RÉSUMÉ
ABSTRACT Objective: Low Intensity Pulsed Ultra Sound (LIPUS) is found to have stimulatory effect on bone healing and regeneration. This review aimed to assess whether LIPUS enhances bone regeneration and healing in terms of efficiency in improving clinical, radiographic, histologic parameters or serum and tissue biomarkers. Methods: A comprehensive search based on PRISMA guidelines with pre-determined eligibility criteria was conducted to identify randomized controlled clinical trials evaluating effectiveness of Low intensity pulsed ultrasound in bone regeneration and healing. The title and abstract of the entries in all languages yielded from the PubMed, Google scholar and Cochrane library were screened. Results: 14 eligible Randomized controlled trials testing the effectiveness of LIPUS was evaluated. More heterogeneity was seen in the screened studies with respect to sample characteristics, type of bone and outcome measures. The studies that screened histological parameters state that LIPUS is significantly beneficial than control. In terms of time for radiographic union, most of the studies stated that LIPUS was more effective than control but numberof studies are very few. Whereas studies which evaluated parameters such as healing time and radiographic union were showing highly inconsistent results regarding effectiveness of LIPUS. Conclusion: This review cannot give a definitive conclusion that LIPUS is effective in bone healing with respect to clinical parameters but a positive influence on radiographical and histological parameters in bone healing and regeneration is promising to pursue future research.
RÉSUMÉ
Background: vaccination is the best known application of immunology to human health. Effective vaccines have successfully eradicated the prevalence of several infectious diseases that were common less than a generation ago. The success of Periodontal vaccines is still elusive due to the complexity of periodontal pathogens that have multiple serotypes. No periodontal vaccine trials have satisfied all the requirements such as preventing colonization of pathogens, protection against tissue destruction and alveolar bone loss, elicit immunoglobulins for phagocytosis, stimulation of T-helper cells. This review aims to discuss the various immunization strategies attempted so far. Objective: this review aims to discuss the various in-vitro and in vivo studies that present supporting evidence for the feasibility of formulating a prophylactic periodontal vaccine that could emerge as an adjunct to mechanical therapy in the future. Material and Methods: an extensive literature Search was performed in electronic databases, such as PUBMED, Cochrane central register of controlled trials, Google scholar and science direct using various search terms such as " periodontal vaccines", " porphyromonas gingivalis", "chronic periodontitis", " genomic vaccine ", " recombinant vaccine", "immune response", " vaccination against periodontal bacteria". No limits and language restriction were applied during the electronic search to include all the possible animal studies, clinical trials in the potential relevant article search phase of the systematic review. Conclusion: Studies evaluating Porphyromonas gingivalis are the most common and the structures showing the most potential as a vaccine candidate are Outer membrane proteins, fimbriae and gingipains, the structure having the least potential is Lipopolysaccharide. (AU)
Fundamentação: a vacinação é a aplicação mais conhecida da imunologia à saúde humana. As vacinas eficazes erradicaram com sucesso a prevalência de várias doenças infecciosas que eram comuns há menos de uma geração atrás. O sucesso das vacinas periodontais ainda é ilusório devido à complexidade de patógenos periodontais que possuem múltiplos sorotipos. Nenhum estudo de vacina periodontal atendeu a todos os requisitos, como prevenção da colonização de patógenos, proteção contra destruição de tecidos e perda óssea alveolar, estimulação de imunoglobulinas para fagocitose, estimulação de células T auxiliares. Esta revisão tem como objetivo discutir as várias estratégias de imunização tentadas até o momento. Objetivo: esta revisão tem como objetivo discutir os vários estudos in vitro e in vivo que apresentam evidências de apoio à viabilidade de formular uma vacina periodontal profilática que possa emergir como um complemento da terapia mecânica no futuro. Material e Métodos: Foi realizada uma extensa pesquisa bibliográfica em bancos de dados eletrônicos, como PUBMED, registro central de ensaios controlados Cochrane, Google Acadêmico e science direct, usando vários termos de pesquisa como "vacinas periodontais", "porphyromonas gingivalis", "periodontite crônica" , "Vacina genômica", "vacina recombinante", "resposta imune", "vacinação contra bactérias periodontais". Nenhum limite e restrição de idioma foi aplicado durante a busca eletrônica para incluir todos os possíveis estudos em animais e ensaios clínicos na fase de busca de artigos potencialmente relevantes da revisão sistemática. Conclusão: Estudos avaliando Porphyromonas gingivalis são os mais comuns e as estruturas que mostram maior potencial como candidato a vacina são proteínas de membrana externa, fímbrias e gengivinas, a estrutura com o menor potencial é lipopolissacarídeo.(AU)