Advancement in therapeutic strategies for immune-mediated oral diseases.

BACKGROUND: Immune-mediated diseases are a diverse group of conditions characterized by alteration of cellular homeostasis and inflammation triggered by dysregulation of the normal immune response. Several immune-mediated diseases exhibit oral signs and symptoms. Traditionally, these conditions are treated with corticosteroids or immunosuppressive agents, including azathioprine, cyclophosphamide, and thalidomide. Recent research into the developmental pathways of these diseases has led to the exploration of novel approaches in treatment. This review examines newer treatment modalities for the management of immune-mediated diseases with oral presentations. Topical calcineurin inhibitors (TCIs) such as tacrolimus and pimecrolimus have been employed successfully in managing oral lichen planus and pemphigus vulgaris. Biologic agents, comprising monoclonal antibodies, fusion proteins, and recombinant cytokines, can provide targeted therapy with fewer adverse effects. Neutraceutical agents comprising aloe vera, curcumin, and honey are commonly used in traditional medicine and offer a holistic approach. They may have a place as adjuvants to current standard therapeutic protocols. Photodynamic therapy (PDT) and low-level laser therapy (LLLT) utilize a specific wavelength of light to achieve desired cellular change. While the use of PDT in immune-mediated diseases is contentious, LLLT has shown positive results. Newer therapeutic modalities involve kinase inhibitors, S1P1 receptor modulators, MSCs, and iRNA providing targeted treatment of specific diseases.

Photobiomodulation in acceleration of orthodontic tooth movement: A systematic review and meta analysis.

BACKGROUND: Photobiomodulation therapy, a non invasive method with no adverse effects, has been used to accelerate tooth movement in orthodontia. However, the specific characteristics of laser settings used in studies documented have reported varied inconsistent conflicting results. OBJECTIVES: We decided to undertake a systematic review to eliminate this inconsistency by quantifying the literature studies that indicated the link between photobiomodulation and acceleration of tooth movement and to assess if there is any association of photobiomodulation therapy in accelerating tooth movement. SEARCH STRATEGY: We systematically searched for articles of existing literatures on Photobiomodulation therapy and acceleration of tooth movement over Cochrane library, Pubmed central, EMBASE, Scopus and Web of sciences from 2000 to 2017. Mesh search terms using various descriptors were used to identify the studies. SEARCH CRITERIA: We included randomized control trial and clinical control trail studies that used Ga-Al-As diode laser and Oseeopulse laser with specific characteristics and company specifications, addressing relevant efficiency and safety outcomes. DATA COLLECTION AND ANALYSIS: Eligible studies were reviewed and data was extracted on a standard from. We used Cochrane review manager software (Revman version 5.3) to assess the qualities of each included trials. Data were analyzed using an inverse variance method with random effects model effect. RESULTS: We observed a statistical significant difference between the photobiomodulation therapy compared to non laser group in the acceleration of tooth movement (Mean difference 0.59 (95%CI- 0.24 to 0.95) I2 95%). However, these results need caution while generalizing in clinical practice due to the large amount of heterogeneity across the studies. CONCLUSION: Findings of the current systematic review suggest a possible benefit with photobiomodulation therapy and tooth movement in orthodontia. However these findings need to be further validated in larger trials using specific standardized characteristics of laser settings to uniform the methodological design that can be used in routine clinical practice.

Chemical Plaque Control Strategies in the Prevention of Biofilm-associated Oral Diseases.

Dental plaque is a biofilm that forms naturally on the surfaces of exposed teeth and other areas of the oral cavity. It is the primary etiological factor for the most frequently occurring oral diseases, such as dental caries and periodontal diseases. Specific, nonspecific, and ecologic plaque hypothesis explains the causation of dental and associated diseases. Adequate control of biofilm accumulation on teeth has been the cornerstone of prevention of periodontitis and dental caries. Mechanical plaque control is the mainstay for prevention of oral diseases, but it requires patient cooperation and motivation; therefore, chemical plaque control agents act as useful adjuvants for achieving the desired results. Hence, it is imperative for the clinicians to update their knowledge in chemical antiplaque agents and other developments for the effective management of plaque biofilm-associated diseases. This article explores the critical analysis of various chemical plaque control strategies and the current trends in the control and prevention of dental plaque biofilm.