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.

Background: The application of platelet concentrates has gained significant attention in regenerative medicine and dentistry, particularly in periodontal regenerative techniques. Platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) are platelet concentrates that facilitate the repair and regeneration of various tissues, attributed to their rich content of growth factors. Objectives: This current research aims at comparing the expression of platelet-derived growth factor (PDGF) from advanced platelet-rich fibrin (A-PRF) and advanced platelet-rich fibrin plus (A-PRF+), with and without application of low-level laser therapy (LLLT). Methods: Twenty systemically healthy subjects were included in this research. A venipuncture procedure was performed to obtain 15 millilitres of blood, which was collected from the antecubital fossa of each participant. After collection, blood was divided into two equal aliquots of 7.5 mL each. The first 7.5 mL aliquot was subjected to centrifugation for 14 minutes at 1,300 revolutions per minute (rpm), generating a relative centrifugal force of 145 g, to obtain A-PRF. The second 7.5 mL aliquot underwent centrifugation for 8 minutes at 1,300 rpm (145 g) to produce A-PRF+. Following the preparation of A-PRF and A-PRF+, each sample was divided into two equal halves. One half of the A-PRF and A-PRF+ samples was subjected to LLLT, while the other half did not receive any light treatment. After 14 days, an enzyme-linked immunosorbent assay (ELISA) was performed to quantify the expression of PDGF-BB in the samples. Results: The highest PDGF-BB levels were observed in A-PRF+ samples exposed to light (1925.09 pg/µl), followed by A-PRF with light (1905.15 pg/µl). Conclusion: The study demonstrated the expression of platelet-derived growth factor (PDGF-BB) from both A-PRF and A-PRF+ without low-level laser therapy, and a noticeable increase in production with LLLT.

Background: Interleukin-6 (IL-6) is a proinflammatory cytokine expressed in numerous chronic inflammatory diseases whose ability to alter the pathophysiology and progression of periodontitis is well documented. Further its role in diabetes mellitus by creating an insulin resistance responsible for poor glycemic control is also being evaluated. The aim was to compare the levels of IL-6 in gingival crevicular fluid in periodontitis patients with and without diabetes and to analyze these levels in patients with poor glycemic control (HBA1c), in order to assess its role in the progression of periodontal destruction. Methods: 60 chronic periodontitis patients confirmed with CPITN index of age group 30-70 years were enrolled for the study. GCF samples from 30 patients with diabetes confirmed using HBA1c reports and 30 without diabetes using Cimasoni method were collected and stored at -70degreescelsiusand subjected to ELISA for IL-6 using krishgen human IL-6 ELISA kit as per manufacturer's instruction. Descriptive and inferential statistics were used using SPSS software. Results: While the diabetic group readings ranged from 4.4 Pg/µl to 7.0 Pg/µl with a mean of 5.8pg/µl, the non- diabetic group ranged from 1.5 Pg/µl to 4.8 Pg/µl with a mean value of3.24 pg/µl. There was a prominent increase in the IL-6 levels in diabetic when compared to non- diabetic which was statistically significant with p value < 0.001. Further, among the diabetic groups, patients with poor HBA1c with reading more than 7.7% showed a significant increase in IL-6 levels when compared to below 6.8%. Conclusions: The IL-6 levels in GCF were increased in chronic periodontitis patients with diabetes and more so in patients with poor glycemic control when compared to non-diabetic group. Therefore, periodontitis along with diabetes can play a major role in the inflammatory response within the periodontium.

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Context: Periodontitis, a chronic inflammatory disease affecting the periodontium, is primarily caused by gram-negative anaerobic bacteria. Conventional periodontal therapy aims to eradicate pathogenic microflora through mechanical debridement, often supplemented with chemical agents. However, the use of these chemical adjuvants is frequently associated with adverse drug reactions and the development of antimicrobial resistance. Consequently, researchers are increasingly exploring herbal antibacterial agents, such as Ocimum sanctum (Tulsi), as viable alternatives due to their broad-spectrum antimicrobial properties and reduced side effect profile. Aim: This study aims to analyze the antibacterial efficacy of the ethanolic extract of O. sanctum (Tulsi) against Tannerella forsythia, a key bacterium of the red complex, using chlorhexidine as a reference standard. Traditionally, chlorhexidine has been utilized as an adjunct to nonsurgical therapy in the treatment of patients with periodontal disease. Materials and methods: The cold extraction method was used to prepare the ethanolic extract of O. sanctum leaves. The resultant substance was mixed into five different concentrations (3.13%, 6.25%, 12.5%, 25%, and 50%) using dimethylformamide as the solvent. The antimicrobial activity of these varying concentrations was assessed against T. forsythia in culture plates employing the agar well diffusion method, with 0.2% chlorhexidine serving as the positive reference. The zone of inhibition of bacterial growth has been determined and compared with that of 0.2% chlorhexidine. Results: The ethanolic extract of O. sanctum exhibited highly statistically significant antibacterial activity against T. forsythia (p < 0.001). At a dosage of 25 mg/mL, the extract created a zone of inhibition measuring 17 mm, while at 50 mg/mL, the zone of inhibition increased to 25 mm. However, when compared to 0.2% chlorhexidine, which had a zone of inhibition of 32 mm, O. sanctum showed a slightly smaller inhibitory effect. Conclusion: The extract of Tulsi showed notable antibacterial activity against T. forsythia, with the antibacterial impact observed at the 50 mg/mL dilution.

Aim: This study aimed to evaluate the effect of quercetin on osteogenic gene expression in lipopolysaccharide (LPS) stimulated human periodontal ligament cells (hPDLCs) under in vitro conditions. Materials and methods: hPDLCs were cultured with LPS for 24 hours to simulate an inflammatory microenvironment. Following this pre-stimulation, cells were treated with quercetin at concentrations of 2.5 µM, 5 µM, and 10 µM for up to 14 days. No further exposure to LPS was performed during the subsequent culture period. The mRNA expression levels of osteogenic markers, osteopontin (OPN) and osteocalcin (OCN), were assessed on day 14 using Quantitative Real-Time PCR (RT-qPCR). Statistical analysis was performed using Welch’s one-way ANOVA with Holm-adjusted post hoc comparisons. Results: LPS stimulation significantly suppressed the expression of both OPN and OCN compared with the control group. However, quercetin treatment restored and dose-dependently increased the expression of these markers, with the greatest effect observed at 10 µM. At this concentration, OPN and OCN expression levels reached 5.80 ± 0.26 and 6.62 ± 0.30, respectively, relative to the control. A consistent dose-dependent upregulation was observed for both markers, indicating restoration of osteogenic gene expression. Conclusion: Quercetin modulates the expression of osteogenic markers, including OPN and OCN, in LPS-stimulated hPDLCs under in vitro conditions. These findings suggest a potential modulatory role for quercetin in influencing osteogenic gene expression. However, additional in vitro functional assays and in vivo studies are necessary to establish its role in periodontal regeneration.