP2/4 and OCN. Local application of autologous PRP proved a viable preventive therapy, which is safe and effective to restore tissue repair capacity of the tooth extraction site and prevent the occurrence of MRONJ following tooth extraction.
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