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New Advances of Agents and Biomaterials of Periodontal and Peri-Implant Disease Therapy and Bone Regeneration

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Materials Science".

Deadline for manuscript submissions: closed (31 March 2020) | Viewed by 40244

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Guest Editor
Department of General Surgery and Surgical-Medical Specialties, University of Catania, Catania, Italy
Interests: periodontitis; oral surgery; oral pathology; oral health-systemic health; bone biology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Periodontitis and peri-implant and oral diseases are a plaque-induced inflammatory condition that affects the periodontium; they are caused by the adherence to the tooth surface of pathogenic bacterial species organized in complex communities that form biofilms. The standard periodontal treatment consists of mechanical debridement to remove biofilm and calculus from the affected root surfaces. This approach has proven successful for most patients. However, although systematic reviews have shown an improvement in clinical periodontal parameters, the traditional surgery approach does not entirely remove periodontal pathogens, particularly in deep periodontal pockets, because it does not eradicate all periodontal pathogens involved in periodontitis and peri-implantitis.

Given the important role played by microorganisms in the development and progression of oral, periodontal and peri-implant diseases, there is an increasing interest in adjunctive therapies that could improve the outcomes of traditional therapies. For many years, systemic and locally-delivered antibiotics, chemical agents and others antimicrobials have been used to enhance oral and periodontal therapies.

Over time, strategies such as local delivery controlled release systems were developed for oral, periodontal disease and periodontal regeneration. Systemic delivery has the potential advantage of reaching pathogens widely distributed in the oral cavity, including those in nondental oral niches, such as the dorsum of the tongue and the crypts of the tonsils.

The aim of this Special Issue is to update the current knowledge of adjunctive agents and biomaterials in the therapy of oral diseases, periodontitis, peri-implantitis and periodontal regeneration based on the most recent scientific evidence. Special emphasis is given to the implications for mild and moderate forms of the disease

We especially welcome intervention studies with an impact on both local and systemic delivery agents, periodontal biomaterials, topical and systemic antimicrobials and interventional studies aiming at improving the knowledge of the effectiveness of the adjunctive therapies on the non-surgical and surgical treatment of oral diseases, periodontitis and peri-implantitis. Review studies including those that use conceptual frameworks on any of the aforementioned topics will also be welcomed.

Potential topics include but are not limited to the following:

  • Local and systemic delivery agents used for the treatment of periodontitis and peri-implantitis
  • New evidence on non-surgical periodontal treatment of periodontitis and peri-implantitis
  • New evidence on biomaterials for periodontal and bone regeneration
  • New antimicrobial therapies for the non-surgical treatment of periodontitis and peri-implantitis
  • Post-treatment supportive care following non-surgical and surgical treatment of periodontitis and peri-implantitis
  • Lasers in minimally invasive periodontal and peri-implant therapy
  • Risk factors that may modify the innate and adaptive immune
  • responses in periodontal diseases Risk factors that may modify the innate and adaptive immune responses in periodontal diseases
  • Critical or systematic reviews on the non-surgical treatment of oral diseases, periodontitis and peri-implantitis

Papers are published upon acceptance, regardless of the Special Issue publication date.

Prof. Dr. Gaetano Isola
Guest Editor

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Published Papers (6 papers)

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Research

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13 pages, 946 KiB  
Article
Role of Cyclosporine in Gingival Hyperplasia: An In Vitro Study on Gingival Fibroblasts
by Dorina Lauritano, Annalisa Palmieri, Alberta Lucchese, Dario Di Stasio, Giulia Moreo and Francesco Carinci
Int. J. Mol. Sci. 2020, 21(2), 595; https://doi.org/10.3390/ijms21020595 - 16 Jan 2020
Cited by 93 | Viewed by 3156
Abstract
Background: Gingival hyperplasia could occur after the administration of cyclosporine A. Up to 90% of the patients submitted to immunosuppressant drugs have been reported to suffer from this side effect. The role of fibroblasts in gingival hyperplasia has been widely discussed by literature, [...] Read more.
Background: Gingival hyperplasia could occur after the administration of cyclosporine A. Up to 90% of the patients submitted to immunosuppressant drugs have been reported to suffer from this side effect. The role of fibroblasts in gingival hyperplasia has been widely discussed by literature, showing contrasting results. In order to demonstrate the effect of cyclosporine A on the extracellular matrix component of fibroblasts, we investigated the gene expression profile of human fibroblasts after cyclosporine A administration. Materials and methods: Primary gingival fibroblasts were stimulated with 1000 ng/mL cyclosporine A solution for 16 h. Gene expression levels of 57 genes belonging to the “Extracellular Matrix and Adhesion Molecules” pathway were analyzed using real-time PCR in treated cells, compared to untreated cells used as control. Results: Expression levels of different genes were significantly de-regulated. The gene CDH1, which codes for the cell adhesion protein E-cadherin, showed up-regulation. Almost all the extracellular matrix metalloproteases showed down-regulation (MMP8, MMP11, MMP15, MMP16, MMP24, MMP26). The administration of cyclosporine A was followed by down-regulation of other genes: COL7A1, the transmembrane receptors ITGB2 and ITGB4, and the basement membrane constituents LAMA2 and LAMB1. Conclusion: Data collected demonstrate that cyclosporine inhibits the secretion of matrix proteases, contributing to the accumulation of extracellular matrix components in the gingival connective tissue, causing gingival overgrowth. Patients affected by gingival overgrowth caused by cyclosporine A need to be further investigated in order to determine the role of this drug on fibroblasts. Full article
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12 pages, 680 KiB  
Article
Expression of Salivary and Serum Malondialdehyde and Lipid Profile of Patients with Periodontitis and Coronary Heart Disease
by Gaetano Isola, Alessandro Polizzi, Simona Santonocito, Angela Alibrandi and Sebastiano Ferlito
Int. J. Mol. Sci. 2019, 20(23), 6061; https://doi.org/10.3390/ijms20236061 - 01 Dec 2019
Cited by 80 | Viewed by 4454
Abstract
Malondialdehyde (MAA) within a lipid pathway has been demonstrated to possess an important role in endothelial function that undergoes periodontitis and coronary heart disease (CHD) development. This study evaluated the impact of periodontitis, CHD, or a combination of both diseases (periodontitis + CHD) [...] Read more.
Malondialdehyde (MAA) within a lipid pathway has been demonstrated to possess an important role in endothelial function that undergoes periodontitis and coronary heart disease (CHD) development. This study evaluated the impact of periodontitis, CHD, or a combination of both diseases (periodontitis + CHD) on salivary and serum MAA levels. The periodontal and clinical characteristics, serum, and saliva samples were collected from 32 healthy subjects, 34 patients with periodontitis, 33 patients with CHD, and 34 patients with periodontitis and CHD. Lipid profile and levels of MDA and C-reactive protein (CRP) were assessed. Patients in the periodontitis group (serum: 3.92 (3.7–4.4) µmol/L; salivary 1.81 (1–2.1) µmol/g protein, p < 0.01) and in the periodontitis + CHD (serum: 4.34 (3.7–4.8) µmol/L; salivary 1.96 (1.7–2.3) µmol/g protein, p < 0.001) group presented higher median concentrations of salivary and serum MAA compared to patients in the CHD (serum: 3.72 (3.5–4.1) µmol/L; salivary 1.59 (0.9–1.8) µmol/g protein, p < 0.01) and control group (serum: 3.14 (2.8–3.7) µmol/L; salivary 1.41 (0.8–1.6) µmol/g protein, p < 0.01). In univariate models, periodontitis (p = 0.034), CHD (p < 0.001), and CRP (p < 0.001) were significantly associated with MAA. In the multivariate model, only CRP remained a significant predictor of serum and salivary MAA (p < 0.001) MAA levels. Patients with periodontitis and with periodontitis + CHD presented higher levels of salivary and serum MAA compared to healthy subjects and CHD patients. CRP has been found to be a significant predictor of increased salivary and serum MAA levels. Full article
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16 pages, 12502 KiB  
Article
Biomimetic Surfaces Coated with Covalently Immobilized Collagen Type I: An X-Ray Photoelectron Spectroscopy, Atomic Force Microscopy, Micro-CT and Histomorphometrical Study in Rabbits
by Antonio Scarano, Felice Lorusso, Tiziana Orsini, Marco Morra, Giorgio Iviglia and Luca Valbonetti
Int. J. Mol. Sci. 2019, 20(3), 724; https://doi.org/10.3390/ijms20030724 - 08 Feb 2019
Cited by 35 | Viewed by 4153
Abstract
Background: The process of osseointegration of dental implants is characterized by healing phenomena at the level of the interface between the surface and the bone. Implant surface modification has been introduced in order to increase the level of osseointegration. The purpose of this [...] Read more.
Background: The process of osseointegration of dental implants is characterized by healing phenomena at the level of the interface between the surface and the bone. Implant surface modification has been introduced in order to increase the level of osseointegration. The purpose of this study is to evaluate the influence of biofunctional coatings for dental implants and the bone healing response in a rabbit model. The implant surface coated with collagen type I was analyzed through X-ray Photoelectron Spectroscopy (XPS), Atomic Force Microscopy (AFM), micro-CT and histologically. Methods: The sandblasted and double acid etched surface coated with collagen type I, and uncoated sandblasted and double acid etched surface were evaluated by X-ray Photoelectron Spectroscopy (XPS) and Atomic Force Microscopy (AFM) analysis in order evaluate the different morphology. In vivo, a total of 36 implants were positioned in rabbit articular femoral knee-joint, 18 fixtures for each surface. Micro-CT scans, histological and histomorphometrical analysis were conducted at 15, 30 and 60 days. Results: A histological statistical differences were evident at 15, 30 and 60 days (p < 0.001). Both implant surfaces showed a close interaction with newly formed bone. Mature bone appeared in close contact with the surface of the fixture. The AFM outcome showed a similar roughness for both surfaces. Conclusion: However, the final results showed that a coating of collagen type I on the implant surface represents a promising procedure able to improve osseointegration, especially in regions with a low bone quality. Full article
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Review

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25 pages, 2109 KiB  
Review
Photonic Therapy in Periodontal Diseases an Overview with Appraisal of the Literature and Reasoned Treatment Recommendations
by Marco Giannelli, Massimo Lasagni and Daniele Bani
Int. J. Mol. Sci. 2019, 20(19), 4741; https://doi.org/10.3390/ijms20194741 - 24 Sep 2019
Cited by 10 | Viewed by 5787
Abstract
Recent reviews and meta-analyses of the literature over the past quarter-century have failed to provide enough evidence to prove or disprove the actual utility of photonic therapy in periodontitis, alone or adjunctive to conventional approaches. This apparent paradox has been explained by the [...] Read more.
Recent reviews and meta-analyses of the literature over the past quarter-century have failed to provide enough evidence to prove or disprove the actual utility of photonic therapy in periodontitis, alone or adjunctive to conventional approaches. This apparent paradox has been explained by the many physical, molecular, biological, anatomical, and technical variables of photonic treatments, which can differ in light-emitting devices (laser or LED), wavelengths, irradiation power and modes, clinical objectives, follow-up times, disease grading, and assessment methods. This multi-faceted, controversial scenario has led practitioners to underestimate the actual potential of photonic therapy in periodontal diseases. In this critical appraisal of the literature, we have briefly summarized the main photonic therapies and instruments used in Periodontology, highlighting their main characteristics and limitations. Then, we have tried to identify and discuss the key methodological issues which can have an impact on the outcome of photonic therapies. Our main goal was to identify the best parameters, settings, and methodologies to perform effective periodontal photonic treatments and to extrapolate some recommendations for clinical use. Should these recommendations find a consensus among periodontologists and be adopted in future clinical studies, they will hopefully contribute to dissipate the present confusion and uncertainty on this complex matter. Full article
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17 pages, 9092 KiB  
Review
Biomaterial-Based Approaches for Regeneration of Periodontal Ligament and Cementum Using 3D Platforms
by Chan Ho Park
Int. J. Mol. Sci. 2019, 20(18), 4364; https://doi.org/10.3390/ijms20184364 - 05 Sep 2019
Cited by 28 | Viewed by 16730
Abstract
Currently, various tissue engineering strategies have been developed for multiple tissue regeneration and integrative structure formations as well as single tissue formation in musculoskeletal complexes. In particular, the regeneration of periodontal tissues or tooth-supportive structures is still challenging to spatiotemporally compartmentalize PCL (poly-ε-caprolactone)-cementum [...] Read more.
Currently, various tissue engineering strategies have been developed for multiple tissue regeneration and integrative structure formations as well as single tissue formation in musculoskeletal complexes. In particular, the regeneration of periodontal tissues or tooth-supportive structures is still challenging to spatiotemporally compartmentalize PCL (poly-ε-caprolactone)-cementum constructs with micron-scaled interfaces, integrative tissue (or cementum) formations with optimal dimensions along the tooth-root surfaces, and specific orientations of engineered periodontal ligaments (PDLs). Here, we discuss current advanced approaches to spatiotemporally control PDL orientations with specific angulations and to regenerate cementum layers on the tooth-root surfaces with Sharpey’s fiber anchorages for state-of-the-art periodontal tissue engineering. Full article
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16 pages, 831 KiB  
Review
Gene Delivery Therapeutics in the Treatment of Periodontitis and Peri-Implantitis: A State of the Art Review
by Funda Goker, Lena Larsson, Massimo Del Fabbro and Farah Asa’ad
Int. J. Mol. Sci. 2019, 20(14), 3551; https://doi.org/10.3390/ijms20143551 - 20 Jul 2019
Cited by 28 | Viewed by 5274
Abstract
Background: Periodontal disease is a chronic inflammatory condition that affects supporting tissues around teeth, resulting in periodontal tissue breakdown. If left untreated, periodontal disease could have serious consequences; this condition is in fact considered as the primary cause of tooth loss. Being highly [...] Read more.
Background: Periodontal disease is a chronic inflammatory condition that affects supporting tissues around teeth, resulting in periodontal tissue breakdown. If left untreated, periodontal disease could have serious consequences; this condition is in fact considered as the primary cause of tooth loss. Being highly prevalent among adults, periodontal disease treatment is receiving increased attention from researchers and clinicians. When this condition occurs around dental implants, the disease is termed peri-implantitis. Periodontal regeneration aims at restoring the destroyed attachment apparatus, in order to improve tooth stability and thus reduce disease progression and subsequent periodontal tissue breakdown. Although many biomaterials have been developed to promote periodontal regeneration, they still have their own set of disadvantages. As a result, regenerative medicine has been employed in the periodontal field, not only to overcome the drawbacks of the conventional biomaterials but also to ensure more predictable regenerative outcomes with minimal complications. Regenerative medicine is considered a part of the research field called tissue engineering/regenerative medicine (TE/RM), a translational field combining cell therapy, biomaterial, biomedical engineering and genetics all with the aim to replace and restore tissues or organs to their normal function using in vitro models for in vivo regeneration. In a tissue, cells are responding to different micro-environmental cues and signaling molecules, these biological factors influence cell differentiation, migration and cell responses. A central part of TE/RM therapy is introducing drugs, genetic materials or proteins to induce specific cellular responses in the cells at the site of tissue repair in order to enhance and improve tissue regeneration. In this review, we present the state of art of gene therapy in the applications of periodontal tissue and peri-implant regeneration. Purpose: We aim herein to review the currently available methods for gene therapy, which include the utilization of viral/non-viral vectors and how they might serve as therapeutic potentials in regenerative medicine for periodontal and peri-implant tissues. Full article
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