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Periodontitis is one of the most common inflammatory diseases in humans. The susceptibility to periodontitis is largely determined by the host response, and the severity of inflammation predicts disease progression. Upon microbial insults, host cells undergo massive changes in their transcription program to trigger an appropriate response (inflammation). It is not surprising that successful keystone pathogens have developed specific mechanisms to manipulate the gene expression network in host cells. Emerging data has indicated that epigenetic regulation plays a significant role in inflammation. Acetylation of lysine residues on histones is a major epigenetic modification of chromatin, highly associated with the accessibility of chromatin and activation of transcription. Specific histone acetylation patterns are observed in inflammatory diseases including periodontitis. Bromo‐ and extraterminal domain (BET) proteins recognize acetylated histones and then recruit transcription factors and transcription elongation complexes to chromatin. BET proteins are regulated in inflammatory diseases and small molecules blocking the function of BET proteins are promising "epi‐drugs" for treating inflammatory diseases. [ABSTRACT FROM AUTHOR]

Subgingival bacterial colonization and biofilm formation are known to be the main etiology of periodontal disease progression. This biofilm elicits host response and the interaction between host defence mechanisms with plaque microorganisms and their products results in periodontal disease. Host modulatory therapy (HMT) is a form of treatment of periodontitis that focuses on treatment of the host in the host–bacteria interaction. Omega-3 fatty acids have emerged as a potential HMT agent to treat inflammation associated with periodontal disease. A total of 60 cases of chronic periodontitis were allocated into two groups; the test group (n = 30) were treated with scaling and root planing (SRP) and given a dietary supplementation of omega-3 fatty acid while the control group were treated with SRP alone. Clinical parameters carried out were plaque index (PI), gingival bleeding index (GBI), pocket probing depth (PPD) and clinical attachment level (CAL) and immunological parameter included interleukin-1β level in saliva at baseline, 3 months and 6 months after therapy. At 6 months, both the groups showed significant improvements with regards to all clinical and immunological parameters compared to baseline (all p < 0.05). However, test group presented with more favourable statistically significant results. The use of omega-3 fatty acid as nutraceutical agent to conventional method acted as beneficial therapeutic measures and effective in patients with chronic periodontitis when compared with SRP alone. [ABSTRACT FROM AUTHOR]

Melatonin is produced by the pineal gland and plays a role in regulating circadian rhythm. It influences the physiologic processes, such as the activation of the immune system and the antioxidant function. Melatonin has been reported in the samples of patients with periodontitis. Therefore, the role of melatonin in periodontal diseases must be appraised. Using the strategy of electronic search of various databases, we included studies, published until December 2021, measuring the expression of melatonin in patient samples and evaluating the effect of periodontal therapy on melatonin expression. This review also included studies evaluating the effect of melatonin supplementation on periodontal parameters. In total, 15 articles fulfilled the study inclusion criteria. The results revealed that melatonin is negatively correlated with the severity of periodontal diseases, and melatonin supplementation reduces the levels of periodontal inflammatory parameters. Hence, melatonin has a role in periodontal diseases, but additional studies are warranted to substantiate its use as a biomarker and host modulatory agent.

Periodontitis is an inflammatory disease caused by bacterial infection directly, 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 therapy 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 applications of biomaterials will promote the development of periodontal therapy.

Objective: This study was performed to explore the impact of telmisartan on experimental periodontitis in mice, in terms of alveolar bone destruction, by using micro‐computed tomography analysis. Materials and methods: Male BALB/c mice were divided into four groups of 7 to 9 mice each: control (C) group; experimental periodontitis (E) group; experimental periodontitis‐plus‐telmisartan 5 mg/kg (ET5) group; and experimental periodontitis‐plus‐telmisartan 10 mg/kg (ET10) group. The mice in Group C were not subjected to experimental periodontitis. The other mice from Groups E, ET5 and ET10 were exposed to periodontitis. Periodontitis was induced by inoculation with Porphyromonas gingivalis. Results: Telmisartan significantly suppressed both the reduction in alveolar bone height and increase of root exposure caused by P. gingivalis infection. When mice were treated with telmisartan, the decrease in the bone volume fraction induced by the infection was notably recovered. In addition, telmisartan reversed P. gingivalis‐induced alterations in the microstructural parameters of trabecular bone, except trabecular thickness.No significant difference was evident between Groups ET5 and ET10 in both the extent of alveolar bone loss and microstructural parameters assessed, except bone volume fraction and trabecular number. Conclusion: Telmisartan may have potential benefits as a host modulation agent for the therapy of periodontitis. [ABSTRACT FROM AUTHOR]

Periodontitis is an inflammatory disease caused by bacterial infection directly, 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 therapy 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 applications 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. [Display omitted] [ABSTRACT FROM AUTHOR]

Periodontal disease is an immuno-inflammatory condition involving the tissues that surround and support the teeth. The earlier focus is towards mechanical debridement but with recent advancements Perioceutics or use of the pharmacological agents emerged as a new therapeutic modality along with mechanical debridement. Host modulation therapy is an emerging therapeutic concept specifically developed to manage periodontitis along with mechanical debridement. Host modulatory therapy (HMT) is a treatment concept that aims to reduce tissue destruction and stabilize or even regenerate the periodontium by modifying or down-regulating destructive aspects of the host response and up-regulating protective or regenerative responses. The rationale of host modulatory therapy is to restore the balance between pro-inflammatory mediators and destructive enzymes and antiinflammatory mediators and enzymes. This review demonstrates Host Modulatory Therapy as a future effective treatment modality for dental clinicians when used as an adjunct to mechanical therapy in treating periodontal diseases. [ABSTRACT FROM AUTHOR]

Choline and geranic acid (CAGE) ionic liquids have recently been shown to have applications in the delivery of macromolecules and poorly soluble drugs across epithelial barriers and in bacterial growth inhibition. Ionic liquids are known to denature proteins by the disruption of forces that guide natural protein folding, and the inflammatory enzyme elastase was recently shown to be inhibited by a variety of ionic liquids other than CAGE. Inhibition of collagenolytic enzymes, including elastase, has been shown to improve outcomes in cases of periodontitis via amelioration of periodontal inflammation and alveolar bone resorption. In this study, we investigated whether CAGE prepared with varying stoichiometries was able to inhibit elastase at varying concentrations and whether these CAGE formulations could inhibit the growth of key pathogenic bacterial species associated with oral health conditions. We found that CAGE was capable of inhibiting both porcine elastase and human neutrophil elastase at concentrations as low as 5 mM, and that CAGE formulations were effective at inhibiting the growth of all tested pathogenic oral bacteria. The inhibition of elastase by CAGE may be a mechanism by which CAGE can improve outcomes in periodontitis independent from CAGE's known antibacterial properties. [ABSTRACT FROM AUTHOR]

Periodontitis is a chronic inflammatory disease induced by dysbiotic dental biofilms. Management of periodontitis is primarily anti-bacterial via mechanical removal of bacterial biofilm. The successful resolution requires wound healing and tissue regeneration, which are not always achieved with these traditional methods. The discovery of specialized pro-resolving mediators (SPMs), a class of lipid mediators that induce the resolution of inflammation and promote local tissue homeostasis, creates another option for the treatment of periodontitis and other diseases of chronic inflammation. In this mini-review, we discuss the host-modulatory effects of SPMs on periodontal tissues and changes in the taxonomic composition of the gut and oral microbiome in the presence of SPMs and SPM precursor lipids. Further research into the relationship between host SPM production and microbiome-SPM modification has the potential to unveil new diagnostic markers of inflammation and wound healing. Expanding this field may drive the discovery of microbial-derived bioactive therapeutics to modulate immune responses.

Neutrophils are abundant, short-lived myeloid cells that are readily recruitable to sites of inflammation, where they serve as first-line defense against infection and other types of insult to the host. In recent years, there has been increased understanding on the involvement of neutrophils in chronic inflammatory diseases, where they may act as direct effectors of destructive inflammation. However, destructive tissue inflammation is also instigated in settings of neutrophil paucity, suggesting that neutrophils also mediate critical homeostatic functions. The activity of neutrophils is regulated by a variety of local tissue factors. In addition, systemic metabolic conditions, such as hypercholesterolemia and hyperglycemia, affect the production and mobilization of neutrophils from the bone marrow. Moreover, according to the recently emerged concept of innate immune memory, the functions of neutrophils can be enhanced through the process of trained granulopoiesis. This process may have both beneficial and potentially destructive effects, depending on context, that is, protective against infections and tumors, while destructive in the context of chronic inflammatory conditions. Although we are far from a complete understanding of the mechanisms underlying the regulation and function of neutrophils, current insights enable the development of targeted therapeutic interventions that can restrain neutrophil-mediated inflammation in chronic inflammatory diseases, such as periodontitis. [ABSTRACT FROM AUTHOR]

Periodontitis and peri-implantitis are microbially associated diseases of the tissues supporting the teeth and dental implants that are mediated by host inflammation and eventually lead to tooth and dental implant loss. Given the probiotics' role in biofilm control, dysbiosis reversal, and host modulation, their potential beneficial effects on the improvement of periodontitis and peri-implantitis have been recently investigated. Moreover, probiotics use has also been proposed in periodontal health management in patients undergoing fixed orthodontic therapy. Therefore, the present study aimed to review, considering the periodontal microbiome composition around teeth and dental implants in healthy and pathological conditions, the putative favorable effects of probiotics on gingivitis, periodontitis, and peri-implantitis. The secondary aim of the present narrative review was to synthesize the supporting evidence and proposed protocols for probiotics use as adjuncts in periodontitis and peri-implantitis treatment and the periodontal health management of orthodontic patients with fixed appliances. Contrasting findings from the literature may be due to the different methods, posology, and duration of probiotics prescriptions and due to the heterogeneous biological and clinical measurement methods employed. Thus, no definitive conclusions could be drawn about the effectiveness of probiotics in periodontal management, both in healthy and pathological conditions. Further studies are needed to validate probiotics for periodontal management and provide recommended protocols. [ABSTRACT FROM AUTHOR]

Periodontitis is an inflammatory disease of periodontal tissue due to pathogenic microorganisms interacting with host responds. Treatment scaling and root planing have been established as the standard in treating periodontitis, but there are limitations. The combination of additional therapy using Subantimicrobial Dose Doxycycline (SDD) is needed to overcome the excessive host response so that it can produce better therapeutic results. This study aims to determine the development of science regarding using SDD as an adjunct therapy in periodontitis patients. Rapid review method with literature screening and selection using the PRISMA protocol. The search strategy was carried out on the PubMed, Science Direct, and ProQuest databases using keywords and Boolean operators according to predetermined inclusion and exclusion criteria. Five articles reviewed showed various changes in clinical parameters and inflammatory mediators. Changes in parameters that are considered significant and insignificant but still offer a better direction. The whole article shows that SDD positively affects the periodontal tissue, as seen by the decrease in Probing Depth (PD), Clinical Attachment Level (CAL), Bleeding on Probing (BOP), Gingival Index (GI), Plaque Index (PI), Matrix Metalloproteinase (MMP) and Gingival Ctevicular Fluid (GCF) which play a significant role in periodontitis. [ABSTRACT FROM AUTHOR]

Background: Periodontal destruction can be the result of different known and yet-to-be-discovered biological pathways. Recent human genetic association studies have implicated interferon-gamma inducible protein 16 (IFI16) and absent in melanoma 2 (AIM2) with high periodontal interleukin (IL)-1β levels and more destructive disease, but mechanistic evidence is lacking. Here, we sought to experimentally validate these observational associations and better understand IFI16 and AIM2's roles in periodontitis.Methods: Periodontitis was induced in Ifi204-/- (IFI16 murine homolog) and Aim2-/- mice using the ligature model. Chimeric mice were created to identify the main source cells of Ifi204 in the periodontium. IFI16-silenced human endothelial cells were treated with periodontal pathogens in vitro. Periodontal tissues from Ifi204-/- mice were evaluated for alveolar bone (micro-CT), cell inflammatory infiltration (MPO+ staining), Il1b (qRT-PCR), and osteoclast numbers (cathepsin K+ staining).Results: Ifi204-deficient mice> exhibited >20% higher alveolar bone loss than wild-type (WT) (P < 0.05), while no significant difference was found in Aim2-/- mice. Ifi204's effect on bone loss was primarily mediated by a nonbone marrow source and was independent of Aim2. Ifi204-deficient mice had greater neutrophil/macrophage trafficking into gingival tissues regardless of periodontitis development compared to WT. In human endothelial cells, IFI16 decreased the chemokine response to periodontal pathogens. In murine periodontitis, Ifi204 depletion elevated gingival Il1b and increased osteoclast numbers at diseased sites (P < 0.05).Conclusions: These findings support IFI16's role as a novel regulator of inflammatory cell trafficking to the periodontium that protects against bone loss and offers potential targets for the development of new periodontal disease biomarkers and therapeutics. [ABSTRACT FROM AUTHOR]

Melatonin is produced by the pineal gland and plays a role in regulating circadian rhythm. It influences the physiologic processes, such as the activation of the immune system and the antioxidant function. Melatonin has been reported in the samples of patients with periodontitis. Therefore, the role of melatonin in periodontal diseases must be appraised. Using the strategy of electronic search of various databases, we included studies, published until December 2021, measuring the expression of melatonin in patient samples and evaluating the effect of periodontal therapy on melatonin expression. This review also included studies evaluating the effect of melatonin supplementation on periodontal parameters. In total, 15 articles fulfilled the study inclusion criteria. The results revealed that melatonin is negatively correlated with the severity of periodontal diseases, and melatonin supplementation reduces the levels of periodontal inflammatory parameters. Hence, melatonin has a role in periodontal diseases, but additional studies are warranted to substantiate its use as a biomarker and host modulatory agent., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Advanced Biomedical Research.)

Periodontal disease is an infection-driven inflammatory disease characterized by the destruction of tooth-supporting tissues. The establishment of chronic inflammation will result in progressive destruction of bone and soft tissue changes. Severe periodontitis can lead to tooth loss. The disease has complex pathogenesis with an interplay between genetic, environmental, and host factors and pathogens. Effective management consists of plaque control and non-surgical interventions, along with adjuvant strategies to control inflammation and disrupt the pathogenic subgingival biofilms. Recent studies have examined novel approaches for managing periodontal diseases such as modulating microbial signaling mechanisms, tissue engineering, and molecular targeting of host inflammatory substances. Mounting evidence suggests the need to integrate omics-based approaches with traditional therapy to address the disease. This article discusses the various evolving and future drug targets, including proteomics, gene therapeutics, vaccines, and nanotechnology in personalized periodontal medicine for the effective management of periodontal diseases. [ABSTRACT FROM AUTHOR]

Background Immuno-modulatory effects of vitamin D3 offer possible therapeutic applications for periodontal diseases. Using the topical application of vitamin D3 into the periodontal pocket, as an adjunct, with the routine scaling root planning (SRP) may contribute to th e treatment of periodontal disease. Objectives are to evaluate the efficacy of locally injected vitamin D3 as an adjunct in the treatment of stage II periodontitis. Materials and Methods Using a split-mouth design; 15 adults of both genders with 96 sites for each test and control groups with periodontitis were enrolled in this study. Their age ranged from 20 to 40 years. A concentration of 0.25μcg/0.2ml of vitamin D3 (Alfacalcidol) was injected into the experimental sites, in three consecutive weeks. Patients were recalled 14 days after the last session of treatment for final periodontal indices registration. Results SRP with and without Vitamin D3 in patients with stage II periodontatitis showed a reduction of all clinical parameters within 35 days. There was a trend in favor of the test side group for PDD. compared to baseline, both treatments demonstrated an improvement in the periodontal parameters of gingival health. Plaque index (PL), Bleeding on probing (BOP), and gingival index (GI) showed a highly significant difference for all participants of both groups between baseline and 35 days. Probing pocket depth (PPD) and clinical attachment level (CAL) have been decreased between the first visit of intervention and the 35 days visit. Compared to SRP alone, SRP plus vitamin D3 yielded a non-significant improvement in PPD (SRP: 1.146 mm ± 0.188 mm vs. SRP plus vitamin D3: 0.823 ± 0.171 mm p>0.05). CAL was (SRP: 2.427 ± 0,064 mm vs. SRP plus vitamin D3: 2.354±0.065 mm, p>0.05) at 35 days. Conclusion Vitamin D3 could be considered as a useful and safe adjunct to SRP in non-surgical periodontal therapy when used locally as intraligamentary injection into residual pockets (4-6mm). [ABSTRACT FROM AUTHOR]

Periodontitis is a rampant global disease with multifactorial etiology. The main harbinger of periodontitis is the plaque biofilm. The mature biofilm in turn interacts with the micro-organisms and the host, with environmental and genetic factors as additional initiators to cause disease. There are several strategies of preventive periodontics which include host modulation therapy to ameliorate the disease. Recently a lot of research has been done related to the role of resolvins in periodontitis. This article showcases the role of resolvins in periodontal health and disease., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Chiluveru et al.)

Background: Periodontal disease is among the sixth most common inflammatory diseases worldwide with high risk to promote complications from other inflammatory diseases including diabetes, cardiovascular disease and Alzheimer's Disease. Failure of active resolution of inflammation pathways is implicated in pathogenesis of periodontal diseases, including gingivitis. Lipoxin A4 (LXA4), a member of the specialized pro-resolving lipid mediators (SPMs) that drive resolution of inflammation via GPC-receptor mediated pathways, offered therapeutic advantages in preclinical models of periodontitis. Methods: We conducted a randomized, placebo-controlled, parallel-group Phase 1 clinical trial to determine the safety and preliminary efficacy of an LXA4 analog in patients with gingival inflammation. One hundred twenty-seven (127) individuals were randomized to daily use of an oral rinse containing a LXA4 mimetic, methyl ester-benzo-lipoxin A4 (BLXA4), placebo rinse or a no-rinse control group for 28 days. Treatment emergent adverse events (TEAEs) were assessed for safety, the primary outcome. Secondary outcomes included the change in the level of gingival inflammation and periodontal pocket depth (PD). Serum SPMs were monitored using targeted lipid mediator lipidomics to assess potential systemic impact of BLXA4. Results: The frequency of TEAEs was similar in BLXA4 and placebo-treated groups with no study-related SAEs. Once-daily rinsing with BLXA4 for 28-days resulted in a greater decrease in gingival inflammation compared to placebo rinse and no-rinse control groups (mean change: 0.26 GI unit vs 0.21 and 0.17, respectively). PD reduction was also greater with BLXA4 oral rinse compared to placebo and no-rinse groups (mean reduction: 1.23 mm vs. 0.71 mm and 0.46 mm, respectively). Topical application of BLXA4 increased serum levels of SPMs. Conclusion: Treatment with BLXA4 reduces local inflammation, and increases abundance of pro-resolution molecules systemically, which may dampen inflammation that can mediate progression and course of inflammatory diseases beyond periodontitis. Clinical Trial Registration: ClinicalTrials.gov, identifier (NCT02342691). [ABSTRACT FROM AUTHOR]

Background: A 6-week Phase I clinical trial was performed to primarily evaluate the safety and secondarily determine the preliminary efficacy of a novel biological solution, ST266, comprised of a mixture of cytokines, growth factors, nucleic acids, and lipids secreted by cultured amnion-derived multipotent progenitor cells on gingival inflammation.Methods: Fifty-four adults with gingivitis/periodontitis were randomly assigned to 1X ST266 or diluted 0.3X ST266 or saline topically applied on facial/lingual gingiva (20 µL/tooth). Safety was assessed through oral soft/hard tissue exam, adverse events, and routine laboratory tests. Efficacy was assessed by modified gingival index (MGI), bleeding on probing, plaque index, probing depth (PD), and clinical attachment level (CAL). Assessments were performed on day 0, 8, 12, and 42. ST266 and saline applied daily starting at day 0 through day 12 except weekend days. Plasma was analyzed for safety and proinflammatory cytokines, interleukin (IL)-1β, IL-6, tumor necrosis factor-alpha, and interferon gamma. Gingival crevicular fluid (GCF) was analyzed for the same cytokines. Subgingival plaque was primarily analyzed by checkerboard DNA-DNA hybridization. Comparisons with saline were modeled through a generalized estimating equations method adjusting for baseline.Results: No safety concern was found related to ST266. Statistically significant reduction in MGI was noted at day 42 by 1X ST266 compared with saline (P = 0.044). PD and CAL were reduced by both doses of ST266 at day 42 (P <0.01) and by 1X ST266 at day 12 (P <0.05). GCF IL-1β and IL-6 levels were reduced by both doses of ST266 at day 12 (P <0.05, P <0.01, respectively). IL-6 was also significantly reduced in plasma of both ST266 groups (P <0.05). Significant reductions in red complex bacteria were detected in both ST266 doses.Conclusions: In this "first in human oral cavity" study, topical ST266 was safe and effective in reducing gingival inflammation in 6 weeks. Longitudinal studies with large sample sizes are warranted to assess the therapeutic value of this novel host modulatory compound in the treatment of periodontal diseases. [ABSTRACT FROM AUTHOR]

BackgroundPeriodontal disease is among the sixth most common inflammatory diseases worldwide with high risk to promote complications from other inflammatory diseases including diabetes, cardiovascular disease and Alzheimer’s Disease. Failure of active resolution of inflammation pathways is implicated in pathogenesis of periodontal diseases, including gingivitis. Lipoxin A4 (LXA4), a member of the specialized pro-resolving lipid mediators (SPMs) that drive resolution of inflammation via GPC-receptor mediated pathways, offered therapeutic advantages in preclinical models of periodontitis.MethodsWe conducted a randomized, placebo-controlled, parallel-group Phase 1 clinical trial to determine the safety and preliminary efficacy of an LXA4 analog in patients with gingival inflammation. One hundred twenty-seven (127) individuals were randomized to daily use of an oral rinse containing a LXA4 mimetic, methyl ester-benzo-lipoxin A4 (BLXA4), placebo rinse or a no-rinse control group for 28 days. Treatment emergent adverse events (TEAEs) were assessed for safety, the primary outcome. Secondary outcomes included the change in the level of gingival inflammation and periodontal pocket depth (PD). Serum SPMs were monitored using targeted lipid mediator lipidomics to assess potential systemic impact of BLXA4.ResultsThe frequency of TEAEs was similar in BLXA4 and placebo-treated groups with no study-related SAEs. Once-daily rinsing with BLXA4 for 28-days resulted in a greater decrease in gingival inflammation compared to placebo rinse and no-rinse control groups (mean change: 0.26 GI unit vs 0.21 and 0.17, respectively). PD reduction was also greater with BLXA4 oral rinse compared to placebo and no-rinse groups (mean reduction: 1.23 mm vs. 0.71 mm and 0.46 mm, respectively). Topical application of BLXA4 increased serum levels of SPMs.ConclusionTreatment with BLXA4 reduces local inflammation, and increases abundance of pro-resolution molecules systemically, which may dampen inflammation that can mediate progression and course of inflammatory diseases beyond periodontitis.Clinical Trial RegistrationClinicalTrials.gov, identifier (NCT02342691).

Periodontitis and peri-implantitis are microbially associated diseases of the tissues supporting the teeth and dental implants that are mediated by host inflammation and eventually lead to tooth and dental implant loss. Given the probiotics’ role in biofilm control, dysbiosis reversal, and host modulation, their potential beneficial effects on the improvement of periodontitis and peri-implantitis have been recently investigated. Moreover, probiotics use has also been proposed in periodontal health management in patients undergoing fixed orthodontic therapy. Therefore, the present study aimed to review, considering the periodontal microbiome composition around teeth and dental implants in healthy and pathological conditions, the putative favorable effects of probiotics on gingivitis, periodontitis, and peri-implantitis. The secondary aim of the present narrative review was to synthesize the supporting evidence and proposed protocols for probiotics use as adjuncts in periodontitis and peri-implantitis treatment and the periodontal health management of orthodontic patients with fixed appliances. Contrasting findings from the literature may be due to the different methods, posology, and duration of probiotics prescriptions and due to the heterogeneous biological and clinical measurement methods employed. Thus, no definitive conclusions could be drawn about the effectiveness of probiotics in periodontal management, both in healthy and pathological conditions. Further studies are needed to validate probiotics for periodontal management and provide recommended protocols.

Human and plant pathogenic fungi have a major impact on public health and agriculture. Although these fungi infect very diverse hosts and are often highly adapted to specific host niches, they share surprisingly similar mechanisms that mediate immune evasion, modulation of distinct host targets and exploitation of host nutrients, highlighting that successful strategies have evolved independently among diverse fungal pathogens. These attributes are facilitated by an arsenal of fungal factors. However, not a single molecule, but rather the combined effects of several factors enable these pathogens to establish infection. In this review, we discuss the principles of human and plant fungal pathogenicity mechanisms and discuss recent discoveries made in this field. [ABSTRACT FROM AUTHOR]

Aim: This study aims to compare the effectiveness of "omega-3 fatty acids" as an auxiliary to "scaling and root planing (SRP)" with traditional "scaling and root planing" in periodontal treatment in humans., Materials and Methods: This study is a randomized control trial and was carried out over a period of 3 months (registered on 02/07/2023). Thirty patients were singled out according to the inclusion criteria, each having periodontitis (Stage II Grade B), and were arbitrarily distributed into two groups (control and test). The test group was treated with "scaling and root planing" along with the adjunctive application of "omega-3 fatty acids" while the control group was treated with "scaling and root planing" alone. Monthly follow-up was carried out over 90 days. Clinical parameters such as pocket probing depth (PPD), gingival index (GI), bleeding index (BI), and plaque index (PI) were measured respectively at baseline and 3 months. The data was recorded and statistically analyzed., Results: The soft tissue architecture remained stable. The mean full mouth plaque index (FMPI) score was statistically significant ( p < 0.001) when the control group was compared to the test group with a mean difference of 0.12 ± 0.02. The mean full mouth papillary bleeding index (FMPBI) score decreased at 3 months and was statistically significant compared to baseline with a mean difference of 0.24 ± 0.04 ( p < 0.001). When the test group was compared with the control group, the FMGI was not significant ( p = 0.02), with a mean difference of 0.16 ± 0.19. The PPD was not significant ( p =1) when comparing both the groups, with a mean difference of 0 ± 0.66. Although the clinical parameters were statistically significant at 3 months when compared to baseline in both the groups, the FMGI and PPD were not significant., Conclusion: The combined action of using omega-3 fatty acid as an auxiliary to conventional scaling and root planing improved the periodontal parameters including both the soft and hard tissue outcomes., Clinical Significance: The present study indicated that supplementary usage of omega-3 fatty acids is more beneficial for treating chronic and mild periodontitis than scaling and root planing alone. Omega-3 fatty acids can be used as energy for our cells, reduce the risk of blood clotting, maintain bone health, regulate metabolism, and reduce inflammation. Host modulatory therapy (HMT) with omega-3 fatty acids aims at reducing inflammation. With HMT as an adjunct, a better result of periodontal therapy was expected. It enhanced the positive effects on periodontal parameters and both the soft and hard tissue outcomes. How to cite this article: Salian S, Dhadse PV, Patil R, et al. Comparative Evaluation of Effectiveness of Omega-3 Fatty Acids as an Adjunct to SRP with Conventional SRP: A Randomized Clinical Trial. J Contemp Dent Pract 2024;25(5):440-444.

Recent advances indicate that periodontitis is driven by reciprocally reinforced interactions between a dysbiotic microbiome and dysregulated inflammation. Inflammation is not only a consequence of dysbiosis but, via mediating tissue dysfunction and damage, fuels further growth of selectively dysbiotic communities of bacteria (inflammophiles), thereby generating a self-sustained feed-forward loop that perpetuates the disease. These considerations provide a strong rationale for developing adjunctive host-modulation therapies for the treatment of periodontitis. Such host-modulation approaches aim to inhibit harmful inflammation and promote its resolution or to interfere directly with downstream effectors of connective tissue and bone destruction. This paper reviews diverse strategies targeted to modulate the host periodontal response and discusses their mechanisms of action, perceived safety, and potential for clinical application. [ABSTRACT FROM AUTHOR]

Periodontitis is a multifactorial disease involving bacterial biofilms and the generation of an inflammatory response. The latter causes the major part of the periodontal tissue breakdown. Alveolar bone resorption is a major component of the periodontal destruction observed in periodontitis. Novel treatment modalities of periodontitis intend to control and modulate the host response to bacterial aggression. Drugs such as bisphosphonates (BPs) are proven antiresorptive agents that can potentially inhibit the alveolar bone resorption. This review describes the potential use of BPs in periodontal treatment and could be said that BPs have an in vitro and in vivo capability of reducing bone resorption. Only a few studies have been carried out on the improvement of clinical periodontal parameters after the administration of BPs. Therefore, the published data are not sufficient to establish an evidence-based relevance for the use of these drugs in the treatment of periodontal diseases. [ABSTRACT FROM AUTHOR]

Perioceutics or use of the pharmacological agents specifically developed to manage periodontitis is an interesting and emerging aids in the development of periodontal disease along with the mechanical debridement. The purpose of host modulatory agent which is a imperative part of perioceutic, is to restore balance between, on the one hand, pro inflammatory mediators and destructive enzymes, and on the other hand, anti-inflammatory mediators and enzyme. Host modulatory therapy (HMT) is a treatment concept that aims to reduce tissue destruction and stabilize or even regenerate the periodontium by modifying or down regulating destructive aspects of the host response and up regulating protective or regenerative responses. This paper review the Host Modulatory Therapy which in future will be the effective tool dental practitioners when used as adjunct to mechanical therapy in treating periodontal diseases.

• Periodontitis is initiated by oral bacterial dysbiosis-induced inflammation. • Tissue destruction is mainly caused by overactive inflammation & oxidative stress. • Host modulation therapy (HMT) strategies are aimed to support periodontal therapy. • HMT agents have substantial positive effects in maintaining homeostasis. • Modulating the immune response & oxidative stress may improve periodontal homeostasis. To highlight the shifting paradigm of periodontitis, describe mechanism of periodontal bone destruction, and propose an updated host modulation therapy (HMT) strategy. To add further clinical relevance, related studies investigating the efficacy of several HMT agents in periodontitis will be discussed. Literature searches were conducted from articles published in PubMed using keywords "periodontal disease AND periodontitis AND host modulation therapy AND anti-inflammatory AND antioxidant", and then the findings were comprehensively summarized and elaborated. Accumulating evidence indicates that periodontitis is no longer defined solely as a pathogen-induced disease; rather, it is now recognized as a consequence of uncontrolled immune response and oxidative stress leading to periodontal tissue damage. Although periodontopathic bacteria initiate the disease, inflammation and oxidative stress were reported to be the main causes for the severity of tissue destruction. Thus, since the concept of periodontitis has shifted, our approach to its management needs to be adjusted to accommodate the latest paradigm. Nowadays, the modulation of inflammation and oxidative stress is considered a target of HMT. HMT agents, such as probiotics, anti-inflammatory drugs, anti-chemokines, lipid mediators, and bio-active fatty acids, have been extensively investigated for their remarkable functions in modulating the immune response and providing antioxidant effects. Findings from in vitro , in vivo , and human studies frequently demonstrate positive association by the administration of HMT in periodontitis. HMT strategy targeted on anti-inflammatory and antioxidant in periodontitis might serve as an excellent therapeutic approach to reach the level of clinical benefit. [ABSTRACT FROM AUTHOR]

Aim: Aim of this study was to investigate the influence of an anti‐inflammatory diet on different parameters in patients with gingivitis. Materials and Methods: Thirty patients were randomly allocated to an experimental and a control group stratified by their plaque values. The experimental group had to change to a diet low in processed carbohydrates and animal proteins, and rich in omega‐3 fatty acids, vitamin C, vitamin D, antioxidants, plant nitrates and fibres for 4 weeks. The control group did not change their diet. Both groups suspended interdental cleaning. Periodontal parameters were assessed by a blinded dentist. Serological and subgingival plaque samples were taken at baseline and end. Results: While there were no differences regarding the plaque values, the experimental group showed a significant reduction in gingival bleeding (GI Baseline: 1.04 ± 0.21, GI End: 0.61 ± 0.29, p < 0.05), a significant increase in Vitamin D values and a significant weight loss. There were no inter‐group differences regarding the inflammatory serological parameters, the serological omega fatty acids, nor the subgingival microbiome composition. Conclusion: The evaluated diet could significantly reduce gingivitis in a clinically relevant range, while serological inflammatory parameters and the subgingival microbiome seem to be unaffected in this study duration. (German Clinical Trials Register; DRKS00009888). [ABSTRACT FROM AUTHOR]

Serkan Dundar,1 Abubekir Eltas,2 Sema S Hakki,3 Sıddık Malkoc,4 M Ozay Uslu,2 Mehmet Tuzcu,5 James Komorowski,6 I Hanifi Ozercan,7 Fatih Akdemir,8 Kazim Sahin9 1Department of Periodontology, Faculty of Dentistry, Firat University, Elazig, 2Department of Periodontology, Faculty of Dentistry, Inonu University, Malatya, 3Department of Periodontology, Faculty of Dentistry, Selcuk University, Konya, 4Department of Orthodontics, Faculty of Dentistry, Inonu University, Malatya, 5Department of Biology, Faculty of Science, Firat University, Elazig, Turkey; 6Research & Development, Nutrition 21 Inc., Purchase, NY, USA; 7Department of Pathology, Faculty of Medicine, 8Department of Animal Nutrition, Faculty of Fisheries, Inonu University, Malatya, 9Department of Animal Nutrition, Faculty of Veterinary Medicine, Firat University, Elazig, Turkey Abstract: The purpose of this study was to induce experimental periodontitis in rats previously fed diets containing arginine silicate inositol (ASI) complex and examine the biochemical, immunological, and radiological effects. Fifty two 8-week-old female Sprague Dawley rats were equally divided into four groups. The control group included those fed a standard rat diet with no operation performed during the experiment. The periodontitis, ASI I, and ASI II groups were subjected to experimental periodontitis induction for 11 days after being fed a standard rat diet alone, a diet containing 1.81 g/kg ASI complex, or a diet containing 3.62 g/kg ASI complex, respectively, for 8 weeks. Throughout the 11-day duration of periodontitis induction, all rats were fed standard feed. The rats were euthanized on the eleventh day, and their tissue and blood samples were collected. In the periodontitis group, elevated tissue destruction parameters and reduced tissue formation parameters were found, as compared to the ASI groups. Levels of enzymes, cytokines, and mediators associated with periodontal tissue destruction were lower in rats fed a diet containing ASI complex after experimental periodontitis. These results indicate that ASI complex could be an alternative agent for host modulation. Keywords: arginine silicate inositol complex, experimental periodontitis, host modulation, micro-computed tomography, periodontal infection

The United States continues to be an incubator for new concepts and approaches to the diagnosis, treatment, and prevention of periodontal diseases. This volume of Periodontology 2000 presents some of these newer areas of research and paradigms that have emerged in the United States from both long-established and new investigators. These areas include: (1) more comprehensive approaches to assessing the total periodontal microbiome, including bacteria, viruses, and fungi, and their interactions with both the local and systemic inflammatory and immune responses, as well as with other oral and systemic conditions and diseases; (2) new developments for a more comprehensive characterization of the patient genome, transcriptome, and proteome profiles and the role of these profiles in periodontal disease pathogenesis; (3) new developments in nonsurgical approaches to periodontal diseases, including broad-based lines of attack using natural antimicrobials and host-modulation therapies and more focused approaches that target specific interactions in the host response; and (4) new big data analysis, machine learning, and imaging approaches, both for understanding the pathogenesis of periodontal diseases and for developing improved risk-assessment tools and better treatment outcomes. [ABSTRACT FROM AUTHOR]

Periodontal pathogens and destructive host responses are involved in the initiation and progression of periodontitis. The emergence of host response modulation as a treatment concept has resulted from our improved understanding of the pathogenesis of periodontal disease. A variety of drugs have been evaluated as host modulation agents (HMA), including Non Steroidal Anti Inflammatory Drugs (NSAIDS), bisphosphonates, tetracyclines, enamel matrix proteins and bone morphogenetic proteins. Chemically modified tetracyclines (CMTs) are one such group of drugs which have been viewed as potential host modulating agents by their anticollagenolytic property. The CMTs are designed to be more potent inhibitors of pro inflammatory mediators and can increase the levels of anti inflammatory mediators.

Background: Periodontitis is a chronic inflammatory disease that affects the supporting structures of the teeth. It is a multifactorial inflammatory disease. Host modulatory therapy (HMT) in periodontics is used as adjuncts to conventional periodontal treatment. Omega-3 fatty acids are among the common HMT in periodontal therapy. Various types of omega-3 fatty acids such as docosahexaenoic acid and eicosapentaenoic acid serve as important precursors for lipid-derived modulators of cell signaling, gene expression, and regulating inflammatory processes. Flaxseeds are known to be a rich source of plantderived polyunsaturated fatty acid. Aim and Objective: The aim of this study was to investigate the effect of flaxseed (omega-3 fatty acid) supplements before and after standard rehabilitation program (SRP) on periodontal inflammation by analyzing serum C-reactive protein (CRP) levels pre- and post-SRP. Materials and Methods: A total of 20 adults with newly diagnosed chronic periodontitis were enrolled in the study. The individuals in the test group were asked to consume one flaxseed tablet per day (Inlife®500 mg) for 1 month. The control group received no supplementation. The serum CRP levels were analyzed for both the groups at baseline and again at 1 month for the test group. Results: The present study showed that the mild periodontitis and gingivitis group had higher mean CRP levels when compared with the healthy individuals. The CRP values were seen to reduce after supplementation with flaxseeds. Conclusion: This study showed a reduction in the CRP levels in the test group which was statistically significant; however, further studies need to be carried out with longer duration. [ABSTRACT FROM AUTHOR]

Perioceutics or use of the pharmacological agents specifically developed to manage periodontitis is an interesting and emerging aids in the development of periodontal disease along with the mechanical debridement. The purpose of host modulatory agent which is a imperative part of perioceutic, is to restore balance between, on the one hand, pro inflammatory mediators and destructive enzymes, and on the other hand, antiinflammatory mediators and enzyme. Host modulatory therapy (HMT) is a treatment concept that aims to reduce tissue destruction and stabilize or even regenerate the periodontium by modifying or down regulating destructive aspects of the host response and up regulating protective or regenerative responses. This paper review the Host Modulatory Therapy which in future will be the effective tool dental practitioners when used as adjunct to mechanical therapy in treating periodontal diseases. [ABSTRACT FROM AUTHOR]

Azithromycin, a macrolide antibiotic, has anti-inflammatory and immunomodulatory activities apart from its antibacterial properties. In this study, we examined the efficacy of subantibiotic dose of azithromycin on ligature-induced periodontitis in rats using micro-computed tomography (micro-CT) imaging and bone parameter analysis. Male Sprague-Dawley rats were allocated to the following four groups: non-ligation (NL) group; ligation-only (L) group; ligation-plus-subantibiotic dose azithromycin (SA) group; and 4) ligation-plus-antibiotic dose azithromycin (AA) group. The rats from Groups L, SA and AA were subjected to periodontitis by placing a ligature around lower right first molar. Immediately after ligation, the rats in SA and AA groups received daily intraperitoneal injections of azithromycin at a dosage of 3.5 or 10 mg/kg body weight, respectively. The ligatures were maintained for 2 weeks at which time the rats had their mandibles hemisected for micro-CT analysis. Subantibiotic dose of azithromycin strongly suppressed reductions in alveolar bone height and bone volume fraction caused by experimental periodontitis. When subantibiotic dosage of azithromycin was administered to rats, ligature-induced alterations in microarchitectural parameters of trabecular bone were significantly reversed. Rats treated with subantibiotic dose of azithromycin presented no significant difference compared to rats with antibiotic dosage in all parameters. While further studies are necessary, subantibiotic dose of azithromycin could be utilized as a host modulator for the treatment of periodontitis. [ABSTRACT FROM AUTHOR]

Periodontitis is a chronic inflammatory disease induced by dysbiotic dental biofilms. Management of periodontitis is primarily anti-bacterial via mechanical removal of bacterial biofilm. The successful resolution requires wound healing and tissue regeneration, which are not always achieved with these traditional methods. The discovery of specialized pro-resolving mediators (SPMs), a class of lipid mediators that induce the resolution of inflammation and promote local tissue homeostasis, creates another option for the treatment of periodontitis and other diseases of chronic inflammation. In this mini-review, we discuss the host-modulatory effects of SPMs on periodontal tissues and changes in the taxonomic composition of the gut and oral microbiome in the presence of SPMs and SPM precursor lipids. Further research into the relationship between host SPM production and microbiome-SPM modification has the potential to unveil new diagnostic markers of inflammation and wound healing. Expanding this field may drive the discovery of microbial-derived bioactive therapeutics to modulate immune responses., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Lee and Tribble.)

“Perioceutics” or the use of the pharmacological agents which are specifically developed to manage periodontitis, is an interesting and an emerging aid in the management of periodontal diseases, along with mechanical debridement. Host modulation therapies are being proposed and developed to bring down excessive levels of enzymes, cytokines, prostanoids, as well modulate osteoclast functions. Over the past two decades, many drugs have been investigated for their host modulating properties in both animal and early human clinical studies. These agents include non-steroidal anti-inflammatory drugs, sub antimicrobial dose doxycycline and systemic bisphosphonates. Recently, a new drug has been added to the list, namely, teriparatide, which is a bone forming drug. It is a biosynthetic human parathyroid hormone. Multiple clinical trials have shown that teriparatide is associated with increased bone mineral density. This review has focused on the mechanism of action of teriparatide and its potential role in the treatment of periodontal disease.

Periodontal disease is a chronic inflammatory disease which represents a primarily anaerobic Gram-negative oral infection that results in gingival inflammation, loss of attachment, bone destruction. Bacterial endotoxins in the form of lipopolysaccharides (LPS) that are instrumental in generating a host-mediated tissue destructive immune response by mobilizing their defensive cells and releasing cytokines like Interleukin-1β (IL-1β), Tumor Necrosis Factor-α (TNF-α), and Interleukin-6 (IL-6), which lead to tissue destruction by stimulating the production of the collagenolytic enzymes: Matrix metalloproteinases (MMPs). Since the host-mediated tissue destruction is to be controlled, various means have been employed for modulating this response. Statins, 3-hydroxy-3-methylglutarylcoenzyme A (HMG CoA) reductase inhibitors, besides having lipid-lowering abilities also have antioxidant, antithrombotic, anti-inflammatory, immunomodulatory and osteomodulatory properties . All of these pleiotropic effects of statins point out to it perhaps becoming the novel host modulation agent in periodontics.

Background: This randomized, controlled clinical study was planned to evaluate the use of anti-inflammatory drug flurbiprofen in the form of locally delivered controlled release gel in the treatment of periodontal disease. Materials and Methods: The flurbiprofen gel was indigenously prepared in the concentration of 0.3%. The 30 patients with localized periodontal pockets measuring ≥5 mm were randomly divided into three groups. The groups received flurbiprofen gel, flurbiprofen gel after prophylaxis, and placebo gel after oral prophylaxis, respectively. The clinical parameters for plaque and gingival inflammation were evaluated at baseline, 7 th day, and 14 th day. Results: The results of the study suggested the statistically significant ( P < 0.05) improvement in the gingival status of the patients with the use of flurbiprofen gel as an adjunct to scaling and root planing as compared to oral prophylaxis or gel alone. Conclusion: The data demonstrated that the additional use of local drug delivery of flurbiprofen through gel media enhances the positive effects of scaling and root planing and helps in faster resolution of the inflammation.

Background: Successful prevention and treatment of periodontal disease are contingent on effective control of periodontopathic microbiota based on the premise of periodontal disease being infectious disorders. An anti-microbial agent, i.e., doxycycline has been incorporated into the allograft to control infection and facilitate healing during and after periodontal therapy. Materials and Methods: Using a split-mouth design, 15 patients showing clinical evidence of almost identical bilateral infrabony defects requiring bone grafting procedures were randomly selected. In each patient, infrabony defects on one side were designated as Group A (control group) and infrabony defects of the contralateral side of the same arch were designated as Group B (test group). Clinical assessment of probing pocket depth and attachment level and radiographic evaluation of the defect depth was done pre-operatively and at 12-week and 24-week post-operatively. The relative efficacy of the two treatment modalities was evaluated using paired Student′s t-test and the comparative evaluation between the two groups over the 3 time intervals was done using independent Student′s t-test. Results: Both the groups exhibited a highly significant reduction in probing depth and gain in clinical attachment level (CAL) and a linear bone fill at the end of 12 and 24 weeks. Comparative evaluation showed a statistically significant gain in bone fill in Group B as compared to Group A, whereas a non-significant reduction in probing depth and gain in CALs between the two groups at the end of 24 weeks (whereas mean reduction in probing depth and gain in CAL were also greater in Group B but the difference was statistically non-significant). Conclusion: The increase in linear bone fill in Group B signifies the role of doxycycline in augmenting regenerative potential of allograft by combating residual infection and through host modulation.

Aggressive periodontitis, although not rare, is a fairly unknown condition. Little is known about its optimal management. While majority of patients with common forms of periodontal disease respond predictably well to conventional therapy (oral hygiene instructions (OHI), non-surgical debridement, surgery, and Supportive Periodontal therapy (SPT)), patients diagnosed with aggressive form of periodontal disease often do not respond predictably/favorably to conventional therapy owing to its complex multi-factorial etiology. Protocols for treating aggressive periodontitis are largely empirical. There is compelling evidence that adjunctive antibiotic treatment frequently results in more favorable clinical response than conventional therapy alone. This article mainly focuses on the role of adjunct use of pharmacological agents in improving the prognosis and treatment outcome of aggressive periodontitis patients.

Introduction: Mast cells are among the first cells to get in-volved in periodontal inflammation. Their numbers have been shown to be in-creased in cases of gingivitis and periodontal disease. The hypothesis: Since mast cell stabilizers like sodium cromogly-cate (SCG) and nedocromil sodium (NS) have been used in the prophylaxis of bronchial asthma without any significant adverse effects and also the fact that drugs like SCG show significant anti-inflammatory activities, it would be logical to use mast cell stabilizers as host modulating drugs for the treatment and prevention of peri-odontal disease. Evaluation of the hypothesis: Safety and efficacy of both SCG and NS are well documented. So, it will be systemically safe to use in humans. However, oral administration SCG or delivery of the drug by means local irrigation will not be very useful because SCG may not be secreted in the gingival crevicular fluid (GCF)(as in the case of oral administraion) or the drug may get washed out from periodontal pocket due to the constant flow of GCF(as in the case of irrigation). A local or targeted drug delivery of mast cell stabilizers can be used in patients with periodontal disease. Role of mast cells in periodontal disease has been dealt in-depth in many studies and articles. However, limited amount of research has been done on using mast cell stabilizers in the prevention and control of periodontal diseases. More studies are needed to study the efficacy and effective-ness of mast cell stabilizers as an adjunct to phase I therapy in the control of periodontal disease.

Background: The understanding of the pathogenesis of periodontitis makes various progresses in the last decades. Today it is well known that the synthesis of high levels of pro-inflammatory mediators from gingival tissues in response to periodontopathogens results in destruction of soft and hard periodontal tissues and clinical expression of periodontal disease. There is enough evidence that PGE2 and IL-1beta are important mediators in the initiation and progression of periodontal disease. Detection of numerous cytokines in high levels in gingival tissues and crevicular fluid may be indicator for activity of periodontitis. The reduction of IL-1beta and PGE2 levels after periodontal therapy may be a potential criterion for successful periodontal therapy. The occurrence of increased IL-1beta and PGE2 levels in GCF or gingival tissue is able to indicate risk from progression of destruction in specific periodontital site. The current conception of the pathogenesis of periodontitis suggests that additional host modulation approach may inhibit the production of pro-inflammatory mediators in periodontal tissues and may enhance the treatment result. Aim of the study: To evaluate the effectiveness of additional host modulation therapy with NSAID (Aulin®) in non-surgical therapy of chronic periodontitis by measurement of IL-1beta and PGE2 gene expression levels in patient’s gingival tissues. Materials and methods: Evaluation of prostaglandin E2 (PGE2) and interleukin-1beta (IL-1beta) gene expression levels in gingival tissue of chronic periodontitis patients before and after non-surgical periodontal therapy (scaling and root planing) was performed. Prostaglandin E2 (PGE2) and interleukin-1beta (IL-1beta) gene expression levels in gingival tissue of patients with chronic periodontitis receiving conventional mechanical therapy alone or with additional host modulation therapy with NSAID (Aulin®) – 100 mg per day were compared. PCR analysis- TagMan RT-PCR for evaluation of gene expression levels of IL-1beta and PGE2 in gingival tissue of periodontal patients was applied. Results: Statistically significant differences were found between additional Aulin® therapy group and conventional therapy group. Received correlative coefficient with Spearman analysis was respectively t = -0.72 (p< 0,05) for IL-1beta and t = 0.81(p

Background: Microbial colonization of the barrier membranes used for guided tissue regeneration is inevitable and can lead to delayed healing. Aims: Antimicrobial coating of the membrane with 25% doxycycline paste has been attempted to prevent infection and achieve enhanced regeneration in periodontal infrabony defects. Materials and Methods: Twenty-four patients with 2-walled or 3-walled infrabony defects were selected and randomly divided into two equal groups. Infrabony defects of group A were treated with a biodegradable membrane coated with 25% doxycycline while those of group B were treated with membrane alone. Clinical assessment of probing depth and attachment level and radiographic evaluation of the defect depth was done preoperatively and at 12 and 24 weeks postoperatively. Statistical Analysis: The relative efficacy of the two treatment modalities were evaluated using the paired Student′s t- test and the comparative evaluation between the two groups was done using the independent Student′s t -test. Results: Both the groups exhibited a highly significant reduction in probing depth and gain in clinical attachment level and linear bone fill at the end of 24 weeks. Comparative evaluation between the two study groups revealed a significant reduction in probing depth ( P = 0.016 FNx01 ) and linear bone fill ( P = 0.02 FNx01 ) in group A as compared to group B. Mean gain in attachment level was greater for group A than for group B but the difference was statistically nonsignificant ( P = 0.065 NS ). Conclusions: The results suggest that doxycycline is beneficial in reducing membrane-associated infection and can potentiate regeneration through host modulation.

Periodontitis, an inflammatory condition, is linked to a higher risk of developing oral cancer. Periodontitis may be a precipitating factor for tumorigenesis and the aggressiveness of specific cancer variants. Although genetics is considered the primary etiologic factor for the development of most cancers, many factors have come to be recognized in the initiation and progression of oral cancer. Consecutively, it is suggestive that periodontitis and oral cancer are distinct disease entities but share common pathogenic mechanisms. Oxidative stress and epigenetic mechanisms are among the most researched mechanisms responsible for initiating apoptotic mechanisms implicated in periodontitis and oral cancer. Current research aims to formulate therapeutic agents to intercede in these mechanisms via host modulation therapy and epigenetic therapy. These advances can revolutionize the treatment of periodontitis and oral cancer. This review aims to shed light on the common pathogenic mechanisms of these diseases and the various host modulation agents that could be beneficial in their treatment. [ABSTRACT FROM AUTHOR]