Host modulatory therapy does not shut off the normal defence mechanism of inflammation instead, they ameliorate excessive or pathologically elevated inflammatory process to enhance the opportunities for wound healing and periodontal stability.
Pharmacological agents are used to stop the progression of periodontitis by intervention of the pathogenic mechanism.
It is used as an adjunct with conventional periodontal disease treatment.
It offers the opportunity for modulating or reducing destruction by treating chronic inflammatory response.
The concept was introduced by William and Golub in 1990.
Initially adjunctive therapies were solely anti-microbial such as use of antibiotics and antiseptics.
New approaches include modulation of host response.
Host modulatory therapy is considered as a BENCH-MARK in the treatment of patients with periodontal diseases.
Also, Useful in the following patients :
Diabetes & immunocompromised situations
peri-implant dis-ease (local and systemic efficiency of host modulatory therapy are used as an adjunct to conventional local disinfection treatment)
Although the efficacy and usefulness of host modulating agents have improved the treatment in several folds still, more research is required to make treatment response faster and to increase periodontal stability.
Chemotherapy and prosthodontics implicationBHU VARANASI
The objective of this presentation to improve removable prosthodontic therapy during chemotherapy to improve the patient's quality of life, enhance nutrition by reducing oral irritation and ulceration, and control the oral microbial populations associated with chemotherapy and the wearing of a denture.
During chemotherapy what all thing, let a dentist know well
it helps to provide information regarding the what all to use or not use .
Host Modulation Therapy (HMT) is a treatment concept that reduces tissue destruction and stabilizes or even regenerates inflammatory tissue by modifying host response factors. It has been used for treating osteoporosis and arthritis for several decades; and its application in treating periodontal disease.
Hello friends. In this PPT I am talking about anti-cancer drugs. If you like it, please do let me know in the comments section. A single word of appreciation from you will encourage me to make more of such videos. Thanks. Enjoy and welcome to the beautiful world of pharmacology where pharmacology comes to life. This video is intended for MBBS, BDS, paramedical and any person who wishes to have a basic understanding of the subject in the simplest way.
The rationale for using antibiotics and chemotherapeutics in the periodontal disease treatment is its polymicrobial nature of disease. Antibiotic use should be done cautiously in treating various periodontal infection as improper use of it can lead to its resistance by bacterial strains. Antibiotic in periodontics is a very helpful adjunct in controlling the bacteria in the oral cavity
Chronic periodontitis, formerly known as “adult periodontitis” or “chronic adult periodontitis” is the most prevalent form of periodontitis.
Chronic periodontitis has been defined as “an infectious disease resulting in inflammation within the supporting tissues of the teeth, progressive attachment loss, and bone loss”.
This definition outlines the major clinical and etiological characteristics of the disease:
Microbial plaque formation.
Periodontal inflammation.
Loss of attachment and alveolar bone.
Flap surgery, also called pocket reduction surgery. Your periodontist makes cuts in your gums to carefully fold back the tissue. This exposes the tooth roots for more effective scaling and root planning. Because periodontitis often causes bone loss, the underlying bone may be reshaped before the gum tissue is stitched back in place. After you heal, it's easier to clean the areas around your teeth and maintain healthy gum tissue.
Soft tissue grafts. When you lose gum tissue, your gumline gets lower, exposing some of your tooth roots. You may need to have some of the damaged tissue reinforced. This is usually done by removing a small amount of tissue from the roof of your mouth or using tissue from another donor source and attaching it to the affected site. This can help reduce further gum loss, cover exposed roots and give your teeth a better appearance.
Bone grafting. This procedure is performed when periodontitis destroys the bone around your tooth root. The graft may be made from small bits of your own bone, or the bone may be made of artificial material or donated. The bone graft helps prevent tooth loss by holding your tooth in place. It also serves as a platform for the regrowth of natural bone.
Guided tissue regeneration. This allows the regrowth of bone that was destroyed by bacteria. In one approach, your dentist places a special type of fabric between existing bone and your tooth. The material prevents unwanted tissue from growing into the healing area, allowing bone to grow back instead.
Tissue-stimulating proteins. Another approach involves applying a special gel to a diseased tooth root. This gel contains the same proteins found in developing tooth enamel and stimulates the growth of healthy bone and tissue.
Chemotherapy and prosthodontics implicationBHU VARANASI
The objective of this presentation to improve removable prosthodontic therapy during chemotherapy to improve the patient's quality of life, enhance nutrition by reducing oral irritation and ulceration, and control the oral microbial populations associated with chemotherapy and the wearing of a denture.
During chemotherapy what all thing, let a dentist know well
it helps to provide information regarding the what all to use or not use .
Host Modulation Therapy (HMT) is a treatment concept that reduces tissue destruction and stabilizes or even regenerates inflammatory tissue by modifying host response factors. It has been used for treating osteoporosis and arthritis for several decades; and its application in treating periodontal disease.
Hello friends. In this PPT I am talking about anti-cancer drugs. If you like it, please do let me know in the comments section. A single word of appreciation from you will encourage me to make more of such videos. Thanks. Enjoy and welcome to the beautiful world of pharmacology where pharmacology comes to life. This video is intended for MBBS, BDS, paramedical and any person who wishes to have a basic understanding of the subject in the simplest way.
The rationale for using antibiotics and chemotherapeutics in the periodontal disease treatment is its polymicrobial nature of disease. Antibiotic use should be done cautiously in treating various periodontal infection as improper use of it can lead to its resistance by bacterial strains. Antibiotic in periodontics is a very helpful adjunct in controlling the bacteria in the oral cavity
Chronic periodontitis, formerly known as “adult periodontitis” or “chronic adult periodontitis” is the most prevalent form of periodontitis.
Chronic periodontitis has been defined as “an infectious disease resulting in inflammation within the supporting tissues of the teeth, progressive attachment loss, and bone loss”.
This definition outlines the major clinical and etiological characteristics of the disease:
Microbial plaque formation.
Periodontal inflammation.
Loss of attachment and alveolar bone.
Flap surgery, also called pocket reduction surgery. Your periodontist makes cuts in your gums to carefully fold back the tissue. This exposes the tooth roots for more effective scaling and root planning. Because periodontitis often causes bone loss, the underlying bone may be reshaped before the gum tissue is stitched back in place. After you heal, it's easier to clean the areas around your teeth and maintain healthy gum tissue.
Soft tissue grafts. When you lose gum tissue, your gumline gets lower, exposing some of your tooth roots. You may need to have some of the damaged tissue reinforced. This is usually done by removing a small amount of tissue from the roof of your mouth or using tissue from another donor source and attaching it to the affected site. This can help reduce further gum loss, cover exposed roots and give your teeth a better appearance.
Bone grafting. This procedure is performed when periodontitis destroys the bone around your tooth root. The graft may be made from small bits of your own bone, or the bone may be made of artificial material or donated. The bone graft helps prevent tooth loss by holding your tooth in place. It also serves as a platform for the regrowth of natural bone.
Guided tissue regeneration. This allows the regrowth of bone that was destroyed by bacteria. In one approach, your dentist places a special type of fabric between existing bone and your tooth. The material prevents unwanted tissue from growing into the healing area, allowing bone to grow back instead.
Tissue-stimulating proteins. Another approach involves applying a special gel to a diseased tooth root. This gel contains the same proteins found in developing tooth enamel and stimulates the growth of healthy bone and tissue.
In the 18th century CAROLUS LINNAEUS called Carl von Linné, revolutionized the field of natural history by introducing a formalized system of naming organisms, what we call a taxonomic nomenclature.
He divided the natural world into 3 kingdoms and used five ranks : Class, Order, Genus, Species & Variety.
FROM 1977 TO 1989, THE AMERICAN ACADEMY OF PERIODONTOLOGY (AAP) WENT FROM 2 MAIN PERIODONTAL DISEASE CATEGORIES TO 5.
The 1989 Classification Had It’s Short-comings Including :
Lack of a category for strictly gingival diseases
Overlap between disease categories
Difficulty in fitting certain patients into any of the existing categories.
Similarity of microbiological and host response features.
A New Periodontal Disease Classification System Was Recommended By The 1999 International Workshop For A Classification Of Periodontal Disease And Conditions.
Periodontal abscesses, combined periodontic-endodontic problems, mucogingival deformities and occlusal trauma all remain unchanged except that they have been ordered in the classification system.
NUG and NUP were combined under the category of necrotizing periodontal diseases with no changes to their definitions.
One of the most significant changes included the addition of a detailed section on gingival diseases and lesions. Another important change was the discontinuation of terms related to age of presentation and rate of progression of the diseases.
The criteria for chronic periodontitis remain similar to those used for adult periodontitis but the age-dependent terminology has been removed.
All syndromes and systemic diseases which predispose a patient to periodontal disease would be classified under the category of “PERIODONTITIS AS A MANIFESTATION OF SYSTEMIC DISEASE”
Refractory periodontitis (low plaque scores and low responsiveness to periodontal therapy) is no longer considered a specific disease.
The 1999 classification system has been approved by the AAP, is now official terminology for that organization, and will be used in accredited graduate periodontal programs and board examinations.
The Parameters of Care approved by the AAP have adopted the new classification and future publications will use it as their standard. Since many of the 1999 workshop participants were from Europe and Asia as well as North America, it is anticipated that the proposed classification will be adopted in most parts of the world.
All of my Lectures are based on information purposes.
It is based on the viva explanation and understanding basis.
Basically for 4th BDS Professional Year.
All of my Lectures are based on information purposes.
It is based on the viva explanation and understanding basis.
Basically for 4th BDS Professional Year.
All of my Lectures are based on information purposes.
It is based on the viva explanation and understanding basis.
Basically for 4th BDS Professional Year.
A MAGNIFICENT ORTHODONTIC TREATMENT CAN BE DESTROYED BY POOR PERIODONTAL SUPPORT. EVALUATION AND MAINTENANCE OF PERIODONTAL HEALTH BEFORE, DURING AND AFTER TREATMENT IS VERY IMPORTANT.
Dr. Abhishek Gaur
BDS, MDS
Some of the slides may appear Blank/White/Black, those are the Videos that I added in the presentation.
Kindly Ignore those slides.
Dental Calculus: Short Presentation
Dr. Abhishek Gaur
BDS, MDS
Some of the slides may appear Blank/White/Black, those are the Videos that I added in the presentation.
Kindly Ignore those slides.
Dr. Abhishek Gaur
BDS, MDS
Some of the slides may appear Blank/White/Black, those are the Videos that I added in the presentation.
Kindly Ignore those slides.
Reconstructive periodontal therapy
Some of the slides may appear Blank/White/Black, those are the Videos that I added in the presentation.
Kindly Ignore those slides.
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
QA Paediatric dentistry department, Hospital Melaka 2020Azreen Aj
QA study - To improve the 6th monthly recall rate post-comprehensive dental treatment under general anaesthesia in paediatric dentistry department, Hospital Melaka
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
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Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
3. Host
Modulation
Therapy Dr. Abhishek Gaur
BDS, MDS, F.A.G.E., MBA, (Ph.D.)
(Department of Periodontology & Oral Implantology)
Teerthanker Mahaveer Dental College & Research Center
Teerthanker Mahaveer University
4. INTRODUCTION
• Dental Plaque is capable of causing direct damage to the periodontal tissue.
• It releases hydrogen sulphide, butyric acid, enzymes and mediators which
causes inflammatory changes in the tissue that initiates destructive processes
and hence, affecting the dentition in oral cavity.
• The host response is essentially protective by intention but can contradictorily
result in tissue damage that includes the breakdown of connective tissue fibers
in the periodontal ligament and resorption of the alveolar bone.
5. • Host modulatory therapy does not shut off the normal defence mechanism of inflammation
instead, they ameliorate excessive or pathologically elevated inflammatory process to enhance
the opportunities for wound healing and periodontal stability.
• Pharmacological agents are used to stop the progression of periodontitis by intervention of the
pathogenic mechanism.
• It is used as an adjunct with conventional periodontal disease treatment.
• It offers the opportunity for modulating or reducing destruction by treating chronic
inflammatory response.
• The concept was introduced by William and Golub in 1990.
• Initially adjunctive therapies were solely anti-microbial such as use of antibiotics and
antiseptics.
• New approaches include modulation of host response.
9. 1. Inhibition of Matrix metalloproteinases (MMPs) -Through chemically Modified Tetracyclines (CMTs)
2. Inhibition of Arachidonic Acid metabolites-through NASIDs
a. COX-1 inhibitors: Indomethacin’s, Flurbiprofen
b. COX-2 inhibitors: Rofecoxib
c. COX and LOX inhibitors: Triclosan, Tropical Ketoprofen
d. LOX inhibitors: Lipoxins
3. Modulation of Bone metabolism
a. Bisphosphonates
b. Hormone Replacement Therapy
4. Regulation of immune and inflammatory responses
a. Suppressing proinflammatory cytokines (IL-1 and TNF- α receptor antagonists)
b. Nitric Oxide inhibition
c. Generation of protective antibodies through vaccine
d. Infusion/ supplementary anti-inflammatory cytokines IL-4 and IL-10.
5. Miscellaneous Host Modulatory agents
a. Aloe vera
b. Probiotics
c. Hypochlorous acid and taurine-N-monochloramine
d. Azithromycin’s.
10. These therapeutic agents are particularly useful in susceptible, high-
risk patients such as smokers, diabetics, genetic predisposition.
FDA has recommended the approved use of ‘Perio-stat’ for systemic
administration as an adjunct to scaling to root planning, in the
treatment of chronic periodontitis.
11. CHEMICALLY MODIFIED TETRACYCLINES (CMTS)
Tetracyclines have been used as an antibiotic from a very long time. Periodontal pathogens (P. gingivalis and A. actino-mycetem-
comitans) produce MMPs.
However, it is believed that endogenous MMPs are not the bacterial proteinases that are primarily responsible for tissue destruction.
This further state the importance of the role of host modulatory approaches in periodontal therapy. Chemically modified
tetracyclines are tetracyclines that lack di-methyl-amino group on the 4th carbon atom.
Mechanism of Action of Chemically modified tetracyclines
1. Inhibits or chelated the calcium atoms that Matrix metalloproteins require for their action.
2. Inhibits already active MMPs.
3. Decreases MMPs expression.
4. Scavengers reactive oxygen species.
5. Modulates the osteoclast functions
Side effects of CMTs
1. Photosensation property
2. Neurotoxicity
3. Cytotoxic effects at higher concentration
4. Rapid emergence of resistant microorganisms
13. Periostat (Sub-Anti-Microbial dose of Doxycycline)
It is a sub-anti-microbial dose of doxycycline hyclate capsule of 20 mg that uses
anti-collagenase properties of tetracy-cline. It is prescribed to patients with
chronic periodontitis twice daily. Administration of drug for only 2 weeks. This
can inhibit collagen activity by 60%-80% in the gingival tissue of chronic
periodontitis patients. However, collagen activity also decreases in GCF.
Prescription of the drug for a smaller duration decreases the chance for drug
resistant. It is an effective tool adjunct to mechanical therapy in treating
periodontal diseases.
Mechanism of Action :
It acts as a host modulator by directly inhibiting MMPs (secreted by plaque biofilm)
which indirectly reduces osteoclast activity and bone resorption. It stimulates
osteoblast activity and hence promotes bone absorption. It also stimulates
fibroblast collagen production.
14. Indications :
• Patients who have not responded to non-surgical therapy.
• Patients with generalized recurrent sites of 5mm or greater pocket
depth that it bleeds on probing.
• Patients with mild to moderate chronic periodontitis but have a high
susceptibility to rapid periodontal disease progression.
• Patient who has aggressive periodontitis
• Patient with periodontitis associated with genotype (PAG), has
specific variation in genes that regulates IL- 1.
15. Contra-indications :
1. The patient who are allergy to tetracycline.
2. Pregnant women, Lactating women, and children below 12 years of age.
3. Patient in whom antibiotic regimen is necessary.
4. May reduce the effectiveness of oral contraceptives.
Side effects :
1. Photosensitivity
2. Hypersensitivity reactions
3. Nausea and vomiting
4. Esophageal irritation
The administration of doxycycline in human osteoarthritis produces benefits in
association with the suppression of matrix metalloproteinases.
16. NSAIDS ( Non-Steroidal Anti-inflammatory Drugs)
Inhibition of Arachidonic Acid metabolites
• In periodontal diseases destructive pathways are initiated as arachidonic acid is activated
which gets metabolized by cyclo-oxygenase, and releases prosta-glandins, prosta-cyclin’s
and thrombo-xane whereas the end product of the Lipoxy-genase pathway releases
Leukotrienes and hydroxy eico-sate-traenoic acid.
• So, an approach to modulate the host response is inhibition of enzymes responsible for the
release of these destructive products can be adopted.
These include:
1. Systemically administered NSAIDS
2. Locally administered NSAIDS
3. Triclosan
17. S.
NO.
SYSTEMICALLY ADMINISTERED
NSAIDS
LOCALLY ADMINISTERED NSAIDS
1. Act by inhibiting cyclooxygenase in an
arachidonic acid pathway.
These drugs are lipophilic and are absorbed into
gingival tissues.
2. Reduce Prostaglandins (PGE2) which are
responsible for bone loss.
Inhibits both cyclooxygenase and lipoxygenase
pathway.
3. EXAMPLE : Ibuprofen, Indomethacin.
Topical use of lipoxins which blocks neutrophil
infiltration induced by P. gingivalis and reduced
in PGE levels can be used as an adjunct in
scaling and root planing.
4. EXAMPLE : Ketoprofen, Ketorolac
trimethamine & S-Ketoprofen dentifrices.
18. TRICLOSAN
• It has both anti-bacterial and anti-inflammatory properties.
• It is a non-ionic antibacterial agent that also inhibit both cyclooxygenase and
lipoxygenase pathway and thus interfere in arachidonic acid pathway.
• Dentifrice containing sodium fluoride and triclosan and a copolymer has been
tested and shows positive results in the treatment of Periodontitis.
Side effects :
1. Haemorrhage
2. Gastric ulceration
3. Renal failure
4. Rebound effect
5. Liver Failure
19. BISPHOSPHONATES
a) Bisphosphonates are drugs that are non-biodegradable analogues of
pyrophosphate with a high affinity for calcium phosphate crystals and that inhibit
osteoclast activity.
b) These bisphosphonates appear to inhibit MMP activity through a mechanism that
involves the chelation of cations.
Alkyl side chains characterize as :
1. First generation bisphosphates : E.g. : Etidronic acid and Clodronic acid
2. Second generation Bisphosphates : Includes an amino-terminal group along with
an amino-biphosphonates. E.g. : Alendronate and Pamidronate.
3. Third generation Bisphosphonates : Have cyclic side chains For example:
risedronate.
20. Mechanism of Action :
1. Inhibition of the development of osteoclasts
2. Induction of osteoclastic apoptosis
3. Reduction of the activity of osteoclast
4. Prevention of the development of osteoclasts from
hematopoietic
5. Initiates the production of an osteoclast inhibitory
factor.
6. Stimulate production of osteoclast inhibitory factor.
7. Decreasing bone reportion by inhibiting MMPs.
21. Disadvantages :
a) Long term use can compromise healing of even micro-
injuries within bone.
b) Can leads to osteonecrosis of jaw following dental
extraction.
c) Inhibit bone calcification.
Contraindications :
The contraindication for use of bisphosphonates
use is the sensitivity to phosphates and gastrointestinal
upset.
22. Osteoprotegerin (OPG)
The discovery of a novel receptor called osteoprotegerin revealed a key
regulatory mechanism in osteoclast differentia-tion and activity.
OPG and receptor activator of NF- kappa B (RANKL)(receptor activator of
nuclear factor kappa beta) ligand are two molecules that regulate osteoclast
formation and bone resorption.
RANKL have the effects on osteoclast as they induce osteoclast differentiation
followed by activation, whereas OPG blocks this process by acting as a decoy
receptor for RANKL.
23. • These are the drugs that lower the lipid level in the body and are hence used to treat
hyperlipidaemia.
• These drugs have pleiotropic effects such as antithrombotic, antioxidant, anti-inflammatory,
vasodilative.
• They inhibit the activity of enzyme 3-hydroxy-3- methyl glutaryl coenzyme.
MECHANISM OF ACTION :
• They act by inhibiting the release of proinflammatory mediators such as cytokines and MMP
and this inhibit osteoclast activity.
25. MODULATION OF NITRIC OXIDE ACTIVITY :
• Nitric oxide (NO) is a molecule that has a wide range of biological
processes.
• It is a highly reactive free radical reacting with metal and thiol
residues that results to lipid peroxidation, protein damage, DNA
damage and stimulation of cytokine release.
• Nuclear Poly ADP-ribose polymerase enzyme decreases NO
toxicity.
26. SUPPRESSING PROINFLAMMATORY CYTOKINES
Cytokines are defined as “regulatory proteins controlling the survival,
growth, differentiation, and function of cells.”
They function as a network and are produced by different cell types and
share overlapping features.
This phenomenon is called “Bio-logical re-dun-dancy”.
To avoid tissue damage and maintain homeostasis, cytokines antagonists
such as IL-1receptor antagonist or soluble TNF receptors can competitively
inhibit receptor mediated signal transduction.
27. OTHER LOCALLY ADMINISTERED AGENTS :
• These include agents such as enamel matrix proteins, growth factors, and bone morphogenic proteins have
been investigated for potential use as adjuncts to surgical procedures.
• It improves wound healing as well as stimulate regeneration of lost bone, periodontal ligament, and
cementum and thus, restoring the complete periodontal attachment apparatus.
• The only local host modulatory agent currently approved by the FDA for adjunctive use during surgery is
Emdogain.
• It affects early stages of osteoblast maturation.
• They are believed to regulate the initiation, propagation, termination, and maturation of enamel
hydroxyapatite crystals.
• They also take part in cementogenesis.
28. 1. Aloe-vera
2. Probiotics
3. Hypochlorous acid and taurine-N-monochloramine
4. Azithromycin’s
5. Cimetidine
MISCELLANEOUS
HOST MODULATORY
AGENTS A
29.
30. Host modulatory therapy is considered as a BENCH-MARK in the
treatment of patients with periodontal diseases.
Also, Useful in the following patients :
1.Diabetes & immunocompromised situations
2.peri-implant dis-ease (local and systemic efficiency of host modulatory therapy are used as an adjunct to
conventional local disinfection treatment)
Although the efficacy and usefulness of host modulating agents have
improved the treatment in several folds still, more research is required
to make treatment response faster and to increase periodontal stability.