Antibiofilm and Immune-Modulatory Activity of Cannabidiol and Cannabigerol in Oral Environments-In Vitro Study.

OBJECTIVE: To evaluate the in vitro antimicrobial and antibiofilm properties and the immune modulatory activity of cannabidiol (CBD) and cannabigerol (CBG) on oral bacteria and periodontal ligament fibroblasts (PLF). METHODS: Cytotoxicity was assessed by propidium iodide flow cytometry on fibroblasts derived from the periodontal ligament. The minimum inhibitory concentration (MIC) of CBD and CBG for S. mutans and C. albicans and the metabolic activity of a subgingival 33-species biofilm under CBD and CBG treatments were determined. The Quantification of cytokines was performed using the LEGENDplex kit (BioLegend, Ref 740930, San Diego, CA, USA). RESULTS: CBD-treated cell viability was greater than 95%, and for CBG, it was higher than 88%. MIC for S. mutans with CBD was 20 µM, and 10 µM for CBG. For C. albicans, no inhibitory effect was observed. Multispecies biofilm metabolic activity was reduced by 50.38% with CBD at 125 µg/mL (p = 0.03) and 39.9% with CBG at 62 µg/mL (p = 0.023). CBD exposure at 500 µg/mL reduced the metabolic activity of the formed biofilm by 15.41%, but CBG did not have an effect. CBG at 10 µM caused considerable production of anti-inflammatory mediators such as TGF-ß and IL-4 at 12 h. CBD at 10 µM to 20 µM produced the highest amount of IFN-γ. CONCLUSION: Both CBG and CBD inhibit S. mutans; they also moderately lower the metabolic activity of multispecies biofilms that form; however, CBD had an effect on biofilms that had already developed. This, together with the production of anti-inflammatory mediators and the maintenance of the viability of mammalian cells from the oral cavity, make these substances promising for clinical use and should be taken into account for future studies.

Cannabinoids in Periodontology: Where Are We Now?

INTRODUCTION: Cannabinoids are a well-documented treatment modality for various immune and inflammatory diseases, including asthma, chronic obstructive pulmonary disease, Crohn's disease, arthritis, multiple sclerosis, and a range of neurodegenerative conditions. However, limited information is available regarding the therapeutic potential of cannabinoids in treating periodontal disease. OBJECTIVE: The objective of this study is to analyze the current evidence on the antibacterial and immunomodulatory effects of cannabis and its role in the healing and regeneration processes within periodontal tissues. RESULTS: This review discusses the potential role of cannabinoids in restoring periodontal tissue homeostasis. CONCLUSIONS: The examination of the endocannabinoid system and the physiological effects of cannabinoids in the periodontium suggests that they possess immunomodulatory and antibacterial properties, which could potentially promote proper tissue healing and regeneration.

Treatment of Miller I Mandibular Gingival Recessions Using PRF vs. Connective Graft.

Gingival recession (GR) can cause aesthetic and functional problems. Using connective tissue graft (CTG) and coronally advanced flap (CAF) is considered the technique of choice for treating GR. Considering the morbidity resulting from taking CTG, different alternative biomaterials have been described, including plasma-rich fibrin (PRF) membrane. Studies in lower teeth are few because of the complexity of the factors that can influence obtaining less predictable outcomes. Objective. To compare between CAF + PRF and CAF + CTG in the treatment of lower teeth Miller I gingival recession. Methodology. Split-mouth included 26 isolated GR (13 in each side of the mouth). The left side was treated with CAF + PRF and the right side with CAF + CTG. Clinical variables, probing depth (PD), GR, keratinized tissue (KT), vestibular soft tissue thickness (VSTT), and teeth sensitivity (TS), were assessed at the baseline. GR, KT, VSTT, extraoral inflammation (EI), and patient discomfort (PaD) were assessed at 45 days. Results. Statistically greater VSTT at 45 days was obtained using CAF + CTG (p < 0.05). Less EI and PaD were obtained using CAF + PRF (p < 0.05). No change was observed in GR, KT, and TS values in the intergroup or intragroup comparisons. Conclusion. Even with the limitations of this study, using PRF and CTG in lower teeth demonstrated an improvement in terms of root coverage, although it was without a total percentage of coverage. Regarding the VSTT, better results were obtained using the CTG + CAF, suggesting eventually long-term stable clinical results. We suggest a combined technique for future investigations.

Oral Dysbiosis and Autoimmunity: From Local Periodontal Responses to an Imbalanced Systemic Immunity. A Review.

The current paradigm of onset and progression of periodontitis includes oral dysbiosis directed by inflammophilic bacteria, leading to altered resolution of inflammation and lack of regulation of the inflammatory responses. In the construction of explanatory models of the etiopathogenesis of periodontal disease, autoimmune mechanisms were among the first to be explored and historically, for more than five decades, they have been described in an isolated manner as part of the tissue damage process observed in periodontitis, however direct participation of these mechanisms in the tissue damage is still controversial. Autoimmunity is affected by genetic and environmental factors, leading to an imbalance between the effector and regulatory responses, mostly associated with failed resolution mechanisms. However, dysbiosis/infection and chronic inflammation could trigger autoimmunity by several mechanisms including bystander activation, dysregulation of toll-like receptors, amplification of autoimmunity by cytokines, epitope spreading, autoantigens complementarity, autoantigens overproduction, microbial translocation, molecular mimicry, superantigens, and activation or inhibition of receptors related to autoimmunity by microorganisms. Even though autoreactivity in periodontitis is biologically plausible, the associated mechanisms could be related to non-pathologic responses which could even explain non-recognized physiological functions. In this review we shall discuss from a descriptive point of view, the autoimmune mechanisms related to periodontitis physio-pathogenesis and the participation of oral dysbiosis on local periodontal autoimmune responses as well as on different systemic inflammatory diseases.

Relationship Between Dental Cement Materials of Implant-Supported Crowns with Peri-Implantitis Development in Humans: A Systematic Review of Literature.

This paper aims to associate dental cement materials excess in peri-implant tissues with peri-implantitis development. Systematic bibliographic research into different databases, such as PubMed, Proquest, Science Direct, and Cochrane, has been made using specific searching terms such as "peri-implantitis AND cement", "mucositis AND cement", and "dental implant failure AND cement", from January 2007 to December 2017. The articles were preselected, taking into account the criteria of inclusion and exclusion. A checklist was used for the evaluation of the items, and the index of agreement was decided (Kappa) of 0.93%. Initially, 602 articles were found by title and abstract. Of these, 188 were eligible and 153 were excluded by the eligibility criteria, obtaining 35 potential studies. They were reviewed by a third reviewer who discarded duplicate articles and those not pertinent to the review. Twelve final articles were submitted to a checklist prepared previously, with parameters of the quality scales: MOOSE, STROBE, and PRISMA. Finally, four articles were selected and fully revised. Regardless of the cementitious materials, the cement excess in the peri-implant tissue in human beings is a clear risk factor for the development of peri-implant pathogenesis. According to the properties of each material, it becomes necessary to have a strict cementation protocol to avoid its invasion to the peri-implant tissue. The prevention starts from the surgical implant placement, since platforms should be avoided in extreme apical locations that allow the runoff of the cementing material.

Diseño e implementación de una propuesta didáctica por medio de la utilización de herramientas virtuales para el aprendizaje de inmunología en enfermedad periodontal / Design and implementation of a didactic model through the use of virtual tools for the learning of immunology in periodontal disease

Introducción: el contexto actual presenta diversas posibilidades para la innovación en el campo educativo, siendo una de estas la utilización de las Tecnologías de la Información y Comunicación (TIC). En odontología los esfuerzos para la introducción de las TIC en los procesos de enseñanza-aprendizaje han sido progresivos y algo difíciles, debido a las características propias de la disciplina, la cual exige prácticas pre-clínicas y con pacientes. Sin embargo, la infinidad de herramientas que ofrecen las TIC han hecho que sean más atractivas, versátiles y útiles para el fortalecimiento de procesos educativos en áreas complejas. En el área de periodoncia se presenta una dificultad para el aprendizaje de Inmunología en Enfermedad Periodontal por la cantidad de horas dedicadas y su complejidad. Objetivo: diseñar e implementar una propuesta didáctica a través de herramientas virtuales para fortalecer el proceso de aprendizaje respecto a la inmunología en enfermedad periodontal. Materiales y métodos: investigación cualitativa de tipo investigación-acción. Se elaboró una plataforma en Moodle con cinco módulos, cada uno con objetivos de carácter cognitivo, procedimental y actitudinal; así como el planteamiento de actividades que fortalecieran el aprendizaje del estudiante y un proceso evaluativo, en el cual tanto el tutor como el estudiante forman parte activa dando lugar a una evaluación procesual. Discusión y conclusión: aunque la elaboración de este tipo de propuestas se redefine constantemente en la práctica, son una estrategia útil en odontología, la cual arrojaría resultados satisfactorios para el fortalecimiento de procesos de aprendizaje en aquellos temas que presentan mayor dificultad.

Background: the current context presents several possibilities for innovation in the educational field, one of which is the use of Information and Communication Technologies (ICT). In dentistry, the efforts for the introduction of ICT in teaching-learning processes have been progressive and somewhat difficult, due to the characteristics of the discipline that requires pre-clinical practices and with patients. However, the myriad of tools offered by ICT have made them more attractive, versatile and useful for strengthening educational processes in complex areas. In the area of periodontics there is a difficulty for the learning of Immunology in Periodontal Disease due to the number of hours dedicated and its complexity. Objective: to design and implement a didactic proposal through virtual tools to strengthen the learning process regarding immunology in periodontal disease. Materials and methods: pedagogical research of qualitative type framed within Action Research. A platform was developed in Moodle with five modules, each one with cognitive, procedural and attitudinal objectives; as well as the approach of activities that strengthened the student's learning and an evaluation process in which both the tutor and the student are an active part, giving rise to a procedural evaluation. Discussion and conclusion: although the development of this type of proposal is constantly redefined in practice, as an initial exercise it is useful to show a useful strategy in dentistry that would eventually yield satisfactory results for the strengthening of learning processes in those subjects that present greater difficulty.