Advances in novel therapeutic approaches for periodontal diseases

Abstract

Periodontal diseases are pathological processes resulting from infections and inflammation affecting the periodontium or the tissue surrounding and supporting the teeth. Pathogenic bacteria living in complex biofilms initiate and perpetuate this disease in susceptible hosts. In some cases, broad-spectrum antibiotic therapy has been a treatment of choice to control bacterial infection. However, increasing antibiotic resistance among periodontal pathogens has become a significant challenge when treating periodontal diseases. Thanks to the improved understanding of the pathogenesis of periodontal disease, which involves the host immune response, and the importance of the human microbiome, the primary goal of periodontal therapy has shifted, in recent years, to the restoration of homeostasis in oral microbiota and its harmonious balance with the host periodontal tissues. This shift in therapeutic goals and the drug resistance challenge call for alternative approaches to antibiotic therapy that indiscriminately eliminate harmful or beneficial bacteria. In this review, we summarize the recent advancement of alternative methods and new compounds that offer promising potential for the treatment and prevention of periodontal disease. Agents that target biofilm formation, bacterial quorum-sensing systems and other virulence factors have been reviewed. New and exciting microbiome approaches, such as oral microbiota replacement therapy and probiotic therapy for periodontal disease, are also discussed.

Role of Dietary Fibre in Managing Periodontal Diseases—A Systematic Review and Meta-Analysis of Human Intervention Studies

“…Furthermore, it is essential to consider the impact of antibiotics on periodontal health in this context, as it opens avenues to explore the potential role of dietary fibre as a prebiotic intervention. While antibiotics are a common approach to combat oral infections, including prophylactic use during intraoral procedures, their broad-spectrum application can significantly affect periodontal disease development [ 76 ]. However, the integration of dietary fibre into periodontal care presents an opportunity to address these concerns as it’s known for selectively nourishing beneficial gut bacteria, which may also exert positive effects on the oral microbiome [ 9 ].…”

Recent advances in metal nanoparticles to treat periodontitis

“…These bacteria are less vulnerable to antibiotics because of the particular periodontal environment and biofilm production. To treat periodontal disorders, new treatment approaches are required [ 31 , 32 ]. In addition to controlling supragingival plaque, manual, sonic, and/or ultrasonic instrumentation is another non-surgical periodontal therapy option.…”

Manipulating the diseased oral microbiome: the power of probiotics and prebiotics

“…Periodontitis-metabolic biomarkers in saliva, GCF or dental plaque have been investigated for years, but there is no consensus in specific metabolites identified as the disease signature across the studies [ 157 , 159 , 181–183 ]. Nonetheless, targets might include short chain fatty acids, as butyrate has been demonstrated to impact epithelial cell junctions, amongst other influences [ 184 ], protease inhibition to tackle the detrimental proteolytic activity [ 185 ] and oxidative stress pathways to counteract the damage caused [ 186 ].…”