Advances in Locally Delivered Antimicrobials for Periodontitis Treatment

Periodontal disease represents an inflammatory disease of the tissues supporting the maintenance and functionality of the teeth on the dental arches. The main cause of periodontitis consists in periodontal dysbiosis, which will trigger an inflammatory response, progressively leading to periodontal tissue breakdown. Scaling and root planing represent the gold standard in treating periodontal diseases but, as it was already established, these measures are unable to completely eliminate the subgingival bacterial plaque. Therefore, new adjunctive therapies have emerged, involving systemic and local delivery of various antimicrobial products. This chapter aims to provide current knowledge on the local application of different periodontal supplementary therapies. The chapter focuses on local forms of antimicrobials, such as irrigations, gels or controlled release systems but also on laser/LED-assisted periodontal pocket photodynamic antibacterial therapy (PDT), along with various photosensitizers. Moreover, we present data from current guidelines regarding the recommendations for the main locally delivered antimicrobials

Reconstructive periodontal therapy with simultaneous ridge augmentation. A clinical and histological case series report

Treatment of intrabony periodontal defects with a combination of a natural bone mineral (NBM) and guided tissue regeneration (GTR) has been shown to promote periodontal regeneration in intrabony defects. In certain clinical situations, the teeth presenting intrabony defects are located at close vicinity of the resorbed alveolar ridge. In these particular cases, it is of clinical interest to simultaneously reconstruct both the intrabony periodontal defect and the resorbed alveolar ridge, thus allowing insertion of endosseous dental implants. The aim of the present study was to present the clinical and histological results obtained with a new surgical technique designed to simultaneously reconstruct the intrabony defect and the adjacently located resorbed alveolar ridge. Eight patients with chronic advanced periodontitis displaying intrabony defects located in the close vicinity of resorbed alveolar ridges were consecutively enrolled in the study. After local anesthesia, mucoperiosteal flaps were raised, the granulation tissue removed, and the roots meticulously scaled and planed. A subepithelial connective tissue graft was harvested from the palate and sutured to the oral flap. The intrabony defect and the adjacent alveolar ridge were filled with a NBM and subsequently covered with a bioresorbable collagen membrane (GTR). At 11–20 months (mean, 13.9 ± 3.9 months) after surgery, implants were placed, core biopsies retrieved, and histologically evaluated. Mean pocket depth reduction measured 3.8 ± 1.7 mm and mean clinical attachment level gain 4.3 ± 2.2 mm, respectively. Reentry revealed in all cases a complete fill of the intrabony component and a mean additional vertical hard tissue gain of 1.8 ± 1.8 mm. The histologic evaluation indicated that most NBM particles were surrounded by bone. Mean new bone and mean graft area measured 17.8 ± 2.8% and 32.1 ± 8.3%, respectively. Within their limits, the present findings indicate that the described surgical approach may be successfully used in certain clinical cases to simultaneously treat intrabony defects and to reconstruct the resorbed alveolar ridge

Causes of genome instability: the effect of low dose chemical exposures in modern society.

Genome instability is a prerequisite for the development of cancer. It occurs when genome maintenance systems fail to safeguard the genome's integrity, whether as a consequence of inherited defects or induced via exposure to environmental agents (chemicals, biological agents and radiation). Thus, genome instability can be defined as an enhanced tendency for the genome to acquire mutations; ranging from changes to the nucleotide sequence to chromosomal gain, rearrangements or loss. This review raises the hypothesis that in addition to known human carcinogens, exposure to low dose of other chemicals present in our modern society could contribute to carcinogenesis by indirectly affecting genome stability. The selected chemicals with their mechanisms of action proposed to indirectly contribute to genome instability are: heavy metals (DNA repair, epigenetic modification, DNA damage signaling, telomere length), acrylamide (DNA repair, chromosome segregation), bisphenol A (epigenetic modification, DNA damage signaling, mitochondrial function, chromosome segregation), benomyl (chromosome segregation), quinones (epigenetic modification) and nano-sized particles (epigenetic pathways, mitochondrial function, chromosome segregation, telomere length). The purpose of this review is to describe the crucial aspects of genome instability, to outline the ways in which environmental chemicals can affect this cancer hallmark and to identify candidate chemicals for further study. The overall aim is to make scientists aware of the increasing need to unravel the underlying mechanisms via which chemicals at low doses can induce genome instability and thus promote carcinogenesis

THE TRICLOSAN -PVM/MA COPOLYMER COMBINATION AND PERIODONTITIS. DATA FROM A CONSENSUS REPORT -PART II

REZUMAT Triclosanul este unul din agentii antimicrobieni ai cavitatii bucale cei mai cercetati astazi. O conferinta de consens desfasurata la Hilton Athenee Palace Bucuresti in 15 februarie 2008 in organizarea Colgate-Palmolive Romania, a reunit concluziile unor lideri de opinie in sanatate orala din Romania privitoare la aplicabilitatea triclosanului in medicina dentara si tehnologia triclosan-copolimer PVM/MA. Articolul reda datele prezentate in cadrul conferintei de consens privind valoarea triclosanului ca agent terapeutic in boala parodontala. Cu referire la asocierea triclosan -copolimer PVM/MA şi parodontita, concluzia desprinsa este ca literatura reuneşte o serie de dovezi care confirmă interesul pentru includerea asocierii triclosan -copolimer PVM/MA în tratamentul bolii parodontale. Cu toate acestea, câmpul studiilor paralele cu paste de dinţi sau geluri continând alţi agenţi antimicrobieni este actualmente restrâns în literatura de specialitate, necesitând o cercetare mai aprofundata, mai ales în direcţia corelării rezultatelor obţinute in vitro cu cele in vivo. Cuvinte cheie: Triclosan, parodontita, pastă de dinți, Colgate Total ® ABSTRACT Triclosan is currently one of the most researched antimicrobial agents of the oral cavity. A consensus meeting organized by Colgate-Palmolive Romania took place on 15 February 2008 at Athenee Palace Hilton Bucharest to reunite the conclusions of Romanian opinion leaders regarding the applicability of triclosan in dental medicine and the triclosan-PVM/MA copolymer technology. The article reflects the data issued by the consensus meeting regarding the value of triclosan as therapeutic agent of the periodontal disease. With respect to the triclosan -PVM/MA copolymer combination and periodontitis, the literature contains lots of evidence confirming the interest to include the triclosan -PVM/MA copolymer combination in periodontal disease therapy. However, the field of parallel studies using toothpastes or gels containing other antimicrobial agents is nowadays limited. A more extended research is necessary, especially concerning the correlation of in vitro with the in vivo data