Periodontal diseases when persistent, results in periodontal pockets, attachment loss and progressive destruction of the alveolar bone. Grafting periodontal bone defects with bone substitute biomaterials has proven clinical success for accomplishing reconstruction of lost attachment apparatus, especially in deep intra-bony defects. Nanoparticles (NPs) have been considered indispensable in the future of health sciences and NP based alloplastic graft materials such as nanocrystalline hydroxyapatite (NCHA) hold great promise for regeneration of periodontal defects. Therefore the aim of this review is to evaluate the role of NCHA as an effective substitute for periodontal bone regeneration. Popular scientific databases such as PubMed (Medline), Cochrane database of clinical trials, Scopus (Elsevier), Web of science (Clarivate Analytics) and Google Scholar, were searched. The literature search was restricted to published reports in English, between January 2000 and December 2021. Database search returned 1227 results which were screened based on title, author names and publication dates. Data from the 14 included studies were reviewed and tabulated. In the present review, all the studies reported using commercially available NCHA for periodontal bone regeneration. NCHA is a suitable bone substitute material for periodontal bone regeneration, with outcomes comparable to that of conventionally used graft materials such as bovine xenograft and other synthetic alloplastic materials. While grafting with NCHA in intrabony periodontal defects, after any form of periodontal flap surgery or debridement, significantly improves bone regeneration by 6 months, addition of adjuncts like EMD and PRF further enhance the outcomes.

Gingivitis and periodontitis are common oral pathological conditions. Several optional adjunctive local therapies are used clinically. While antibiotics and chlorhexidine are the most common agents of choice, their long-term use is associated with several adverse effects. Some of these include staining of teeth and restorations, cellular cytotoxicity and hypersensitivity. Topical oxygen therapy has been recently introduced and could be clinically capable of inhibiting plaque bacterial biofilm growth. Available as a mouthwash, toothpaste and oral gel, this formulation comprises cellulose, glycerol and sodium peroxoborate, and releases topical oxygen in a controlled manner. Moreover, it releases topical oxygen, in a controlled manner, and lactoferrin, which are capable of antibacterial action and stimulation of bone cells, respectively. The aim of this paper is to report a case of gingivitis and another case of periodontitis, both of which were successfully treated clinically with adjunctive local oxygen therapy (blue^®m). Additionally, this paper aims to review the relevant literature in terms of adjunct topical or local therapies used in the treatment of gingivitis and periodontitis, in order to understand how local therapies are helpful and to know if local oxygen therapy is a suitable clinical alternative.

This meta-analysis was to systematically investigate all preclinical researches on the possible benefits of antiosteoporotic drugs on titanium implants. Also, we performed a subgroup analysis to examine if the methods of drug delivery (systemic vs. local vs. surface coatings) or the types of antiosteoporotic drug (anticatabolic vs. anabolic) have more effect on bone-to-implant regeneration. A total of 116 articles (animal studies) were included. Poor reporting was assessed in the majority of the included studies. Then, results of meta-analysis showed that the use of osteoporotic medications significantly increased the overall values of micro-CT bone volume (BV) (mean differences [MD]: 21.7%, confidence interval [CI]: 17.8–25.7), bone-to-implant contact (BIC) (MD: 12.1%, CI: 10.6–13.7), torque-out (MD: 5.7N.cm, CI: 4.6–6.8), and push-out (MD: 67.3N, CI: 54.6–79.9) compared with the values of implants without osteoporotic medications. Also, implants coated with drugs showed higher values of BIC (MD: 16.8%, CI: 12.4–21.3) compared with implants received drugs through systemic administration (MD: 12.2%, CI: 10.1–14.3) or local administration (MD: 8.6%, CI: 5.8–11.4). A positive effect of local delivery of antiosteoporotic drugs was significant on push-out testing (MD: 169.8N, CI: 120.1–219.6) compared with the use of drugs through systemic route (MD: 51.6N, CI: 38.7–64.6) or as surface coatings (MD: 24.1N, CI: 15.4–32.7). Finally, anabolic drugs showed a significant effect on push-out forces (MD: 125.5N, CI: 95.5–155.5) compared with the use of anticatabolic drugs (MD: 51.9N, CI: 39.5–64.5). In conclusion, the positive effect of antiosteoporotic drugs on osseointegration is observed in the present meta-analysis. Mainly, antiosteoporotic drug-coated implant surfaces showed an increase of BIC% compared with implants received drugs through local routes, but not with systemic routes. Also, the positive effect of anabolic drugs seems beyond the effect of anticatabolic drugs in terms of mechanical stability of implants as tested by push-out. Impact Statement: This meta-analysis was to investigate literature on the administration of antiosteoporotic drugs as an effective adjunct therapy for implant osseointegration using in vivo animal models.

Peri-implant diseases including peri-implant mucositis and peri-implantitis are among the major causes of failure of implant-supported dental restorations. They are characterized by progressive inflammation of the peri-implant mucosa, extending to the surrounding connective tissues and leading to bone loss and implant failure. Although strict oral hygiene practices help in preventing peri-implant diseases, plaque buildup around the implant restoration leads to chronic inflammation, due to the adherent bacterial biofilm. While mechanical debridement and non-surgical therapy to remove inflamed connective tissue (ICT) form the mainstay of treatment, additional local adjunctive therapies enhance clinical outcomes. Topical oxygen therapy is known to reduce inflammation, increase vascularity, and act as a bacteriostatic measure. The use of oxygen-based therapy (blue^®m) products as a local adjunctive therapy for peri-implant mucositis and peri-implantitis can result in clinical outcomes similar to that of conventional local adjuncts such as chlorhexidine, antibiotics, and antibacterial agents. This report aims to present the clinical findings of patients with peri-implant mucositis and peri-implantitis, who were managed using local oxygen-based therapy as an adjunct to non-surgical therapy. In addition, a review of the literature about commonly used local adjuncts for peri-implant diseases has been included in the report to provide a means of comparison between conventional local adjunct therapy and topical oxygen-based therapy. Based on the reported findings and reviewed literature, local oxygen-based adjunct therapy was equally effective as conventionally used local adjuncts such as antibiotics, antibacterials, and probiotics, in treating patients with peri-implant diseases.

The aim of this research was to assess the effect of 0.12% chlorhexidine (CHX) and a Salvadora persica–based mouthwash on whole salivary tumour necrosis factor-alpha (TNF-α) levels and periodontal inflammation in patients with type 2 diabetes mellitus (T2DM). Patients with and without medically diagnosed T2DM were included. Patients’ medical records were evaluated to confirm the diagnosis of T2DM. All patients underwent nonsurgical periodontal therapy (NSPT). Patients were divided into 2 subgroups. In the test and control group, patients were advised to rinse with an S persica–based mouthwash and a non-alcoholic 0.12% CHX after NSPT twice daily for 2 weeks, respectively. Demographic data were collected. Full-mouth plaque index (PI), gingival index (GI), probing depth (PD), and clinical attachment loss (AL) were measured, and whole salivary TNF-α levels were gauged at baseline and at 3-month follow-up. Haemoglobin A1c (HbA1c) levels were measured in all patients at baseline and at 3-month follow-up. Sample size estimation was done, and group comparison was performed. Level of significance was set at P < .01. Twenty-one nondiabetic individuals and 21 patients with T2DM were included. At baseline, there was no significant difference in clinical and radiographic periodontal parameters amongst in patients with and without T2DM. At 3-month follow-up, HbA1c, TNF-α, PI, PD, and clinical AL were comparable with their respective baseline values in the test and control groups amongst patients with T2DM. In nondiabetic individuals, there was a significant reduction in PI (P < .01), GI (P < .01), and PD (P < .01), and TNF-α (P < .01) at 3-month follow-up in the test and control groups compared with their respective baseline scores. In the short term, NSPT with 0.12% CHX or S persica–based mouthwashes is more effective in reducing periodontal inflammation and whole salivary TNF-α levels in nondiabetic individuals than in patients with T2DM with periodontal inflammation.

We evaluated the effect of osteoporotic induction after eight weeks of initial healing of bone defects grafted with a xenograft material in a rat model. Bone defects were created in the femoral condyles of 16 female Wistar rats (one defect per rat). The defects were filled with bovine bone (Inter-Oss) granules. After eight weeks of bone healing, rats were randomly ovariectomized (OVX) or sham-operated (SHAM). At 14 weeks of bone healing, all animals were euthanized. Bone specimens were harvested and processed for histological and histomorphometric analyses to assess new bone formation (N-BF%), remaining bone graft (RBG%) and trabecular bone space (Tb.Sp%) within the defect area. After 14 weeks of bone healing, histological evaluation revealed a significant alteration in trabecular bone in OVX rats compared to SHAM rats. There was lower N-BF% in OVX rats (22.5% ± 3.0%) compared to SHAM rats (37.7% ± 7.9%; p < 0.05). Additionally, the RBG% was significantly lower in OVX (23.7% ± 5.8%) compared to SHAM (34.8% ± 9.6%; p < 0.05) rats. Finally, the Tb.Sp% was higher in OVX (53.8% ± 7.7%) compared to SHAM (27.5% ± 14.3%; p < 0.05) rats. In conclusion, within the limitations of this study, inducing an osteoporotic condition in a rat model negatively influenced bone regeneration in the created bone defect and grafted with a xenograft material.